Much of NLP, from the swish pattern to future pacing, is built on imagination. Outside NLP, guided imagery is a recognised technique in healthcare, and it’s one of the better-supported parts of this territory.
What guided imagery is
Guided imagery is a relaxation and mental-focus technique in which a guide, in person or on a recording, leads you through a vivid mental scene, usually peaceful or reassuring, using several senses. It’s related to hypnosis (see hypnosis series, part 1) but doesn’t need a formal induction, and to meditation, though the focus is on constructed images.
Examples include:
- A safe place scene: a beach, a forest, a favourite room.
- A healing or comfort image: warmth spreading through a painful area.
- Rehearsal: imagining a procedure going smoothly.
What the research says
- Surgery. A meta-analysis of 15 studies with 1,216 patients examined guided imagery used around surgery to reduce anxiety, stress and pain. A 2020 meta-analysis looked at preoperative guided imagery for preoperative anxiety and postoperative pain.
- A 2024 systematic review of nine studies reported that most found significant reductions in perioperative anxiety, and concluded guided imagery appears effective for this.
- Cardiac surgery. A review suggests that adding guided imagery to usual care may reduce anxiety and pain, and possibly length of stay.
- Overall, the evidence supports guided imagery as a low-cost, patient-centred option for reducing anxiety and pain around procedures.
(Summaries from search results; not checked against the original papers.)
Caveats: trials are often small, can’t blind participants, and vary in what the imagery involves and how much is delivered. Effects tend to be modest.
How it compares with NLP’s imagery
| Guided imagery in healthcare | NLP imagery techniques | |
|---|---|---|
| Purpose | Reduce anxiety and pain, prepare for procedures | Change habits, feelings or beliefs |
| Claims | Modest, specific | Often broad |
| Research | Reviews and meta-analyses | Limited |
| Setting | Hospitals, clinics, self-help | Courses and coaching |
The difference isn’t in the tool but in the aim and the evidence: guided imagery sets narrower goals and has been tested against them.
Why it may help
- Distraction. Absorbing attention leaves less for pain and worry.
- Relaxation. Calming imagery tends to slow breathing and lower tension.
- Control. It gives people something to do when they feel powerless.
- Expectation. Feeling prepared and cared for reduces fear.
A simple script
- Settle and breathe slowly for a minute.
- Picture a place where you feel safe and calm.
- Add detail: what you see, hear, smell and feel on your skin.
- Enjoy it for several minutes, returning to it if your mind wanders.
- Come back by counting up, feeling your body in the chair, and opening your eyes.
Recordings by health services or hospitals are a good place to start.
Cautions
- For some people, imagery can bring up distressing material, particularly with trauma. Stop if it does and seek support.
- Not a replacement for pain relief, anaesthesia or treatment.
- Some people can’t form mental pictures. Focus on sounds, sensations or ideas instead.
- Don’t use it while driving or in situations needing full attention.
The bottom line
Guided imagery is a good example of imagination used well: focused on a specific aim, tested in trials, and modest in its promises. If NLP’s imagery techniques interest you, this is a solid place to start.
Next in the series: Habit Change and Pattern Interrupts: What NLP Gets Right and Wrong
This article is for general information and is not medical advice.