ORIGINAL RESEARCH

DIFFERENCES IN RELAXATION BY MEANSOF GUIDED IMAGERY IN A HEALTHY

COMMUNITY SAMPLEEri Watanabe, PhD, MPii; Saiiae Fukuda. PhD; Hisako Hara; Yuko Maeda, MA, MHd; Hideki Ohira. PhD; Taro Shirakawa, Ml), PhD

Objective • This study investigated differences in relaxationinduced by guided imagery in healthy community samples.Methods • One hundred forty-eight people took part in ourinvestigation. The mean age of the 50 males and 98 femaleswas 39.36 ± 11.86 years. We took saliva samples to measuresalivary cortisol (SC) hefore the first session, after the firstsession, and after the second session. Subjects were asked tocomplete the short form of the Multiple Mood Scale (MMS)questionnaire before the first session and after the second ses-sion. The shortened form of Betts' Questionnaire uponMental Imagery (QMl) was collected once before the first ses-sion, and vividness of the imagery was measured using a visu-al analogue scale once after the second session.

Results • SC levels were significantly decreased after the firstsession and after the second session in all participants. Wefound, most significantly, that age and QMI scores were stronglyrelated to changes in SC level throughout the relaxation sessions.Conclusions • Unpleasant information, a cause of mentalstress, is replaced by a comfortable image, and this replace-ment affects a participant's SC level. The greater one'simagery ability is. the more successful the displacement ofstress and the shift toward a comfortable mental and emo-tional state will be. This study provides a basis for explainingthe mechanism through which relaxation by means of guidedimagery is effective in reducing stress. {Allern Ther HealthMc(/.2006;12(2);60-66.)

Eri Watanabe, PhD, MPH, is a member of the Department ofHealth Promotion and Human Behavior at the KyotoUniversity Graduate School of Public Health, Japan. SanaeFukuda, PhD, is an assistant professor in the Department ofHealth Promotion and Human Behavior at the KyotoUniversity (Graduate School of Public Health. Hisako Hara isa chief at the Hara Academy, Nishiogi-Minami Suginami-ku.Tokyo, Japan. Yuko Maeda, MA, MEd, is an assistant professorin the Department of Health Promotion and HumanBehavior at the Kyoto University Graduate School of PublicHealth. Hideki Ohira, PhD, is an associate professor in theDivision of Social and Human Environment, Graduate Schoolof Environmental Studies, Nagoya University, Japan. TaroShirakawa, XfD, PhD, is a professor in the Department ofHealth Promotion and Human Behavior at the KyotoUniversity Graduate School of Public Health,

In this study, we investigated how relaxation by means ofguided imagery enables individuals to manage stress.Imagery creates a bridge between mind and body, linkingperception; emotion; and psychological, physiological,and behavioral response.'' Guided imagery, a mind-body

relaxation technique, is a behavioral and cognitive technique bywhich individuals exert active control over the focus of attention."'''It has been used as a therapeutic process during which partici-pants invoke a comforting image to connect with psychologicalprocesses outside conscious awareness for the purpose of achiev-ing specific health goals.'' Relaxation using guided imagery hasbeen applied to management of the following symptoms (or withspecific groups of patients), and has been found to be effective insymptom management' and reduction'of chronic pain, headache,"for use in patients treated with chemotherapy," and for use in can-cer patients in general.'" And some experiments performed after1980 shov\ed that imagery influences the physiological andimmune measure. For example, one study showed that cell-specificmental imagery was associated with decreases in peripheral bloodcell counts of lymphocytes and neutrophits." Other studiesshowed that subjects practicing relaxation alone and with imageryhad a higher level of salivary immunoglobulin A (igA) than thecontrol group.'-' A study in which relationships between absorp-tion, imagery, and immune responses were examined found thatmore high than low absorbers responded to relaxation withmucosai immune imagery by producing higher mucosal IgA."

