Meditation and Visualization It's the Thought That Counts

Once viewed as the domain of cave-dwelling hermits, meditation has shaken off much of its mystery and has joined the ranks of respected relaxation techniques. Because of its effectiveness, meditation practice is included in many disease treatment and stress-reduction programs. Meditation has been used successfully to relieve the pain of headaches, backaches, and other musculoskeletal disorders (Kabat-Zinn, 1990; Sharma, Kumaraiah, Mishra, & Balodhi, 1990). Many people have used meditation to help control blood pressure and prevent the progression of atherosclerosis (Benson, 1984; Ornish, 1992; Sothers & Anchor, 1989). Meditation has helped people to cope with cancer therapies and chronic pain (Kaplan et al., 1993) and to lessen the severity of many other disorders (Deepak, Manchanda, & Maheshwari, 1994; Gaston et al., 1991; Kabat-Zinn et al., 1992). Meditation instruction is found in hospitals (Benson, 1984; Kabat-Zinn, 1990), prisons (Kabat-Zinn, 1994), athletics programs (Cox, 1991), workplaces (Alexander et al., 1993; Collings, 1989; Smith, 1993), and schools and colleges (Fergusson, Bonshek, & Boudigues, 1994; Greene & Hiebert, 1988; Laselle & Russell, 1993).

    Meditation is not complicated; that may explain why many Westerners warm up to the practice of meditation slowly. We are accustomed to complicated instructions, activity, stimulation, and busy-ness. To sit quietly and observe our thoughts goes against our nature. A first attempt at meditation can feel strange and uncomfortable, but many students have found that learning to meditate is worth the effort. College students especially are likely to have a hectic pace and little quiet time. Those with roommates or families may rarely have a chance to be alone with their thoughts. The practice of meditation can provide a much-needed antidote to jampacked days. Listening to the voices inside can help us sort out our values and priorities and can guide us as we make decisions and plan our lives.

    Meditation has as its goal a change in a person's mental state. There are many types of meditation, and all include some sort of directed focus. So, when you practiced the Body Scan exercise in the previous chapter and focused on the various physical sensations in your body, you were meditating. Some forms of meditation train you to focus on one thing at a time to achieve control over your thoughts. That one thing might be a word or phrase, a visual image, or your breathing. Other forms ask you simply to observe your thoughts and feelings and to be open to insights that happen. Since body and mind are connected, meditation can be used to achieve physiological changes as well as changes in mental state. Meditation practice can result in heightened awareness, euphoria, and/or deep relaxation (Alexander et al., 1993; Delmonte 1986, 1990; Ikemi et al., 1986; Kabat-Zinn, 1994; Soskis, Orne, Orne, & Dingis, 1989; Wallace & Benson, 1972).

MEDITATION MEETS SCIENCE

Meditation practices are as old as recorded history. They are found in almost every religion, where they are often used to quiet thoughts and to make the mind receptive to divine inspiration. Meditation practices are especially important in the Eastern religions, such as Hinduism and Buddhism, and in many Asian cultures (Seaward, 1997). They have also been used in Western traditions, often combined with forms of prayer. 

    The potential of meditation as a treatment to reduce stress and physiological arousal began to receive popular notice in North America in the 1960s when interest in Eastern spiritual practices surged. Stories of the mysterious physical and mental control achieved by practitioners of yoga piqued the curiosity of scientists and seekers alike. Researchers verified accounts of yogi masters who could decrease their heart rate to ten or fewer beats per minute, change the temperature of their bodies, alter their brain wave patterns, and dramatically lower their systolic blood pressure (Brown, 1974, 1984; Green & Green, 1977; Green, Green, & Walters, 1972; Rice, 1972; Wenger & Bagchi, 1961). Native American medicine men and Sufi mystics showed similar abilities (Green & Green, 1977). 

    Scientific verification of this control was exciting for two reasons. First, it required scientists to revise their theories of animal physiology. Researchers had previously believed that autonomic functions, such as regulation of heart rate, blood pressure, and body temperature, were outside voluntary control. Demonstration of the physical changes that could be induced by meditation meant that the textbooks had to be rewritten. Second, medical researchers began to wonder whether such control could be achieved by ordinary people and whether the power of meditation could be harnessed to produce therapeutic results, such as blood pressure control. 

