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11 Nov


I have no current conscious memory of PTSD but I have the symptoms of it. (I wake up in the middle of the night screaming and I have panic attacks during the day.) I read Invisible Heroes, your book about PTSD, but every survivor had some sort of memory or recollection of their trauma. How should I go about healing if I cannot remember anything?


Dear Kara,

Not every trauma survivor in the book had a clear memory of what caused his or her posttraumatic stress symptoms, and it is not at all uncommon for memory to be clouded or missing, due to the burst of pain-killing biochemicals that flood the bloodstream during a terrifying event.

04 Nov


How can I keep myself from dissociating during guided imagery? I seem to float out of my body and don't know where I've been when the music stops. Is this a commonly occurring problem? Any advice?


Yes, it's pretty commonplace. Don't forget, guided imagery is a dissociative technique –strategic and deliberate, certainly, but dissociative nonetheless. So it's natural for people to float in and out of awareness, and a lot of people float so far out that they don't know where they've been. It happens to me a lot, too.

28 Oct

Dear BR,

I am middle-aged and still unable to quit biting my fingernails. I have tried all sorts of things: gloves, bandaids, bitter flavored topicals, crocheting. I wonder if this is a form of self-injury or maybe pica. Only time I definitely don't bite my nails is if my hands are dirty, and, yes, I've been known to get up and go wash my hands so I can bite the nails.

I often "decide" not to do this anymore, but when the urge hits, usually while watching TV or reading, it's as if my priorities shift and I feel some kind of distracted anxiety if I don't bite them. I was eight yrs old when this started. I hated the sensation of having my nails trimmed and my sister taught me how to "trim" them myself.

21 Oct


I'm a psychologist specializing in PTSD. A client's husband has just received orders to go to Liberia to work on the Ebola crisis. Do you know of or could you develop any imagery that could help prevent PTSD in such health workers who will likely witness scenes of horror that may haunt them in the future? Thanks! It's okay to post this.

14 Oct

Hi, Belleruth. How does progressive muscle relaxation compare to guided imagery? Is it as effective? Can imagery be improved by combining PMR with it?

Tina Barrow RN

07 Oct

We got this question a while ago, and it's a great opportunity to talk about how fast guided imagery can work in a pinch... every study with our pre-surgical audio program supports the answer we provide here.

Dear Belleruth and Health Journeys:

I am interested in conducting research at my facility using your surgery audio program. How long prior to the patients scheduled surgery should the patient start listening to the imagery? Is there any evidence of its effectiveness if the patient only starts using it a day or two prior to surgery? Thanks.

John P.

30 Sep


I am an EMDR (Eye Movement Desensitization and Reprocessing) therapist.  I am thinking that using alternating bilateral stimulation during the guided imagery would intensify the positive effect.  Do you have any anecdotal clinical experience or research to support this idea?

Roger P.

23 Sep

We got this great question from K. after she read about all the state National Guards using guided imagery for returning service members. She asks about using guided imagery preventively. Here is her question:  

Just read your article re various state National Guards ordering your CD's for their national guardsmen and women returning from service. I have a National Guard friend who is preparing to ship out in December.

Would listening to the CD's you mentioned help to prevent build up of stress while serving? Or would you suggest other CD titles to help processing of stressful events as they occur?

16 Sep

A while ago we got this question from a concerned husband, whose wife has a condition that makes it hard to breathe. She can’t do the usual relaxation preliminaries:
Dear BR,

Many of your guided imagery meditations have to do with breathing.  What if people suffer from a disease where they have trouble breathing, or are even using oxygen?  What do they do then?  This is the case with my wife.

Ralph P.

Dear Ralph,

Thanks for asking.  You’re absolutely right that for someone who is having difficulty breathing, directions to “take a nice, deep, full, cleansing breath” are not merely pointless, but downright annoying, not to mention distressing and anxiety-producing.

That’s why on our Asthma imagery, we have the listener place his or her hands on the chest and focus on the sensation of the warmth from the hands permeating the lungs and soothing them.  A device like touch can substitute for the healing, relaxing, grounding effects of conscious breathing. In general, that would be my first choice.
It could be her own hands or perhaps even better, yours, gently sending warmth into her shoulders or back. So you’d be making that substitution – the sensation of nourishing warmth from the hands permeating her body, instead of the warmth of the breath.
Another approach is to take the focus off the breathing altogether, as for some people the very idea of breathing is too closely associated with discomfort, and instead to just go directly to a favorite place or to imagine healing occurring on the cellular or energetic level, or in some other abstract way.
Some of these generic, nonspecific images are incorporated into some of the affirmations we use.  For instance:  “I can see and feel a powerful blue-green wave of healing, washing through me from head to toe, clearing away any unwanted debris and taking it out with the tide.

Or another:  “I can see and feel a warm, pulsing, glowing blanket of magical comfort surrounding me, enveloping me with peace and safety, soaking its energy into me.”

I hope this helps.  My best to you and your wife.


09 Sep

Jamie, a frustrated Mom, writes:
My only child (daughter) is a spirited, high-energy (redundant), non-sleeper, who feels she will miss out on something Mommy & Daddy get to do when she sleeps. I have no down time.  Nothing that I've tried seems to work to get her to go down at night.  HELP. Thanks for your suggestions…..

Dr. Yvonne Arquette, a child psychologist who read the question, answers:
How old is your daughter, Jamie? All things being equal, it sounds to me like some loving but firm limits are in order.
As a child psychologist, I see this all the time.  Parents are reluctant to cause unhappiness and feel that their job is to gratify their child's wishes, even when they aren't realistic.
All this does is create disappointment for the child later on when they discover that the rest of the world doesn't feel the same way about their wishes.
So I think you're going to have to nip this one in the bud and tolerate the anxiety and upset that this causes inside of YOU when she hollers and screams and yells "NO FAIR!!!!!".