The effects of imagery on stress and psychological distressin healthy adults have been explored in several studies,'""^ and

60 ALTERNATIVE THERAPIES, MAR/APR 2006. VOL 12. NO. 2 Effects of Guided Imagery iti a Healthy Comrininity Siiinplc

preliminary evidence supports the effectiveness of guidedimagery for managing stress, anxiety, and depression, as well asfor lowering blood pressure and for reducing pain and the sideeffects of chemotherapy.'

The infiuences of negative emotions caused by stressful con-ditions on mind and body have been studied. One pathwaythrough which stressors are thought to influence physiology isthrough their effects on emotion. In studies of tlie effects of acutelaboratory stressors. participants responded with both a height-ened cardiovascular response and a deepening of negative mood."

We hypothesized that comforting imagery facilitates the tem-porary shift ofa negative mood to a positive mood, with the resultthat the effects of stressors (ie, negative information received bythe brain) are less severe. A study of imagery rehearsal providespreliminary evidence that the positive treatment effects of com-forting imagery on posttraumatic nightmares, posttraumaticstress disorder (PTSD), and on a broader symptomatology inmales with chronic combat-related PTSD are maintained over thelong term.''This effect is attributed to a lessening of the effects ofstress via the displacement of its associated unpleasant imagery.Data from a hypnosis study support this explanation, indicatingthat the emotional valence of unpleasant imagery can overwhelmhypnosis-related relaxation.'"

Numerous studies have found that relaxation by means ofguided imagery is associated with changes in physiological para-meters. Previous studies investigating relaxation using guidedimagery have measured IgA," cellular immune function.-"-' plas-ma beta-endorphin," heart rate, skin temperature, electrodermalactivity,-' breathing rate and pattern, and end-tidal carbon dioxide(PETCO^). in addition to using electroencephalography (EEG),"'' asphysiological indicators of stress and of the relaxation response.We were most interested in the physiological measurement of sali-vary cortisol. which has been labeled a stress-related hormone.

When a stressor is received in the cerebral cortex, a stressreaction occurs, and adrenocorticotropic hormone (ACTH) isreleased from the hypothalamus. As this promotes secretion ofACTH by adenohypophysis, secretion of cortisol from the adrenalcortex increases."' There is consistent evidence that many forms ofpsychological stress increase the synthesis and release of cortisol.Glucocorticoids can increase the effects of corticotropin-releasinghormone (CRH) on conditioned fear responses and facilitate theencoding of emotion-related memories.^"

A number of investigations have examined the effects of briefpsychological interventions on cortisol level™ There are manyreports that cortisol levels, as physiological parameters, are vari-ously related to mood levels, which, in turn, are affected byimagery; these reports include information on the effects of psy-chotherapy on depression and plasma cortisol levels,"' of cognitivetherapy on mood and cortisol levels," of acute relaxation trainingon salivary cortisot levels,'" and ofa longer training program onmoods and salivary cortisol levels in healthy adults."

There have been a few reports on individual differences withrespect to relaxation that makes use of guided imagery. For exam-ple, changes in cardiac rate and skin temperature during the use of

imagery are not related to the age or gender of children,'' and therelationship between physiological parameters and an individual'sunique imaging ability with respect to using guided imagery inrelaxation has not been investigated.

To investigate the effects of relaxation using guided imagery,we evaluated the ability of each participant (as a function of theirdifferent abilities to image, their age, and their gender) to generaterealistic mental images. In a previous study of imaging abilitiesthat examined individual differences, subjects participated in aguided-imagery exercise to relieve anxiety associated with anupcoming stressftil task; the participants who were relatively suc-cessftil at imaging were compared with unsuccessful participantsafter the intervention. Scores on Tellegen's absorption scale, onemeasure of absorption in mental imagery, were significantly high-er for people in the successful group." This was identified as apotential predictor of success with guided imagery. The findingsmay be helpflil in developing a usefiil instrument to predict likeli-hood of success with guided imagery.

Another study suggested that imaging ability is related to anindividual's subjective responses to both stress and relaxation.''We assumed that participants with limited imaging ability wouldfeel uncomfortable with the guided imagery content and wouldachieve very low levels of subsequent relaxation, so we measuredand examined the relationships among cortisol, mood, and indi-vidual imaging ability.