    Meditation became popular among many groups in the 1960s with the advent of transcendental meditation (TM), a technique popularized by the Maharishi Mahesh Yogi. The Maharishi simplified mantra yoga practice to make it more palatable to a secular Western lifestyle. A mantra is a phrase from a prayer or other spiritual text that is repeated during meditation. It is used for its sound quality. Early interest in TM grew out of a desire to achieve an altered state of consciousness without drugs, but meditators also benefited from the relaxation they experienced when performing the meditation. People desiring to learn TM enroll in a short series of training sessions. At the last session, a guide aids the student in selecting a secret mantra or word. During meditation, TM practitioners continuously repeat their mantra (Rice, 1992).

    Because of its timing and popularity, TM attracted quite a bit of attention from both the lay and scientific communities. Practitioners of transcendental meditation have provided a convenient subject pool for researchers interested in the effects of meditation. One group of researchers included Harvard cardiologist Herbert Benson. Observing the physiological relaxation that occurred during transcendental meditation, Benson wondered whether the seemingly simple procedure of meditation would still be effective without the secret ceremonies and expensive price tag. Benson further simplified the TM meditation technique and taught it to his patients to learn whether meditation could help them control their hypertension. It could (Benson, 1984).

    Benson called his meditation technique the Relaxation Response, as it evoked the physiological relaxation of resting homeostasis. It contained the elements found in most meditation techniques: sitting in a comfortable position in a quiet environment combined with a mental focus. When Benson first began teaching his meditation technique, he advised people to pick any word or phrase to repeat silently with each exhalation. For people who couldn't think of a word, he suggested the word "one," which is relatively value-free and could fit into any belief system. Benson later discovered that patients who had chosen a prayer or other deeply meaningful phrase to meditate with had better results both in terms of adherence to their meditation practice and their clinical improvement (Benson, 1984). Benson concluded that drawing upon one's spiritual beliefs during meditation created a more potent meditation experience.

THE PSYCHOPHYSIOLOGY OF MEDITATION

Like all relaxation practice, meditation affects both body and mind. Meditation is therapeutic because the relaxation response can reduce pain and allow natural healing processes to work at their maximal level. By calming thoughts and reducing anxiety, meditation can short-circuit the escalating cycle of pain causing panic causing further pain and panic. By relieving stress, meditation may reduce cortisol levels. You may remember from Chapter 3 that cortisol works to increase energy availability for short-term emergencies. This is an adaptive response in the short run, but when levels remain elevated, cortisol causes long-term havoc by inhibiting immune function and tissue repair.

    Meditation affects brain function by changing normal thought patterns. The brain emits electrical charges, just as the heart and muscles do. These tiny currents can be amplified and displayed by a machine known as an electroencephalograph (EEG). Different brain waves indicate different states of consciousness. Alpha waves reflect a relaxed, meditative state and can be produced at will by people experienced in meditation (Rice, 1992). People who regularly practice some form of meditation report fewer stressors and illness symptoms; lower levels of anxiety, depression, and hostility; and higher levels of subjective well-being than people who rarely or never meditate (Alexander et al., 1993; Beauchamp-Turner & Levinson, 1992; Gelderloos, Hermans, Ahlscrom, & Jacoby, 1989; Pearl & Carlozzi, 1994; Shapiro, 1992; Zika, 1987). Many people find that meditation practice increases their stress resistance (Collings, 1989; Delmonte, 1990; Seaward, 1997).

MEDITATION BASICS

Although there are many varieties of meditation, most include the following elements.

Reduce the distraction potential of your meditation environment as much as possible. Choose a time when you will not be interrupted, turn off the telephone, and put a sign on the door. If you have a roommate or family, find a time when they will respect your need to practice and not need to disturb you. Many meditators find that first thing in the morning before the household (and the rest of the world) awakens is best.

    A truly silent environment is often impossible. Perhaps you hear voices out in the hall, traffic noise outdoors, dogs barking, or children playing. No problem. These noises are part of real life, and meditation must take place despite real life. Learning to meditate with some background noise is valuable practice.

