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 Guided Imagery: Personalized Therapy 
In developing an effective visualization, one must consider a number of qualities, especially a positive image. In Imagery of Cancer, Achterberg and Lawlis state: "The symbols of positive connotation are those representing strength and purity; powerful enough to subdue an enemy--pure enough to do so with justification. Such images are frequently knights or . . . Vikings-- heroes only slightly removed in time and place from the white knights. The knight is an archaic symbol from fairy tales in which most of us have a common exposure."

A second quality of the visualization that I have found to be essential is that it must be ego-syntonic; that is, it must conform with the person's deepest desires and values. An excellent illustration of this point comes from a young woman who consulted me when I was giving a lecture in Phoenix, Arizona. She had a cancer growing against her cervical spine, pressing against the spinal cord. This was causing gradual loss of the use of her arm and immobility of her head and neck. It was growing in spite of medical treatment and also in spite of a program of biofeedback and visualization which she was following faithfully and in which she had invested effort and positive expectation. She was following a sound nutritional plan, exercising, doing everything she could to increase her health. In spite of all these things, her condition had deteriorated to the point where her physician had told her that she should prepare a will and prepare for the care of her two young daughters. She had been given only a few months to live.

She told me that her visualization just didn't seem to be working, and she wasn't sure why. She was visualizing her cancer as a dragon and her immune system as white knights attacking the dragon, but the knights never really seemed to be effective.

I asked her to draw a picture of her imagery. She drew a picture of white knights and a dragon that seemed pretty ordinary to me, but when she looked at her own drawing, she gasped and said, "Oh, my God, that's my husband." Her eyes filled with tears, and she said, "I can't kill my husband."

Her story unfolded. She was separated from her husband, an alcoholic who abused her and her daughters when he was drunk. She had been forced to leave him. She believed that the strain, tension, and sorrow of this situation, as well as the ensuing loss of the relationship, were the precipitating causes of her cancer. In other words, she believed that her husband was the dragon on her back.

In this case, only a simple reframing of her visualization was necessary. When she said that she could not kill her husband, I responded that it was not her husband that she needed to be rid of but rather the qualities and events that had caused her pain. It was the drunkenness and the abuse that needed to be symbolically eliminated.

If by means of this imagery she could eliminate these qualities from her husband, he would not only be unharmed, but he would be better off. And she could at least get these painful occurrences off her back, since they were the dragons she needed to release. Her eyes lit up at this suggestion, and she exclaimed enthusiastically, "Oh, the abuse, I can really kill the abuse."

The next time I saw her was a year later when I ret turned to the same annual conference in Phoenix to present a workshop. She told me that with this new perspective on her visualization, she had been able to put everything she had into it, and soon her tumor began to melt away. She was now in complete remission. She told this story to the workshop attendees, adding much to their experience and helping to make this point memorable: the visualization must be something that you are willing to do.

There are frequent variations on this theme among patients, the most common being that if their white cells are good, they can't kill or do harm. Patients also frequently identify in some way with their cancerous cells. It is essential not to simply ignore such issues. The patient must be helped to resolve them in a satisfactory way.

Tommy is another champion. When Tommy and I began his psychophysiologic therapy, he was eleven and one half years old and had stage IVB Hodgkin's Disease. He had been diagnosed and staged the first time when he was nine years old. At that time Tommy's disease was IA, the least serious stage of Hodgkin's. As treatment progressed, Tommy's disease also progressed, to stage IVB. He had not responded to chemotherapy so far, and life was becoming pretty tough for him.

The time I first met him, Tommy had begun to try to solve his very great problems by setting fires and other acting-out behavior. He was referred by David Berland, M.D., a child psychiatrist who was seeing Tommy and his family for formal family therapy.

Tommy had already been through much agony, including laparectomies, radiation and chemotherapy, pneumonia, chicken pox, and shingles. He had also had his spleen and appendix removed. He hated needles and injections, of which he had a great many. Now he was contemplating another course of treatment, a "sandwich" of chemotherapy, radiation, and chemotherapy. He wasn't sure he wanted to go through with it all, and in some ways he wanted to "burn his world down" instead.

The week Tommy was referred to me, Garrett was on a panel with Dr. Jerry Jampolsky and children who had recovered or were recovering from cancer. Jerry talked about the Center for Attitudinal Healing telephone network, and Garrett also told about his own hotline in Topeka. When the program was over, I saw Tommy go up to the front and speak with Garrett for a few minutes, and I assumed that he was asking Garrett for the hotline telephone number. A couple of weeks later, I asked Garrett if Tommy had called him and he said no, that Tommy had asked him for his autograph! I thought this strange at first, but later I realized the significance of it. Tommy considered Garrett a role model.

From the very beginning, Tommy worked intensely on all of the self-regulation skills. Since he was going through so much when we started, the first thing I showed him was the breathing exercises, believing they would help him get through the initial rough times more quickly than anything else. The second time he came, he sat down in the chair and immediately began the deep, calm, slow breathing so effectively that it was clear he had been practicing and practicing. He attended to everything earnestly and with the greatest concentration and seriousness.

