Mental Imagery May Hasten Recovery after Surgery

Guided imagination exercises help the body repair itself after surgery

By Tori Rodriguez


Mental imagery might help you “find a happy place” in more ways than one: it can actually hasten recovery from surgery, according to two recent studies.

In the first study, people who had undergone surgery to repair the anterior cruciate ligament of the knee (ACL) were randomly assigned to one of two groups. All participants received standard rehabilitation during the six months after surgery, but one group also practiced guided imagery while recovering. The imagery, which was conducted in sessions with a therapist and recorded for later listening, included mentally rehearsing physical therapy exercises and visualizing the physiological healing process specific to ACL surgery, such as scar tissue becoming flexible with gentle stretching. According to the results published in the December 2012 issue of the Scandinavian Journal of Medicine and Science in Sports, the group that practiced imagery showed greater improvements in knee stability and reduced levels of stress hormones. The study authors speculate that imagery may speed recovery by reducing stress, which has been shown to interfere with healing.

The other experiment focused on patients scheduled for gallbladder removal and was published in the February 2012 issue of Brain, Behavior, and Immunity. The patients were randomly assigned to either a group receiving only standard care or to one that also involved relaxation and guided imagery for three days before and seven days after surgery. “We used a relaxation intervention to try to reduce stress and therefore get a better inflammatory response to surgery and improve healing,” says Elizabeth Broadbent, professor of medicine at the University of Auckland in New Zealand and co-author of the study. The first set of imagery exercises focused on being relaxed and ready for surgery, whereas the postsurgery imagery concentrated on the body’s healing process. For example, participants imagined oxygen and nutrients traveling to the surgical wound and helping the body knit the skin back together, easing discomfort and bringing soothing relief.

Compared with the control group, participants who practiced imagery reported a larger reduction in stress, and their wounds showed signs of greater collagen deposition and faster healing. Although it is not possible to determine how much the effects result from the imagery versus simply being relaxed, Broadbent says both factors probably worked together and that the imagery most likely enhanced the stress-reducing effects of the relaxation.

This article was originally published with the title Healing the Body with the Mind.


Top Secret to Performance: Mental Imagery

The other day I had a conversation with a gifted athlete who shared his frustration about his recent struggles with hitting the ball. Did he suddenly forget the basic techniques of hitting or had he lost some of his muscle strength or had he simply lost the ability to remain mentally focused? What was different from the early games of the season where performance was at its peak and his current performance late in the season?

The science around what makes for top performers centers on two key elements: mental visualization and self-talk. With any peak performance, mentally visualizing the task and turning up the volume on our positive self-talk is critical.

Our self-talk or what I refer to as the “noise in our head’ is always active. Sometimes we are able to focus on inspirational and positive thoughts but more often than not we hit the default button of negative dialog. We replay negative thoughts of fear, doubt and insecurity that serve to undermine our confidence and fuels our anxiety which subsequently interferes with performance. These thoughts can often occur as a running dialog even without our conscious awareness. Learning to listen to our internal dialog and replacing the thoughts with realistic and positive messages is the first step to realizing our greatest potential. The power of our thoughts guides our emotions which in turn influences our behavior and our performance.

Michael Jordan once admitted in an interview that he took great pride in identifying the mental weaknesses of his opponents and then would actively attempt to “get into their heads.” His negative voice would often become the negative self-talk of his opponents serving to undermine their confidence and ability to perform. Top performers are able to create such a strong, positive internal self-dialog that can withstand the “mental bullying’ of an opponent and the negative chatter of a crowd.

Top performers also have a short attention span for failure. While it is critical that peak performers mentally see where an error occurred, the focus needs to be short lived with a refocusing of the effort onto imagining the corrective action. Many successful coaches have shared that while it is important to give concrete advice to athletes on observed errors this needs to be short lived and followed by film highlights or mental imagery of the team and individual players at their peak performance. This focus on the positive skills and strengths is most effective at pulling a player and a team out of a slump. The last image or word that a player hears or sees before hitting the field is the one that will often guide performance.

As a health psychologist, I have observed the power of the mind to heal the body through its influence on the immune system, to control pain and to override the negative effects of chemotherapy. Similarly, peak performances come from the mind’s ability to enhance physical talents and to override outside influences that undermine performance. Peak performers not only have physical or mental talents but know how to use the power of the mind to enhance those skills and thereby create a winning combination.

The key to a top performance is practicing in the mind or what is often referred to as mental visualization. Visualization is a vital component of managing performance anxiety and distractions that can cause an athlete to over think a play or lose focus. Research has demonstrated that the same pattern of electrical changes in the brain occur whether an athlete is actually performing a physical task or simply imagining it. The brain interprets both the visualization and the physical performance the same.

Consider that when a player actually performs an act like hitting or catching a ball, the brain sends signals from the primary motor cortex of the brain to the secondary cortex and then down the spinal cord to send signals to the muscles. When visualization is used, the same signal starts in the primary motor cortex then to the secondary motor cortex but instead of sending the signal to the muscles it transfers it the frontal lobe where a mental memory is created.

The power of mental imagery is that a player can create a vivid image that not only includes the mechanics of the task but also the emotions that go with it. That is, every player knows that there will be anxiety, nervousness and aggression during a performance, imagery gives them the power to feel it but to overcome and manage it. The more vivid and realistic the imagery is to the actual game day performance the more powerful the control.

The saying, “it is all in your head” is particularly true when we are taking about athletic performance. To compete or be at ones best requires the ability to quiet the conversational areas of the brain and “turn on” the mental images in the brain related to performance.

Become your own best performer by learning to harness the power of the mind.