To summarize, the purpose of this study was to examine therelationship of salivary cortisol levels to individual differences withrespect to imaging abilit)', age, and gender in healthy adults whoparticipated in relaxation and guided-imagery sessions. A recentstudy determined that there were changes in the pattern of plasmacorfisol levels measured under stressful conditions and that thesechanges emerged as a function of age and gender."' There also havebeen reports of individual differences in EEG as a function of sus-ceptibility to hypnosis" or with respect to blood-pressureresponse'" in studies that examined the relationship of physiologi-cal parameters to individual differences with regard to relaxationor to hypnosis.

In addition, it is necessary to validate—in a laboratory set-ting—the type of guided-imagery relaxation method that can beused effectively by healthy aduhs. It is important to note that thiswas investigated without changing the method; the relaxationmethod used with the participants was that usually used with ageneral group.

METHODSEor several years, public relaxation sessions using guided

imagery have taken place each month in Tokyo, Japan. We investi-gated the sessions for 1 year (Figure 1). The content of each sessionwas similar, and there were approximately 30 participants in eachsession. Participants had commonly read pamphlets or books thatdescribed relaxation by means of guided imagery and that pro-moted participation in relaxation sessions. The participants dif-fered for each session.

We explained our study to the participants individually, and

Effects of Guided Imagery in a Healthy Community Sample ALTERNATIVE THERAPIES. MAR/APR 2006. VOE. 12, NO. 2 61

Investigation Term

Sept

2001

Oct Nov

11=21 n=lfi

Dec

n=17

Jan

n=19

iTb

n=22

March

n=7

April

n=8

2002

May

11-10

June

n-lU

July

11-9

Aiig

n=7

Sept

n=2

^

Oct

(N=148)

Salivary cortisol levelbefore session (SC-A):

4uestionaire 1*

Salivarv cortisol levelbetween sessions (SC-B)

Salivarv cortisol levelafter session (SC-C);questionaire 1^

2::iUi'M T 2:45 PM T 4:30 PM

First session—stretch Rest Second session—guided imagery

*QLiestionnaire I consisted ol the short form oi the .Multiple Mood Scaie and the shortened form of Betts's Questionnaire on Mental Imagery."̂ Questionnaire 2 consisted of the MMS and a visual analog scale of vividness of iiiiagerv.

FKil'RE 1 Timetable of Sessions and Experunental Procedure

176 of the session participants were asked to participate in ourstudy. Twenty-eight people refused, so 148 of 176 people (84%)took part in our investigation. The mean age of the 50 males and98 females was 39.36 ± 11,86 years (mean ± SD, minimum 18.maximum 72). In addition, several participants took part in manysessions over the course of our investigation. Data were collectedonly once per participant during the investigation, however. Allparticipants provided informed written consent: we used identifi-cation numbers rather than names to protect personal informa-tion when compiling statistics.

The program session lasted 3.5 hours. After completing ques-tionnaires, participants volunteered to provide saliva samples. Thedata from 2 individuals taking antidepressants were excludedfrom the statistics; an additional 8 individuals were excludedbecause of technical difficulties in measuring their cortiso! levels.

Relaxation ProgramThe relaxation program was carried out from 1 PM to 4:30

!>M. Data collection was performed once a month, and the relax-ation program was executed at exactly the same time, in thesame room, in which the temperature was kept at about 20°C:the only illumination was that provided by fluorescent lamps.

In the first session (ie, from 1 PM to 2:30 PM), subjects wereinstructed to stretch slowly. Participants repeatedly tensed andrelaxed each skeletal muscle of the body in conjunction withabdominal breathing, in a manner similar to a yoga exercise.During skeletal muscle relaxation, participants were instructed to

invoke mental images such as, "My muscles were stretched com-fortably." While tensing muscles, subjects were asked to recallimages such as, "My body becomes warm and then gentlyrelaxed," and, "My body's cells become younger and are activated."