2. A Comfortable Position

Although lying down is permitted for some of the relaxation exercises, meditators find the position too suggestive of sleep. A sitting posture produces a more alert mental state. Your sitting position should be as comfortable as possible-one you can maintain for at least ten minutes to begin with. You might think a slouch in your chair is best, but you'll find it uncomfortable after a while. Sitting with a straight back presents the best musculoskeletal balance, with no one muscle group taking all the antigravity stress. A straight back is also conducive to an alert mental state. During meditation, you may either close your eyes, or keep them focused on a point in front of you. Examples of sitting positions are shown in Figure 16. 1.

Pick one. If you wish, try the word one to begin with. Or choose a suggestive word or phrase like relax, peace, or let go. A short line or phrase from a favorite prayer works well. The word or phrase should help you feel safe, secure, and relaxed. For many meditators, relaxation is enough. But remember Benson's observation that faith and meaning conferred superior clinical advantages. Many meditators will use a word or phrase that helps them feel connected to a deeper reality than daily life, a word that will help them achieve transcendence. Transcendence is a grand word for a reachable experience. When you transcend your daily "normal" state of mind, you step outside the daily grind. You may sense a connection to a larger spiritual reality. But whether you believe in a god or spiritual power, you might at least feel as though you are part of the continuum of history, the family of humanity, and life on earth. And if the idea of transcendence is not relevant to your present experience, read on! The relaxation benefits are still yours to enjoy.

FIGURE 16.1 Sitting Positions for Meditation

4. Physical Relaxation and Calm Breathing

Meditation practice often begins with a minute or two of physical relaxation and breathing awareness. With a quick body scan and a few deep breaths, you can lower your physiological arousal and bring your awareness into the present moment. The mental focus is often coordinated with the breath. For example, try repeating your word or phrase with each exhalation.

A passive attitude prevents your judgmental mind from interfering with your meditation practice. The harder you try and the more harshly you criticize your wandering mind, the farther you stray from the relaxation response. The first minute or two might seem easy. Then your mind might begin to wander, until your thoughts sound something like this: "Relax ... relax ... relax ... I'm doing it! Relax ... relax ... what happens next? Is ten minutes up yet? Oh, 9 more to go ... relax ... relax ... I hope I do OK on that exam this afternoon. OOPS, I'm not doing it any more, RELAX ... Relax ... relax." When your mind starts to wander, simply bring your attention back to your focus, without judgment, scolding, or frustration.

Like everything, meditation gets easier with practice. Practice is essential for the realization of meditation's benefits. If you are new to meditation, start with one 10 minute session per day, gradually increasing the time to 15 or 20 minutes when you are ready. How will you know when the time is up? Setting an alarm ruins your relaxation. Keep a clock within reach of your peripheral vision and sneak a glance at it periodically.

We discussed mindfulness in Chapter 11 in the context of allowing yourself to experience pleasure, to bring your awareness to the present moment. Mindfulness meditation is the meditation version of mindfulness and grows out of Buddhist meditation practice. It is similar in practice to the Relaxation Response except that you do not repeat a word or phrase. Instead, you try to keep your awareness in the present moment, using your breath as a focus.

   Like other forms of meditation and relaxation, the goal of mindfulness meditation is to step outside your habitual thought patterns and automatic thoughts. Mindfulness meditation gives your linear, judgmental left brain a time out and allows your creative, intuitive brain some room to stretch its wings and to help you soar above the daily ruts that are so easy to get stuck in.

    Remember from Chapter 12 how we interpret and unquestioningly accept our perceptions as "reality." Our habitual thought patterns tend to keep us mainly in the past, ruminating over what we did or failed to do, or in the future, worrying about what is yet to come. Mindfulness meditation helps us let go of unnecessary attachment to prior judgment and automatic thoughts that limit our perception.

    One of the goals of mindfulness meditation is to break the spell of the automatic thoughts that keep you from experiencing the present moment, and thus to bring more present-moment awareness into your daily life. Such awareness can help you see more clearly and to accomplish more effectively the action plans you have set in previous chapters. With this awareness you become more in touch with your values and life goals, so you make better decisions and you make them more easily. You become a better problem solver because you see a broader picture and think creatively to come up with more effective solutions. You become a better listener and communicate more directly and clearly. You will have less trouble deciphering troubling emotions, such as anger and hostility, and you will achieve a greater understanding of their sources. You will find strength in yourself so you need not look to outside addictive agents, such as food, alcohol, or drugs, for relief. Mindfulness is about waking up from ignorance and responding more appropriately to potential sources of stress.

