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I found myself wondering how a 20-minute tape could make such a difference. To get a firsthand feel for its impact, I recently listened to Successful Surgery. Created and narrated by Belleruth Naparstek, the tape began with a lush, soothing soundtrack that nudged me to sink into my chair. Before long, Naparstek's lilting voice joined the music and began to lead me through a full-body relaxation exercise. Lulled by her plummy, reassuring tones, I felt myself enter a zone of calm.

Next she invited me to visualize a safe place from which I could observe my upcoming surgery. I wasn't about to have any surgery soon, so I focused on an operation I'd had five years earlier that had caused me heart-pounding anxiety beforehand. Naparstek encouraged me to imagine several aspects of the surgery, including the ministrations of a highly capable staff, minimal bleeding, and a quick, comfortable healing process. As each of these images bloomed in my mind, I found myself growing in confidence: Why shouldn't surgery go well? I thought.

Yet the part of the tape that I found most affecting had nothing to do with actual operative procedures or their aftermath. About halfway through the recording, Naparstek encouraged me to picture a "magical band of allies"—people who loved me and who were rooting for my successful operation—filling up the entire operating room. When I visualized this cheering section of family and friends, I felt a sense of protection spread over me like a warm quilt. Later Naparstek would tell me that such "heart moments" are a vital part of guided imagery's healing power. "Illness is lonely and scary," she said, "and imagining a roomful of supportive faces provides people with a huge amount of safety and nourishment, which we believe influences health outcomes."

"But we need to be very careful not to give false hope," says Lara Krawchuk, director of clinical services for the Conill Institute for Chronic Illness in Philadelphia. "If guided imagery has a physiological effect, that's wonderful, but it won't necessarily cure the problem." Yet Krawchuk, who uses guided imagery in the support groups she leads for people with chronic illnesses, believes that the process "can help anyone regain a sense of control over an illness, which is a big issue for people dealing with pain or disability. Even if you're quite sick, imagery can provide a real sense of hope and well-being."

The emotional benefits of imagery were recently documented in a pilot survey of heart patients conducted by Columbia University's Integrative Medicine Program. Research has shown that in the aftermath of heart surgery, people commonly feel helpless and dispirited. But among the 20 heart surgery patients who listened to a guided imagery tape on cardiac recovery, 83 percent reported a greater appreciation for being alive, 75 percent felt less depressed, and 68 percent said that guided imagery "helped me increase my commitment to reclaiming my life."

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