In the second session, from 2:45 PM to 4:30 PM, the partici-pants meditated with abdominal breathing, according to theguided-imagery instruction, with a locus or facing upward. Acompact disk entided "Water," consisting of slow-tempo, mixednature sounds (eg, the sound of water flowing or birds singing)was played as background music. The instructor told the partici-pants to close their eyes, breathe deeply, and relax. The guidedimagery included the following: and (1) a rising sun—the sub-jects are on a large, sandy beach lit by the rising sun and feeldeeply relaxed; (2) comfortable landscapes—forests or individu-ally selected favorite places; (3) harmony with people and expres-sions of gratitude toward them; and (4) a warm and peacefullight expanding and surrounding the person, the earth, andspace. Participants become light and can see the entire world.After telling participants. "You feel relaxed, refreshed, and atease." the instructor allowed them to open their eyes.

Study DesignWe collected saliva samples using a Salivette (Sarstedt,

Rommelsdorf. Germany), a special plastic tube that contains cot-ton. Participants chewed accessory cotton in their mouths for 90seconds before sample collection. Samples were centrifliged for 5minutes at 3.000 rpm at 4' C and were stored immediately after

62 ALTERNATIVE THERAPIES. MAR/APR 2006. VOE. 12. NO. 2 cd Imagery in a Heallhy Comuiimity Sample

collection at -20° C until assays were performed. Salivary cortisollevels were measured by radioimmiinoassay methods using aDiaSolinlnc/GammaCoat cortisol kit {Mitsubishi Kagaku BCLInc, Japan).'^

Psychological MeasuresShort Form of the Multiple Mood Scale

Mood states were measured using a mood adjective check-list constructed in Japan: its reliability and validity have beenconfirmed in studies of Japanese undergraduate students.^" It hasbeen used widely in japan and can be used for a general adultpopulation from its contents." The 40-statenient list wasdesigned to measure current multiple mood states. The scale has8 subscales with 5 items each, representing depression (anxiety),hostility, and boredom as negative moods; liveliness, well-being.and friendliness as positive moods; and concentration and star-tle as relatively neutral moods. Participants were asked to ratehow well the statements reflected tlie way they felt "right now"using a 4-point scale. Items such as "calm" or "fair" were ratedfrom 1 (I feel not at all) to 4 (I feel very much so), based on theparticipant's mood at the time of the test.

Shortened Form of Betts' Qiiestionaire on Mental imageryThe shortened lorm ot Betts' Questionaire on Mental

Imagery -̂ (QMI) is a 35-item questionnaire designed to measure theability to generate images using 7 modalities: visual, auditory, cuta-neous, kinestlietic. gustatory, olfactory, and organic. In this study,participants were instructed to rate how clearly each suggestedimage appeared to them on a scale of 1 (no image at all) to 7 (per-fectly clear). Higher scores indicate a greater ability to generatemental images. The correlation between the short form and theoriginal long fomi of the QMI is .92. The validity of the long formhas been demonstrated by high correlations between QMI scoresand actual ability to generate images in experimental settings." AJapanese version of the QMI was constructed," and 'Iabane's ver-sion was used in our study. Reliabilit)' and validity of this versionhave been demonstrated in populations of university students."The vividness of the imagery was measured using a visual analoguescale (VAS. 0-100 mm) to assess whether participants were able toremember imagery clearly, according to the instructions, during asession: participants rated image vividness along a 100-mm measur-ing stick, anchored at the left by a description of "no image at all."and at the right by a description of "perfectly clearly." Such VASquestions of vividness imagery were used on the Tobacco CravingQuestionnaire (TCQ). and the reliability and validity of the TCQand VAS have been verified." The questionnaire also asked aboutthe subject's age. gender, stress level, physical condition, exercisehabits, alcohol and smoking status, and behavioral style.

ProcedureWe took saliva samples to measure SC before the first session

(SC-A, 1 PM), after the fyst session (rest period; SC-B. 2:30 I'M), andafter the second session (SC-C, 4;30 PM). Subjects were also askedto complete the Multiple Mood Scale (MMS) questionnaire before

the first session and after the second session. The QMI was collect-ed once before the first session, and VAS vividness of imagery (VI)scores were collected once after the second session. The experi-mental procedure is summarized in Figure 1.