    An excellent description of meditation comes from Jon Kabat-Zinn's book on mindfulness meditation, Wherever You Go There You Are (1994):

Meditation does not involve trying to change your thinking by thinking some more. It involves watching thought itself ... By watching your thoughts without being drawn into them, you can learn something profoundly liberating about thinking itself , which may help you to be less of a prisoner of those thought patterns-often so strong in us-which are narrow, inaccurate, self-linvolved, habitual to the point of being imprisoning, and also just plain wrong. (p. 94)

To visualize is to make real in your mind's eye. When you combine your imagination with a meditationlike focus, you are using visualization techniques. Most of us have already had experience visualizing things we want to come true or things we are afraid of. We imagine opening that acceptance letter or job offer that comes in the mail. The phone rings and we imagine it is that special someone, or we imagine having a nice vacation on the beach. We are also experts at imagining disasters. Your friend is late for lunch with you. An accident? Heart attack? Standing you up because of something you said yesterday?

    When you use visualization for stress management or healing, you purposefully direct your imagination and sharpen the focus. Visualization is often used in stress management programs to counteract the fight-or-flight response and achieve deep relaxation. It is used medically to induce relaxation and stimulate the healing process (Achterberg, 1985; Achterberg & Lawlis, 1980; Brown 1974, 1984; Ornish, 1992; Simonton, Matthews-Simonton, & Creighton, 1978). Visualization is also used to reprogram destructive thoughts and behaviors and to replace self-defeating beliefs with more realistic and positive ones (Gawain, 1978).

One of the earliest forms of visualization to be used by Western medicine is hypnosis (Ulett & Peterson, 1965). While hypnosis has been around for a long time, it is probably the least understood of all stress management techniques, and scientists disagree on what actually occurs during hypnosis. Some believe that the person undergoing hypnosis enters an altered state of consciousness or hypnotic trance (Barber, Spanos, & Chaves, 1974). Studies suggest, however, that only about 16 percent of people who undergo hypnosis actually achieve a deep trance (Edmonston, 1981). Therefore, many researchers believe that subjects are willing to carry out suggestions given during hypnosis simply because they have positive expectations that make them willing to do what is requested by the hypnotist (Barber et al., 1974).

    Hypnotism helps people achieve a state of cortical inhibition. Like other visualization and meditation techniques, hypnosis may inhibit the processes associated with the dominant cortical hemisphere (linear thinking, logic, language) and allow more input from the nondominant hemisphere (ideas, pictures) (Cox, 1991).

    Hypnosis should be performed only by a trained professional, since hypnotized people are vulnerable to suggestions made during hypnosis. Hypnosis begins with a clarification of goals and procedures between the therapist and the client. The therapist then begins the induction process during which the client is guided into a deep relaxation and possibly a hypnotic trance. During the relaxation or trance, the therapist makes therapeutic suggestions. For instance, a student dealing with test anxiety might receive suggestions that "when waiting for the teacher to pass out the exams, you will feel calm and confident." At the end of the session, the therapist brings the client out of the trance and reinforces the suggestions.

    Hypnosis has been used effectively to treat a variety of stress-related complaints. It is often used in combination with other forms of psychotherapy (Sachs, 1986; Stanton, 1989). Its usefulness is limited in that it requires the involvement of a hypnotherapist. However, many hypnotherapists work with a client for only a few sessions, then turn the responsibility over to the client to continue with self-hypnosis procedures.

AUTOGENIC TRAINING: DO-IT-YOURSELF RELAXATION

Autogenic training is a very popular form of self-hypnosis, which grew out of research on hypnosis by physiologist Oskar Vogt at the end of the nineteenth century. Vogt noticed that many patients reported an improvement in medical symptoms such as fatigue, headaches, and muscle tension following hypnosis. He taught his experienced patients to put themselves in a trance to obtain these benefits (Davis, Eshelman, & McKay, 1995).

