Does looking at beautiful artwork help increase the effectiveness of guided imagery, or is it better to just close your eyes and experience your own, unique, inner images? Inquiring minds want to know.. Dear Belleruth,

I am a project lead to design a one-stop, open heart recovery unit with a healing environment and a holistic philosophy of care at a major hospital system in the Midwest. We will be offering our patients all of your cardiac guided imagery audios, healing touch, essential oils and music.

My question is this: are there any images (art work) that we could use that would enhance the use of guided imagery? We have an art designer and she has this question as well.

I first learned about your work when I heard you speak in 1997 at Hilton Head. (Ed. Note: This is the extraordinary annual NICABM conference - National Institute for the Clinical Application of Behavioral Medicine, at

Thank you.

Barb M. RN, Clinical Director of Heart Care

Dear Barb,

Hello, and best wishes with designing this exciting, new program! You must be having great fun with this. And how lovely that you have the joy and luxury of working with an art designer! This bodes well for your new unit.

To answer your question: the thing to remember about guided imagery is, it''s almost always best done with eyes fully closed or three-quarters closed, in order to drive awareness down into the body, and toward the inner reaches of each person’s unique imaginal world, as opposed to externals (even beautiful ones!) that are presented from the outside. So looking at pictures during a guided imagery session is actually counterproductive. It’s only a good idea if someone is completely unable to evoke a single sensory image (by which I mean they can’t imagine seeing, hearing, feeling, smelling or tasting) on his or her own - a circumstance that is very unusual.

That being said, it wouldn’t hurt if certain patients who are interested in their own physiology could actually see, before shutting their eyes, the way healthy arteries look, or, better yet, the progression of gunky, clogged, inflexible, narrow, arteriosclerotic arteries transforming themselves into smoother, cleaner, juicier, more open and flexible vessels - the way it occurs naturally in the body with lifestyle and diet changes. It needn''t be fully representational (some people get squeamish when it’s too anatomically correct), but the basic idea and dynamics should be accurate. Other people prefer to imagine symbolic or metaphoric images, and those work fine too.

Of course, having lovely, relaxing scenes around the room certainly wouldn''t hurt, for when patients are just awake and alert. Any scene or visual art piece that encourage a peaceful, balanced feeling and a nice, slow 60 pulse rate (or whatever HR you are after) is a wonderful thing.

Oh! And if there''s a little extra room in the budget, I would recommend some face and/or foot massage. Some people are weird about other people touching their feet, but they are in the minority. I personally think it''s the next best thing to heaven. And since you’ll have a lot of fidgety type A’s on your floor, some of whom will balk at the idea of "relaxing" to tapes and CDs, this kind of massage might be the easiest way for them to slow down from the inside out. And if you can’t afford a staff position, you might be able to get MT students from the local community college massage school - it wouldn’t be the first time that this has been done, especially on a step-down unit.

In any case, I’m excited about your evolving program! Best of luck with it, and let me know if you have any other questions.