Monthly Archives: November 2011

This poignant poem goes right to the heart, inspiring a rich, open-hearted awareness of what’s precious with its perfectly chosen words and everyday details.  Please enjoy and linger over it a little. It’s by Ellen Bass, who co-wrote Courage to Heal with the very gifted Laura Davis.  This one is in her latest collection of poems, The Human Line.

If You Knew

What if you knew you'd be the last
to touch someone?
If you were taking tickets, for example,
at the theater, tearing them,
giving back the ragged stubs,
you might take care to touch that palm,
brush your fingertips
along the life line's crease.
When a man pulls his wheeled suitcase
too slowly through the airport, when
the car in front of me doesn't signal,
when the clerk at the pharmacy
won't say Thank you, I don't remember
they're going to die.

A friend told me she'd been with her aunt.
They'd just had lunch and the waiter,
a young gay man with plum black eyes,
joked as he served the coffee, kissed
her aunt's powdered cheek when they left.
Then they walked half a block and her aunt
dropped dead on the sidewalk.

How close does the dragon's spume
have to come? How wide does the crack
in heaven have to split?
What would people look like
if we could see them as they are,
soaked in honey, stung and swollen,
reckless, pinned against time?

Ellen Bass,The Human Line

Dear Belleruth,

I have a patient with complex, longstanding, posttraumatic stress from years of childhood sexual abuse. She gets panicky at the idea of closing her eyes to do her guided imagery.

She also has fears of “losing” herself – getting so ungrounded and dissociated during the immersive, hypnotic experience, that she’ll float out of her body and never come back, so to speak.

Any ideas for how I can structure this experience to make it feel safer for her? She and I both feel that the imagery would do her a lot of good, if she could get through it.  We just need to figure out how to make it so she can tolerate it.  All suggestions welcome.

Thanks.

Dr. James L. McMahon

Researchers from UCLA investigated whether a cognitive-behavioral treatment known as Interoceptive Exposure (originally developed for treating panic disorder) targeting visceral anxiety could alleviate the symptoms of Irritable Bowel Syndrome, a potentially debilitating condition with few efficacious pharmacological or psychosocial treatment options available.

[Ed. Note:  for a fuller explanation of Interoceptive Exposure, click here]

The protocol randomly assigned 110 subjects to receive 10 sessions of either: (a) interoceptive exposure (IE) targeting visceral sensations (b) stress management (SM); or (c) an attention control condition (AC).  They were assessed at baseline, mid-treatment, post-treatment, and follow-up sessions.

Well, after three months of hounding, nagging, cajoling and ordering newly returned soldiers at Fort Sill to listen to their guided imagery and collecting their survey data at four different points along the way, (from early August through early November,) we were finally able to have our first meeting with Dr. Edgardo Padin (who is actually Chief of Psychology at the Louis B Stokes V.A.M.C. in Cleveland, generously volunteering his time to this effort) and his numbers-crunching wunderkind, Dr. Kevin Young, to go over the first round of data analysis.  

I’m happy to report that we do indeed have some useable findings here, which will be helpful to the Army, to our returning soldiers and to subsequent research efforts.  

We learned a lot.  We were trying something new – offering a guided imagery resource, not through regular mental health channels, but through the command side, to see if there would be stronger adoption rates that way.

Dear BR,

For 8 years my wife and I have been doing literacy work, connecting with prisoners. We would like to invite the chaplain to help us, but we don’t want to rock the boat, because it’s easy to be sent out. Do you have any suggestions on how to use guided imagery in educational settings for these men?

Thanks.

Joe B.

In a randomized, controlled trial, investigators from a Eugene, Oregon company called mPower evaluated the efficacy of an interactive, computer-assisted cognitive-behavioral program called The Wellness Workshop for alleviating depression.
   
A total of 191 individuals referred by primary-care physicians were randomly assigned either to a treatment group, where treatment as usual was supplemented by the Wellness Workshop CD-ROM, delivered by mail (WW+TAU), or to a control group, where treatment as usual was provided (TAU).

Measures included symptom ratings obtained via structured clinical diagnostic interviews, as well as a battery of self-report questionnaires on symptoms specifically targeted by the intervention. Data were collected at baseline, at 6 weeks' post-intervention, and at a 6-month follow-up assessment. Participants were given a reimbursement of $75 for completion of each assessment.

A terrific story by Philadelphia Inquirer writer, Sally Friedman, describes how a scrappy, 10 year old soccer player named Jarrod Skole converted his experiences with bladder cancer treatment and guided imagery into a terrific book to guide other kids.  He wrote it with his father, Gary, and it’s called, Imagine What’s Possible, published by the American Cancer Society.

We were pointed to a really nice shout-out and discussion about the value of guided imagery for heartbreak in Brenda’s Blog, a heartfelt, movingly honest blog by a courageous cancer survivor and grieving widow – talk about a nasty, double-whammy slam up side the head! There are great pages by her kids in there, too – an altogether impressive and inspiring family.
 
She writes that the Heartbreak, Abandonment and Betrayal imagery seemed to be a big help to her with her grief, although she didn’t think much of our all time, bestselling, uber-popular Healthful Sleep audio. Go figure. Maybe she should try KRS Edstrom’s Sleep through Insomnia.  Or Gael Chiarella’s PM Yoga Meditations might be a better fit.

We got this note from the extraordinary Mary Bowes, RNC, 200-Hour RYT, BSN, PRYT Yoga Teacher & Practitioner-in-Training, who is looking into launching an evidence based program and evaluation of using guided imagery CDs with patients facing difficult medical procedures.  Recent changes in patient/staff ratio make it hard for her to provide one-on-one imagery, so she’s investigating going digital.  And she’d love to hear from any of you out there who have done something similar or are thinking about it.

Dear Belleruth,

Your CD's populate our patient library cases with a large variety of topics. You are considered the expert in Guided Imagery by the group I work with.

I am spearheading an Evidence Based Practice project, "Guided Imagery for Procedural Pain" in the unit where we frequently perform quick, sometimes uncomfortable, procedures, such as Bone Marrow, Thyroid, Endometrial Biopsies, Lumbar Punctures, and so on.

May I have your permission and advice? I would like your permission to use one of your tapes for this project. I would like your advice for a title you recommend for this purpose.  I would be writing up the experience of guided imagery for the patients, as well as the experience of implementing guided imagery in our hospital, and evaluate both the patient and nurse perspectives.  This is one of the reasons I am asking your permission to use your work, as I would be referencing your recording in writing. Please let me know if this is acceptable to you.

I have been providing guided imagery verbally for a very long time. Since our patient/staff ratio has changed, it has become increasingly difficult to provide this important individual care. I hope the project will support the use of CD's to implement increased comfort for these and other patients. We often care for patients in Pain Crisis. I hope to begin a nursing trend to use Guided Imagery readily for pain management.

Mary Bowes

After reading this jaw-dropper of an upbeat report from the pluckiest, newly diagnosed, 75-year-old cancer patient in America, everyone in the office has set a new goal: we all want to be Dr. Ann McGee-Cooper when we grow up.  Read on and take heart! (She gives all the credit to guided imagery.  We hand all the credit right back to her.)  

And wait til you see her list of post-surgical activities (which we do not recommend for the average mortal).  She also has some very helpful ideas about how and where and when to use imagery.  Check it out