    Vogt's work piqued the interest of Johannes Schultz, a Berlin psychiatrist. He noted that Vogt's patients had reported physical feelings of warmth and heaviness in their arms and legs when coming out of their trances. Schultz found that by simply imagining heaviness and warmth in your arms and legs you can create a state of relaxation similar to a hypnotic trance. Schultz combined autosuggestion with some yoga techniques to create his system called autogenic training, which he published in a book by the same name in 1932 (Schultz & Luthe, 1959).

    Like other relaxation methods, autogenic training is designed to counter the fight-or-flight response and induce relaxation. Autogenic training has been found helpful for many stress- related disorders (Davis et al., 1995). Its simplicity makes it an ideal relaxation technique for beginners. Autogenics uses visualization of certain physical sensations as its focus. During relaxation, you repeat phrases silently to yourself or listen to them on a tape. Each phrase is repeated three to six times.

FINE TUNING: BIOFEEDBACK FOR RELAXATION AND HEALING

With autogenics, you are attempting to change the way your body feels. Autogenic training and other relaxation training methods can be combined with biofeedback training to help you monitor your response. Biofeedback instruments give you information about what is happening in your body and enable you to use this information to gain control of the variables being monitored. For example, people who suffer from tension headaches can use biofeedback to learn how to relax tense muscles in the head and neck. Electrodes are attached to the skin over one of the offending muscles, typically the frontalis muscle of the forehead. The electrodes detect muscle electrical activity: the more activity, the more contraction. The electrodes send this information to the biofeedback instrument, which converts it into a signal such as a beep or flashing light that can be received by the user. As you relax your forehead muscle, the beeps or lights slow down; if the muscle gets more tense, they speed up. Biofeedback instruments respond instantaneously to any change in muscle electrical activity, so users receive immediate feedback on how they are doing in their relaxation training.

    Can't you just become aware of muscle tension levels without a machine? You can, but biofeedback machines have more sensitivity than most people do, so they can speed the relaxation training process. Their ultimate goal, however, is to help you increase your own awareness. As you may have noticed when you tried progressive relaxation (Chapter 15), some muscle groups are harder to tune in to. Muscles that are chronically contracted are especially difficult to feel. Biofeedback can help you learn to sense contraction in and relax these important muscle groups.

    If a body response can be monitored, biofeedback training can be applied. Responses most commonly measured are those that are most accessible. Electromyography (EMG) senses the electrical activity of muscles, as described in the example above. Electroencephalography (EEG) gives information about brain wave activity. The electroencephalograph is the instrumentation that allowed scientists to describe the alpha wave production seen in meditation discussed above. Using EEG, people can learn to produce the types of brain waves associated with relaxed or creative mental states. The galvanic skin response (GSR), also known as electrodermal response (EDR), is what lie detector tests use. Changes in the electrical conductivity of the skin reflect minute changes in sweat gland activity and skin cell membrane permeability, which occur in response to stress.

    Biofeedback instruments can also sense changes in skin temperature, which reflect vasodilation (opening) of peripheral blood vessels. The more relaxed a person is, the greater will be the peripheral vasodilation. Blood pressure, heart rate and rhythm, and even stomach acid secretion can also be controlled with biofeedback training.

How DOES BIOFEEDBACK WORK?

  No one knows exactly how autonomic functions are brought under voluntary control. Learning to elicit the relaxation response results in the physiological changes associated with activation of the parasympathetic nervous system and hormone levels associated with resting homeostasis; this is probably at least part of the answer. If you ask people who have used biofeedback to induce relaxation how they make their headaches go away, they'll say they make their arms heavy, or they imagine they're on the beach, or they focus their eyes in a certain way.

    People learning to use biofeedback usually work with a therapist who adjusts the instruments and gives suggestions. When biofeedback is used to decrease sympathetic arousal, people usually practice a relaxation technique, such as meditation, autogenic training, or some other form of visualization. If you are trying to increase blood flow to your cold hands, you might focus on the autogenic phrase "My hands are warm." You might imagine putting your hands into a hot bath, making this image the focus of meditation. Once the therapist has set up the instrumentation, the success of the biofeedback program is in the hands of the person seeking treatment. The machines can't make you relax; they can only tell you about your progress. If the beeps slow down, you know whatever you're visualizing is helping; whatever you are doing (or not doing) is working. What works varies from person to person. With practice, you learn to associate certain images, thoughts, and sensations with relaxation. As with any relaxation technique, the practitioner must maintain an attitude of passive attention, a "trying not to try." Willing the arteries in the hand to open only leads to more tension and less opening. Instead, you must simply be aware, tune in, relax, and notice what seems to work. 