Statistical AnalysisDifferences in pre- and post-session scores were measured

using a paired ^test. Repeated measures analysis of variance(ANOVA) analyses were performed to test for changes in SC lev-els and to examine potential covariance factors related to chang-ing SC levels. Pearson correlation and a 1-way ANOVA examinedthe relationships between age and SC levels. QM! scores, and VIscores. These analyses were performed using the StatisticalPackage for the Social Sciences (SPSS) version 10] (Chicago. III).

RESULTS

PsychologicalPre- and post-session MMS scores are shown in Figure 2.

Initial scores indicating negative moods (depression, hostility,boredom;/ =-10.04. P< .001; / = -fi.793. P< .001; / =-8.504,P < .001, respectively) and neutral moods (startle and concentra-tion: t = -7.19, P < .001: / = -2.18, P = .031, respectively) decreasedsignificantly throughout the session. Conversely, initial scoresindicating positive moods (PO) (liveliness, well-being, friendliness;/ = 6.807, P < .001; / = 5.816, P < .001; I = 4.627, P < .001, respec-tively), increased significantly throughout the session. AverageQMI score measured before the first session was 183.13 ± 3.08.

Before sessions

After sessions

X +X

X

Mood

Mt'an ± SD for each mood.Paired /-test to evaluate Multiple Mood Scale scores before and after sessions.'/'<.0.'i; t / '<.oi; ¥<.nOl

FIGURE 2 Comparison of Multiple Mood Scale Scores From Before

and After Sessimis

EfFects of Guided Imagery in a Healthy Community Sample AITERNATIVE THFRAPICS, MAR/APR 2006. VOf. 12. NO. 2 63

Salivary CortisolRepeated measures ANOVA analyses revealed significant

decreases in levels of SGA, SC-B. and SC-C (F = 12.378, P <.001). A repeated measures analysis of covariance (ANCOVA)with 3-point SC levels as a covariate was conducted to examinerelationships among individual difference faciors.

Age, gender, height, weight, smoking, drinking, hungertime, liealtli status, stress status, change.s in MMS positivescores, changes in negative scores. VI scores, and QMI scoreswere examined as covariates in the repeated measures analysis.In a repeated measures ANCOVA, age and QMI scores as covari-ates were associated with changes in 3-poiiit SC levels (age; 1 -5.828, P = .003, QMI; F = 3.632, P = .028, respectively).

The results showed that age was strongly related tochanges in SC levels. Because previous studies have shown thatSC levels differ according to both age and gender, we examinedthe effect of the relaxation program as a function of hoth ageand gender.

Participants were sorted by age, and a 1-way ANOVA wasperformed for SC levels and changes. The SC-level changes byage are displayed in Figure 3; SC levels measured at 1 PM (SC-A), 2:30 PM (SC-B), and 4:30 PM (SC-C) differed significantlyaccording to age (F = 4.853, P < .001; F = 8.007. P < .001; F =4.132, P = .003, respectively). The mean levels of SC-A, SC-B,and SC-C were highest in the over-60 age group. The mean levelof SC-A was higher in participants under 30 years of age than inparticipants in the 3 age groups between 30 and 59 years ofage. In the under-30, 30-39, and 40-49 age groups, SC levelsdecreased continually through the first and second sessions, inthe order of under-30. 30-39, and 40-49 age groups. In theolder age groups (the 50-59 and over-60 age groups), SC levelsincreased through the first .session and decreased through thesecond session. There were no differences in SC levels betweenmales and females.