Like Garrett, Tommy had to come to grips with whether he wanted to live or die. For him, the struggle took place on a more symbolic level. He identified with his cancer cells and felt they were being "scapegoated" and were trying to protect themselves. The drawings he made during the course of his therapy, especially following visualization sessions, were very revealing and useful to both of us in uncovering a number of unconscious attitudes. At one point, he imaged his cancer cells as hiding behind a lead shield that had been made to protect his liver during radiation treatments. He said, "They are just trying to survive like everybody else."

Tommy now explains that his belief that the cancer cells were hiding was reinforced by the fact that the cancer had always come back or had never been completely eliminated in the previous treatments. Eventually, he was able to realize that his cancer cells were on a self-destructive course and could not survive no matter what; the only question was whether or not they would destroy Tommy in the process.

Tommy was as intent as he could be on getting well, and he faithfully followed all the instructions and guidelines. He learned to like salads, grains, and vegetables, and reduced his intake of meat, sugar, and fried foods. He became very good at the self-regulation skills and enjoyed working with the biofeedback equipment as a result of the control he could demonstrate. He used these skills in a number of ways: to relax, to enhance his performance in sports, and to enhance his visualizations. And as was the case with Garrett, his parents were very supportive of all the things he was doing to heal himself. Although there was much stress, Tommy and his family confronted problems with love and openness.

As treatment progressed, a number of experiences served to build Tommy's confidence. Although previously he had hated his treatments and often resisted the chemotherapy through fighting and fear, he now used his newfound relaxation and imagery skills to remain calm. He became a model patient and was very pleased that he could handle things so well. He visualized the treatment as "coming into the neighborhood of his body like the army or the national guard, ready to mop up all the trouble makers." He became a great deal more serene. Although he had missed a lot of school in the beginning of the year, he managed to get caught up with his work and was justifiably proud of that.

Things were going much better for Tommy by the time the radiation phase of his treatment was to begin. He was looking forward to it with happy anticipation. During the chemotherapy, he had been wearing a heparin lock (a small shunt inserted into his vein and taped securely, holding the vein open for the repeated injections he would need) and could hardly wait to have it removed. He was an active and macho kid, and he was anxious to play football and engage in the rough and tumble play of his age group without always having to be careful of the shunt in his forearm.

So he was extremely disappointed to be told that the radiation would make him quite sick, that he would vomit and have diarrhea, and that he should eat meat and cheese and avoid vegetables and fruit. His mother told me that he was very upset. I decided to call Carl Simonton to see what he might suggest.

Carl said that the reaction that had been described was at one end of a continuum of reactions to full-body radiation. Responses can range from almost no adverse reaction at all to the kind of reaction that had been described to Tommy. He suggested that since Tommy was good at self regulation, he could just observe his body objectively, like a scientist, to see what his own reaction would be. Then, if he wanted to modify his reactions, he could work on them like he was working on all the other things he had been doing. As for his diet, the foods suggested were binding and would help if he had a lot of diarrhea Otherwise, he could eat as he had been, and all the better for him.

Tommy was reassured to hear this and delighted to think that I had called Dr. Simonton on his behalf. These suggestions made sense to him because he had been able to tolerate the chemotherapy so much better this time, experiencing few adverse side effects. He knew that this was because of the control he was exercising within himself.

Before the radiation could be undertaken, a shield had to be made to protect his liver. When the shield was completed, there was a picture-taking session to assure that the liver was completely covered by the shield. Tommy thought that this process was actually his first radiation treatment. When it was finished, he told his Dad that it wasn't bad at all. His Dad replied that it was no wonder, since they were just taking pictures to be sure his liver was completely covered. About half an hour later, on the way home, Tom remarked to his father, "It's a good thing you told me they were only taking pictures, because otherwise I'd be getting sick about now." Then he smiled, chagrined, realizing the power of his mind in that a negative placebo was causing that queasy feeling until he remembered that he had not had radiation.

This was an important realization. After that, he sailed through the radiation with few adverse side effects. He did play football and other sports, and he did eat whatever he wanted to, including his good nutritional diet, without discomfort.

During the next phase of chemotherapy, he continued to do well and feel better. His imagery was becoming powerful, and his confidence was growing all the time. He was doing fine in school and at home, and he was doing very well with his self-regulation and his visualizations. He decided to visualize growing hair every day, and his hair began to get thick and curly again.

In May 1981, just before school let out, the course of treatment was completed, and he went to the hospital for re-staging. The plan had been to do another laparectomy, a procedure of opening an incision from collar bone to groin to visually inspect and biopsy the lymph nodes and other tissues on one side of the body. He had already had three of these procedures, which he called his zippers. This time, he did not want that test, and his parents backed him up. The medical team then decided that they might be able to do a needle biopsy of his liver, although he was much younger than patients usually considered suitable. He would need to be awake for the procedure and fully cooperative, holding his breath when told to do so, even though there would be some pain with the procedure. Tommy thought he could do it, and because he had been doing so well during his other treatments, the staff agreed.

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 About The Author
Patricia Norris PhDPatricia Norris is Director of Clinical Psychoneuroimmunology at Life Sciences Institute of Mind-Body Health, Inc., with 25 years work in psychophysiology psychotherapy......more
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