    An important part of biofeedback training is learning to transfer the skills learned during practice sessions to real-life situations. A person must be able to regulate blood pressure while driving in traffic, talking to friends, and performing a job, not just when meditating in a quiet room or hooked up to the biofeedback machine.

CLINICAL APPLICATIONS OF BIOFEEDBACK

Biofeedback treatment can be expensive and difficult to find, so most people seek it only when driven by some sort of health problem that appears to be stress related. It has been effective for treating ulcers, colitis, irritable bowel syndrome, hypertension, tension and migraine headaches, and muscle tension problems such as back pain and TMJ syndrome (Albright, Andreassi, & Brockwell, 1991; Greenspoon & Olson, 1986; Jones, 1989; King, 1992; Shellenberger, Turner, & Green, 1986; Thackwray-Emmerson, 1988, 1989). Biofeedback has also been helpful for a disorder called Raynaud's disease whose symptoms are cold extremities due to peripheral vasoconstriction (Green & Green, 1977). Depression, insomnia, and psychological anxiety disorders, such as phobias, often respond to biofeedback training (Hudesman, Beck, & Smith, 1982). Biofeedback has also been helpful in the treatment of addiction (Denney & Baugh, 1992).

CREATIVE VISUALIZATION

Have you ever talked yourself into doing something you once believed you couldn't do? Or did you ever convince yourself that you would fail at something that you could really have succeeded at? Your beliefs are enormously important in shaping your reality. Self-talk has been discussed in this regard. Daydreams and memories continually shape one's present reality as well. All are forms of visualization.

    So far we have presented visualization techniques that take more focus than imagination. In the rest of this chapter you will explore visualization techniques that call more deeply on the creative power of your imagination. You are already familiar with the idea that reality is at least partly what you perceive it to be. Creative visualization is based on the premise that your perception is not only a reflection of the reality that is "out there" but that your perception and imagination also help to create that reality. You are probably familiar with the phrase "a self- fulfilling prophecy." And perhaps you have heard people say, "Be careful what you wish, for it might come true." These may come from observations that predictions and wishes, even those that appear far-fetched, can subconsciously guide your actions and create opportunities for them to be realized.

    Visualization exercises may be classified into two categories:

     1. Programmed visualization. With programmed visualization, you focus on an image decided on beforehand. Programmed visualization is similar to self-hypnosis. You might focus on an image that makes you feel relaxed, or you might visualize a goal you hope to attain, a new behavior pattern, or an improvement in your health. Athletes might visualize competitive success, and heart patients might visualize arteries healing and adequate cardiac blood flow.

     2. Receptive visualization. Psychologist Carl Jung used receptive visualization with many of his patients. He asked them to meditate in a fashion similar to the mindfulness meditation described earlier in this chapter, with no goal or focus. He told his patients simply to observe the images that came into their awareness during the meditation session. These images were later explored in therapy (Davis et al., 1995). In receptive visualization exercises, you might also ask your deeper mind questions. You might ask, "Why am I not comfortable with this relationship?" or "Why can't I get going on this project?" Sometimes you get no answer, but sometimes the answers that come from your deeper wisdom are surprisingly helpful. Receptive visualization often begins with a programmed visualization that is somewhat open-ended. You might begin with a pleasant place visualization (described on page 351), then visualize some sort of inner guide entering the scene to whom you direct your questions and from whom you receive advice.

GUIDELINES FOR VISUAL1ZATION PRACTICE

     1. Begin visualization practice by lying down in a comfortable, quiet place. Let your eyes close.

     2. Practice a relaxation technique, such as the body scan or diaphragmatic breathing, to relax your body and mind.

     3. Focus on the visualization you have decided to practice, using all your senses to make the images as real as possible in your mind's eye. For example, if you are imagining walking through a beautiful garden, visualize the lovely surroundings. Hear the sound of the wind rustling the leaves and feel the wind against your skin. Imagine touching the soft flower petals and smelling the fragrances. Perhaps you can even taste the sweet nectar of the honeysuckle or chew on a blade of grass. The more real you can make your image, the more successful your visualization will be.