1.2 J

1 •

• SC-A(lPM)

nSC-B (2:30 PM)

• SC-C ( 4 : 3 0 PM)

<29(n=26)

30-39 40-49 50-59(n=30) (n=22)

Participant age

AH(N=138)

Mt'aii ± Sn fur l̂i sessionsSC-,'\=Salivar) cortisol level belbre sessionsSC-B=Sali\ary l•orli^ol level between sessionsSC-C-Salivary cortisol level after sessions

FIGURE 3 Cliange in Salivary Cortisol Levels, by Age

Relationship of Salivary Cortisol and Betts' Questionaire onMental Imagery

QMI scores ofthe group in which SC levels increased werecompared with those ofthe group in which SC levels decreased,using the independent /-test procedure. The QMI scores ofthe "SCiticreascd group" were significantly lower than those ofthe "SCdecreased group" (/ = -2.218, P = .028).

SC levels and imagery measures for males and females wereexamined using independent /-tests. SC levels and changesshowed no significant differences between genders. VI scoreswere significantly higher among females than among males(/^-2.392,/'=.019).

Participants were divided into 3 age groups based on differ-ences in the SC change pattern. In the under-30 age group (n = 26),CS levels decreased sharply and continually in the first and secondsessions; in the 30-49 age group (n = 80), SC levels decreased slow-ly and continually in the first and second sessions; and among sub-jects older than 50 (n = 29), SC levels increased in the first sessionand decreased in the second session. The comparison of SC levelsand imagery measures hy age are presented in Tahle 1. QMI scoresand VI scores tended to increase as age increased.

In the 30-49 age group, QMI and SC changes in the first ses-sion and throughout hoth sessions were negatively correlated(r = -0.228. P = .043; r = -0.233, P = .041, respectively). There wasno correlation between QMI and CMS in the under-30 and theover-50 age groups.

Discussion

This study investigated individual differences with respect torelaxation induced by guided imagery in healthy community sam-ples. Relaxation sessions were found to significantly increase posi-tive mood scores and to decrease negative mood scores asmeasured by the MMS. SC levels were significantly decreased afterthe first session and after the second session in all participants.McKinney et al reported that guided imagery might positivelyaffect mood and reduce SC levels in healthy adults, and the presentstudy supports those results.'' We found, most significantly, thatage and QMI scores were strongly related to changes in SC levelthroughout the relaxation sessions.

We noted first the factor of age, as reflected in the SC 3-pointchange pattern. Figure 3 indicates the following as a function ofchange in the pattern of SC. From the age group ofthe 20s and up,the SC level was lower before the sessions, but the SC baseline wasinitially high and increased rapidly in participants who were aged()() years and older. In the 20s, 30s, and 40s age groups, SC levelsdropped continually during the first and second sessions, as com-pared to the younger age groups, in which SC levels dropped morerapidly through the sessions. Conversely, in the 50s and 60s agegroups, SC levels increased during the first session, which consist-ed of stretching, but decreased during the second session, whichconsisted of guided imagery. SC 3-point levels in the 60s age groupwere extremely high compared to those in the younger age groups,and the SC4evel change from session to session was more abrupt.

Previous data indicated that baseline SC levels in healthy men

64 ALTERNATIVE THERAriES, MAR/AHR 2006. VOL. 12. NO. 2 Kffects of Guided Imagery in a Healthy rotiiinunity Sample

in the over-40 age group are significantly lower than those in theunder-40 age group. '̂' Our data support that trend; our study, how-ever, is the first to investigate specific cortisol responses to relax-ation training in different age and gender groups. We suspect thatSC levels decreased more rapidly throughout the sessions as afunction of decreasing age because SC secretion sensitivity maydecrease with age.̂ " In our study, however. SC levels decreased lessin the 50-59 age group in the first session, which consisted ofstretching; in fact, SC levels increased. It is likely that the stretch-ing performed in the first sessions led to exercise effects in the 50s-and fJOs-age groups, which appear to have heen temporarilygreater than the relaxation effects. An earlier study ofthe impact ofprogressive muscle relaxation as a result of brief exercise foundthat SC levels decreased significantly in young subjects betweenpre- and post-intervention." In contrast, a study examining theeffects of heavy resistance training indicated that exercise elevatedSC levels in the younger (under-30) and older (over-60) age groupsand that SC levels after training were significantly higher in theolder group than in the younger group.'''

In the 60s age group in the present study, the SC baselinelevel was extremely high, and SC levels changed more rapidly thanthey did in the 20s age group.

