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15 Aug

Essential hypertension and stress. When do yoga, psychotherapy and autogenic training help?

Another summary article from Germany by J.M. Hermann reports on the effectiveness of relaxation techniques, behavioral therapy and biofeedback for hypertension and stress, stating that these techniques lower elevated blood pressure by an average of 10 mmHg (systolic) and 5 mmHg (diastolic). Further, as a "secondary effect", these measures frequently prompt the hypertensive patient to adopt a more health-conscious lifestyle.

Citation: J. M. Hermann. Essential hypertension and stress. When do yoga, psychotherapy and autogenic training help? MMW Fortschr Med 2002 May 9;144(19):38-41.

15 Aug

A special report published in Circulation by the American Heart Association, The National Heart, Lung, and Blood Institute and the National Center for Complementary and Alternative Medicine examines the impact of mind-body techniques, and, because it is seen as the most widely researched method, Transcendental Medititation on Heart Disease.

The report states that the first major study to show that TM could reduce blood pressure was conducted by Robert Schneider with a population of hypertensive African Americans. In addition, this study showed that the technique had high cultural acceptability and compliance in a high-risk minority population.

15 Aug

A randomized controlled trial compared a group of bulimic patients receiving 6 weeks of individual guided imagery therapy with a control group receiving standard care. Fifty participants who met the criteria for bulimia nervosa completed the study. Measures of eating disorder symptoms, psychological functioning and the response to the guided imagery experience were used. The guided imagery treatment substantially reduced bingeing and purging episodes; the imagery group had a 74% mean reduction of bingeing and a 73% reduction of vomiting. The imagery treatment also demonstrated improvement in attitudes about eating, dieting and body weight in comparison to the control group. In addition, the guided imagery group demonstrated improvement on psychological measures of aloneness and the ability for self-comforting. The study concludes that guided imagery is an effective treatment for bulimia nervosa, at least in the short-term.

Citation: Esplen MJ, Garfinkel PE, Olmsted M, Gallop RM, Kennedy S. A randomized controlled trial of guided imagery in bulimia nervosa.Psychol Med 1998 Nov;28(6):1347-57.
15 Aug

Researchers from the Eating Disorders Research Program at the University of Minnesota examined long-term outcomes of cognitive behavioral therapy, delivered 3 different ways to 51 people suffering from a binge eating disorder.

There was a therapist-led condition, where the psychologist provided psycho-educational information for the first half hour and led a group discussion for the second half hour of each session; there was a partial self-help condition, where participants viewed a 30-min psycho-educational videotape, followed by a therapist-led discussion; and finally, there was a structured self-help condition, where participants watched a psycho-educational videotape and led their own discussion.
15 Aug

In a huge study by Duke’s John Barefoot, PhD and his team, 1250 cardiac patients with coronary artery disease were assessed over a span of nearly 20 years for their levels of depression, to see if the degree of depression correlated in any way with mortality rates, and, if so, which features packed an especially mean punch. (Other research had already established the connection between depression and heart disease, but this study was designed to tease out what elements did the damage.)

The study showed that depressive symptoms did indeed predict survival. The risk of death increased by 40% for patients with negative affect, which meant downheartedness, sadness, irritability and restlessness. When negative affect was found in younger patients - under 51 mortality risk increased to a whopping 70%.

The other potent predictor of mortality was hopelessness.

Citation: Barefoot J, et al. Depressive symptoms and survival of patients with coronary artery disease. Journal of Psychosomatic Medicine. 2000 Nov-Dec; 62(6):790-5
15 Aug

In a 1997 pilot study by McKinney, Antoni, Kumar, Tims and McCabe, 28 randomly selected adults were studied to see if the Bonny Method of Guided Imagery and Music (GIM) had an effect on mood and cortisol levels.

Subjects were given the POMS test (Profile in Mood States) and donated 15 cc’s of blood before and after a 13-week intervention period, and again at a 6-week follow up.

Subjects reported significant decreases in depression, fatigue and total mood disturbance, and had significant (and proportional) decreases in cortisol levels.

15 Aug

The good news: A new survey of the research on music and healing was recently published by Myskja and Lindbaek at the University of Oslo. The bad news: it’s in Norwegian. But the English abstract is available in PubMed.