     4. Practice regularly.

EFFECTIVE IMAGES

It may take time and practice to create effective images for your visualization practice. For example, designing your "special place" (see exercise on the opposite page) might take several visits. One stress management student initially thought a garden would make a nice special place, but once she imagined relaxing there she found too many bees buzzing around, and thoughts of the hours of weeding that needed to be done in her garden at home kept intruding on her ability to relax. The next time she went to an imaginary cottage at the beach! Images are entirely personal and must feel right and work for you.

    Behavior change visualizations must be believable. You must be able to visualize them as though they are already a reality. If the images are too phony, your subconscious mind will reject them. One stress management student, who was on the verge of failing two of his courses, was trying to manage his time better and reduce his tendency to procrastinate. During his visualization practice in class, he tried to imagine himself looking at his straight-A report card, but having never received straight-A's in his life, he couldn't believe his image. Instead, he came up with an image of himself going to the library at a set time each afternoon to do his homework. This image was more constructive and reinforced the behavior he needed to strengthen.

VISUALIZATION FOR STRESS MANAGEMENT

You can use both programmed and receptive visualization for stress management. Visualizing a relaxing scene elicits the relaxation response. Reinforcing behavior change for stressful behaviors, such as procrastination, is also helpful. You can imagine yourself beginning research for the paper you have put off, or visualize yourself getting to that aerobics class you've been meaning to attend. Receptive visualization can help you explore questions that need answering: What do I want to be when I grow up? Where does this relationship want to go? What do I want to major in?

Observe the faces of athletes right before competition. What are they thinking about? They are visualizing probably the upcoming event and focusing on peak performance. Successful athletes train their minds as well as their bodies. They practice visualization exercises to keep distracting thoughts from interfering with their performance and to allow the parts of their brain responsible for peak performance to be uninhibited by anxiety or fear.

    Visualization exercises improve your ability to concentrate on one thing at a time and can thus enhance the quality of your work or performance in any area. Visualization practice turns down the volume of that constant "mind chatter" that can get in the way of problem solving, clear thinking, and performance. It's difficult to deliver a powerful tennis serve if you are thinking, "I'll never be able to do this." You probably can't deliver an oral presentation with confidence if you keep saying to yourself, "I'm not prepared for this. I hate talking in front of people."

    Sport psychologists have long known that the learning and execution of motor skills is inhibited by distracting mental monologues. Players learn to visualize the successful performance of a motor skill before playing and to put all their attention on the activity at hand, without the distraction of mental verbiage. This is what some sport psychologists have termed playing out of your mind. Such practice results in better progress and performance.

    Visualization can also help you make a commitment to positive behavior change, such as exercising regularly, choosing healthful foods, or quitting smoking. When you set behavior change goals and visualize yourself achieving these goals, your motivation and chances of success improve.

    One of the most important benefits of visualization is the formation of a more positive outlook and self-concept. Visualization can change the way you talk to yourself, see yourself, and perceive events around you. This in turn affects your behavior; it helps you take better care of yourself and communicate more effectively with others.

    Since visualization techniques calm busy minds, they decrease feelings of stress and promote good health. Some people take advantage of these relaxation effects and use visualization to assist the body's natural healing processes. They focus on images of healing, like immune cells engulfing foreign invaders. People with chronic pain use visualization to induce relaxation and reduce pain severity.

AFFIRMATIONS: POSITIVE SELF-TALK To REINFORCE YOUR VISUALIZATION

Affirmations are positive statements that reinforce your goals. When you repeat your affirmations to yourself in a deeply relaxed state, you are practicing selfhypnosis. Affirmations can reinforce your intentions to increase your stress resistance, organize your time better, improve the quality of your relationships, find a satisfying job, and so forth. Here a few guidelines for writing effective affirmations from Creative Visualization by Shakti Gawain (1978):

     1. Phrase affirmations in the present tense, as though your goal is already achieved. You must focus on your goal's potential for present reality and not think of it as something that will happen later, or later may never come. "I choose healthful foods" has more influence than "I will be thinner by springtime."

     2. Phrase affirmations in a positive way, affirming what you want. "I set priorities and manage my time well" is more effective than "I won't procrastinate anymore." Say these statements to yourself. Can you feel the difference? The first is reaffirming. The second almost shakes a finger at you, reminding you of your previous bad behavior. It calls you to focus on what you don't want.