The study ofthe impact of age and gender on hypothalamic-pituitary-adrenal (HPA) axis responses to an acute stress taskfound that the SC baseline was high and that SC levels increasedgreatly, but that they decreased after stress in a group of older men(mean age 70), as compared to younger men (mean age 20), close-ly resembling the pattern of SC change ofthe 60-year-olds in thepresent study.

The fundamental cause of this change in SC levels accordingto age is probably an endocrine feedback mechanism. In the pre-sent experiments, we hypothesized that healthy aging disruptsthe adaptive SC response; we identified several strongly age-spe-cific contrasts in cortisol dynamics and inferred that healthyaging probably disrupts neuroendocrine mechanisms that coor-dinate the HPA axis. The majority of investigations suggest thatnegative glucocorticoid feedback is attenuated in human aging.'"*Although they are likely to produce equivalent psychologicaleffects in all age groups, the physiological reactions of stress hor-mones may differ hy age.

Based on age-related differences in SC levels, we examinedmoods and imagery measures in 3 age groups: under 30, 30-49,and over 50. The older the participant, the higher the MMSscores for positive mood and imagery, and the lower the MMSscores for negative mood (Table 1). This is consistent with previ-ous reports that age is related to positive effects in women,*" thatnegative effects are greater among younger adults,''" and that pos-itive and negative effects exhibit different patterns of change indifierent age groups.''

When age—the factor that most strongly influenced SC levelchange—was examined, the relationship between QMI as an indi-vidual difference factor and SC became clear. For the 30-49 agegroup, the QMI and SC changes in the first session and duringboth sessions were negatively correlated. In other words, the

greater a participant s imaging ability, the more the SC leveldecreased through guided-imagery relaxation. For all participants,the QMI scores ofthe group in which cortisol levels increased weresignificantly lower than those ofthe group in which cortisol levelsdecreased throughout the sessions.

We suggest that the comforting imagery remembered byparticipants throughout the sessions influenced the decrease inSC levels. Unpleasant information, a cause of mental stress, isreplaced hy a comforting image, and this replacement affects aparticipant's SC level. The greater the individual's imaging abili-ty, the more successful the displacement of stress and the shifttoward a comfortable mental and emotional state. The presentstudy provides a basis upon which to explain the mechanismthrough which relaxation by means of guided imagery is effectivein reducing stress.

Future studies are needed to evaluate the influence of individ-ual differences more precisely, including the ability to formimages, such as age. gender, lifestyle, and stress sensitivity, on thelong-term effects of relaxation. It is necessary to elucidate themechanism hy which imagery connects with physiological andpsychological parameters and influences the mind and f)ody. Thistechnique could have important implications for improving well-being and preventing illness in healthy but vulnerable individuals,such as the elderly. Application ofthe practice of relaxation usingguided imagery may prove useful.

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Resister now for Uie Inter in Winston-SHear new lectures by Peter Fraser and Harry Massey, creators of the NES-Professional™ and Infoceuticais, and talk to practitioners

from around the world. For more information on the conference, email office@nes-us.com or cail Linda @ 336 778 1950.

IS d S T r U C T U f G U G n c r y y TIGIO that is the master control system for the physical body. TheNES-Professionai is the most advanced health assessment device for the analysis of the "human body-fie!d." It represents a

radical re-visioning of how the body works and assesses physiologicai function along the energy spectrum, from phonons

(low-frequency sound) to photons (light), identifying distortions that could lead to health problems.

The NES-Professional:• Compares your client's field to the detailed "map" of the optimum quantum electrodynamic (QED) body-field. .

• Reveals the optimal sequence for healing and works with the body's own self-healing intelligence.'^

• Is the only system that directly corrects the underlying deviations in your client's body-field through

the use of NES Infoceuticais, which are imprinted with QED information to correct the distortions.

Healing at thespeed of light Integraiing biology

and physics ^

For nnore information, email office@nes-us.com, call Linda @ 336 778 1950 or visit www.nutrienergetlcs.com