Tidsskr Nor Laegeforen 2000 Apr 10;120(10):1186-90 draws tentative conclusions about music’s efficacy for treating anxiety and depression, and improving function in schizophrenia and autism; its utility for pain, reducing the need for medication aqnd helping during uncomfortable diagnostic procedures; its usefulness as a support tool during pregnancy and gestation, in internal medicine, oncology, paediatrics and other related fields; with geriatric patients, alleviating symptoms in stroke rehabilitation, Parkinson''s disease, Alzheimer''s disease and other forms of dementia; and its supportive role in palliative medicine and terminal care.

The article concludes that music as a therapeutic agent, and music with guided imagery, is well tolerated, inexpensive, and delivers good compliance with few side effects.

Citation: Myskja A, Lindbaek M. How does music affect the human body? Examples of the use of music in clinical medicine. Tidsskr Nor Laegeforen. 2000 Apr 10(10):1182-5, 1186-90.
15 Aug

Web-based cognitive behavior therapy: analysis of site usage and changes in depression and anxiety scores.

Helen Christensen of The Centre for Mental Health Research at The Australian National University in Canberra (This email address is being protected from spambots. You need JavaScript enabled to view it.) developed a free Internet-based cognitive-behavior therapy intervention called MoodGYM at http://moodgym.anu.edu.au. The MoodGYM is designed to treat and prevent depression in young people, and is especially targeted for those with no formal contact with professional help.

All visitors to the MoodGYM site over about 6 months were investigated as aggregate data, including 2909 registrants of whom 1503 had completed at least one online assessment. (Outcomes for 71 university students enrolled in an Abnormal Psychology course who visited the site for educational training were included and examined separately.)

15 Aug

A study from Siriraj Hospital in Thailand looked at the effect of a 7-day, intensive meditation program for 101 older adolescent male deliquents in the Upekkha Detention Center. All the boys completed the program and answered questionnaires. Seventy percent of the subjects described feelings of contentment and calm, 53 per cent requested the program be repeated, 52 per cent reported a clearer undestanding in the doctrine of Karma, 44 per cent noted improved concentration and awareness, 36 per cent felt less impulsive. All felt that the meditation practice had been beneficial. The report concludes that meditation is a positive adjunctive therapy for institutionalized juvenile delinquents.

Citation: Witoonchart C, Bartlet L. The use of a meditation programme for institutionalized juvenile delinquents. Journal of the Medical Association of Thailand, 2002. Aug; vol. 85 Supplement 2: pp. S790-3.
15 Aug

A British pilot study assessed the effectiveness of a cognitive-behavioral therapy specifically designed to prevent relapses and improve social functioning in patients with bipolar affective disorder (this diagnosis used to be called manic depression).

The clinical trial at London’s Institute of Psychiatry randomized 103 patients with bipolar disorder, who experienced frequent relapses despite the prescription of commonly used mood stabilizers, into a cognitive-behavioral therapy group or control group. Both groups received mood stabilizers and regular psychiatric follow-up. In addition, the cognitive-behavioral group received an average of 14 sessions of CBT training during the first 6 months and 2 booster sessions in the second 6 months. The study found that during the 12-month period, the CBT group had significantly fewer bipolar episodes, feewer days in a bipolar episode, and fewer number of admissions for this type of episode.

15 Aug

When sixty-two patients were randomly assigned to nitrous oxide sedation (NO), cognitive therapy (CT), or applied relaxation (AR) therapy, to help them reduce their fear of dental procedures, highly significant reductions in fear and general distress were found in all three groups. Patients in the applied relaxation group showed the greatest benefit and the most dramatic reduction on dental fear measures. One year later a majority (95%) of the participants had undergone dental treatment, and on the whole, showed continued favorable effects. Every subject judged the dental fear treatment to have been beneficial, and 80% reported the treatment successful. All three treatment groups scored in the normative range for general distress both at the end of treatment and at one year follow-up.

Citation: Willumsen T, Vassend O, Hoffart A. One-year follow-up of patients treated for dental fear: effects of cognitive therapy, applied relaxation, and nitrous oxide sedation. Acta Odontologica Scandinavica. 2001 Dec; 59(6): 335-40.
15 Aug

Although this article is more a program description than a clinical trial, it is very much worth mentioning as an experimental pilot effort. A program designed at the Jewish Home and Hospital in New York City used meditation, relaxation, sensory awareness and guided imagery in a group setting to enhance self-awareness, self-esteem, and body awareness among demented elderly.

These techniques were used to address many of the daunting issues residents face – i.e., coping with disability, changes in body image, the promotion of self-empowerment, and the preservation of autonomy and personal integrity within the nursing home setting.