     3. Keep affirmations simple and direct. An affirmation should be "a clear statement that conveys a strong feeling; the more feeling it conveys, the stronger the impression it makes on your mind" (Gawain, 1978, p. 24). Avoid affirmations that get lost in too many words and details.

     4. Create affirmations that feel right to you. We each respond differently to a given affirmation statement, just as we all respond differently to visual images. If the wording of an affirmation sounds stupid or silly, it won't be believable and will be rejected by your deeper mind.

     5. As you practice your affirmations, keep in mind that you are creating something new, not redoing what currently exists. Adopt the attitude that you accept what currently exists while creating a better future. This prevents you from getting stuck in a conflict with your present reality and again focusing on what you do not want.

     6. Affirmations are not intended to repress negative feelings. just as you observe your thoughts and feelings during mindfulness meditation, so too do you observe your feelings during visualization. Even negative thoughts and feelings have an important message that must be acknowledged.

     7. When repeating your affirmations during relaxation, try to believe them, even if only for a few moments.

     Try writing some affirmations of your own. Here are some examples of affirmations students have used in the past (several adapted from Gawain):

"Every day in every way I'm getting better and better. "

"I love and appreciate myself just as I am. "

"I have everything I need to relax and enjoy my life. "

"Everything is just the way it is supposed to be. "

"I communicate clearly and effectively. "

"It's okay for me to have fun and enjoy myself, and I do!"

"I enjoy everything I do. "

"I make good decisions, and my higher self is guiding me in everything I do. "

     Gawain notes that people who connect their affirmations to spiritual beliefs reap greater benefits, just as Benson found that meditation was more effective for those who called upon a higher power. If you are not comfortable with the word God, or a specific spiritual figure such as Christ or Buddha, try a term such as higher self, divine light, or the light within me.

The light of God surrounds me, the love of God unfolds me, the power of God flows through me. Wherever I am, God is, and all is well.

SUMMARY

1. Meditation refers to a variety of techniques that include some sort of mental focus to alter one's mental state.

2. Like other relaxation techniques, meditation has been associated with the prevention and treatment of many stress-related disorders.

3. Meditation practices are as old as recorded history and are found in almost every religion. Western scientists became especially interested in meditation in the 1960s.

4. Transcendental meditation teaches the meditator to focus on a special mantra, or phrase, during meditation.

5. Herbert Benson introduced a secular meditation technique that he called the Relaxation Response. It mimics transcendental meditation except that meditators select their own meditation mantras rather than being given mantras by their teachers.

6. Meditation practice elicits the physiological relaxation of resting homeostasis. Meditation is associated with alpha brain waves, which are indicative of a relaxed, meditative state.

7. Most forms of meditation include the following elements: (a) a quiet environment, (b) a comfortable sitting position, (c) a mental focus, (d) physical relaxation and calm breathing, (e) a passive attitude, and (f) regular practice.

8. In mindfulness meditation, meditators simply try to keep their awareness in the present moment, using the breath as their focus. The goal of mindfulness meditation is to observe the process of thought itself.

9. Visualization combines use of the imagination with a meditationlike focus. 

10. Hypnosis is one type of visualization that combines deep relaxation or a trancelike state with suggestions made by the hypnotherapist.

11. Autogenic training was created by Johannes Schultz, a Berlin psychiatrist, who noted that people coming out of hypnotic trances reported specific physical sensations, such as warmth and heaviness in their arms and legs. Schultz found that visualizing these sensations could induce a state of relaxation.

12. Biofeedback training uses instruments that measure physiological variables such as muscle tension to give people information, or feedback, on their relaxation efforts. Biofeedback instrumentation can speed the mastery of relaxation techniques by helping people monitor their physiological responses.

13. Programmed visualization is a form of creative visualization in which a person focuses on an image designed to achieve some specific purpose, such as relaxation, behavior change, athletic performance, or healing.

14. Receptive visualization is similar to mindfulness meditation, in which a person simply becomes aware of ideas and images that emerge during the visualization session.

15. Affirmations are positive statements that reinforce one's goals. When repeated to oneself in a deeply relaxed state, they serve as hypnotic suggestions.

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