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Jul 24, 2000
by Dorsey Griffith
Guided Imagery May Smooth Road To RecoveryAllen Hackett was feeling lousy. Hours earlier, surgeons had transplanted his son's healthy kidney into his abdomen. And now, when the patient needed to rest, nurses kept coming into his room, flipping on the lights, monitoring his fluids and drawing blood for tests.
That's when the 60-year-old Chico farmer closed his eyes and began to imagine a powerful green wave washing over him, clearing out the debris and taking it out with the tide -- just as he had been instructed in a guided imagery tape provided by his health plan.
The next morning, with his new kidney doing a respectable job of filtering impurities from his blood, Hackett's outlook brightened.
"I feel this is really going in the right direction," he said Thursday, sitting up to enjoy the British Open golf tournament from his bed at Sutter Memorial Hospital in Sacramento.
No one will ever know whether Hackett's positive, soothing thoughts eased him through his transplant surgery or if they are helping his body adjust to the new kidney he hopes will keep him healthy enough to operate his walnut orchard for years to come.
There are a lot of people who think it's a lot of nonsense.
"This is more marketing than it is science," snapped Dr. John Renner, president of the National Council for Reliable Health Information. "The proof of the pudding is not in yet."
But plenty of health providers, citing scientific research, are convinced that guided imagery gets results for patients -- which translates to savings for hospitals and health plans -- lending legitimacy to the alternative approach.
Blue Shield of California, for example, now offers free guided imagery recordings to its preferred provider organization members who have upcoming surgeries. Hackett was among the first to get them.
"We found of all the things we could do, guided imagery had the best clinical information behind it and was a nice complement to traditional therapy," said Dr. Jeff Rideout, the health plan's chief medical officer.
Hospitals, too, are riding the powerful green wave. Dr. Richard Miller, medical director of the Mercy Heart Institute at Sacramento's Mercy General Hospital, tested guided imagery on its heart surgery patients. He found that those open to the idea suffered less pain, stayed fewer days in the hospital and were more satisfied with their experience than their more dubious counterparts. Miller liked the results so much, he plans to introduce guided imagery tapes to about 30 percent of Institute heart surgery patients.
"In the past five years, guided imagery has gained quite a bit of popularity," said Nancy Harazduk, a clinical director at the Center for Mind-Body Medicine in Washington, D.C. "People are beginning to realize they have control over their physical and emotional health."
Although the term "guided imagery" was born in the modern era, guided imagery guru Bellruth Naparstek says the idea is as old as prayer.
"He maketh me to lie down in green pastures; he leadeth me beside the still waters," she said, quoting from the 23rd Psalm. "The idea of the Lord as a shepherd is a delicious piece of imagery."
But scientists are only beginning to fathom how imagination can help the body's organs to function, blood to circulate and cells to heal. Researchers in immunology, psychiatry and neurology are now probing that question.
What isn't disputed is that the mind and body do not operate in isolation. Why else would some people salivate when reading a delicious-sounding recipe or feel aroused when looking at sexual images, asked Naparstek, who practiced psychotherapy for 32 years before launching her successful guided imagery company, Health Journeys, 15 years ago.
"Your body doesn't quite know the difference between the images your mind is creating and actually being there," she said.
Naparstek believes the tapes take people beyond ordinary time and into a different state of consciousness, "to a place of love and power where they feel safe." It's there that healing or change can happen, she said. "It's a state of supremely focused attention. It allows us to pick up cues and become extremely perceptive."
Allen Hackett, whose mind is generally focused on irrigation, pesticides, pruning and harvesting, isn't sure about all that. But when a Blue Shield representative contacted him before his transplant, he agreed to try it.
Although fairly relaxed about his surgery, Hackett admitted he never wanted one of his children to sacrifice a kidney for his benefit. That sense of guilt can make living organ donation even more stressful than other types of surgeries, said Sutter transplant coordinator Kelly Guerrero. To cope with that, Sutter organ recipients are counseled and offered sedatives before surgery.
In the darkened living room at his Nutcracker Farm last Tuesday, Hackett settled into his favorite leather recliner and kicked off his sneakers. He closed his eyes to the sounds of relaxing New Age music and Naparstek's voice coaxing him to picture guardian angels watching over his body, the strong, new cells weaving together and warm sunlight soaring into tense, tight places and softening the discomfort.
"I think what it overcomes is the uncertainty, fear and anxiety," Hackett said later. "It puts you in a positive framework. You are more relaxed."
Hackett's son, David, his father's organ donor who was going under the knife for the first time, declined to try the tapes. The 33-year-old said he'd go into the surgery with the same blind faith he has when skiing down mountains after a heavy snowfall.
"I'm not going to prepare for it mentally," he said. "I'm just going to go in and do it." And unlike his dad, who declined a sedative, David Hackett accepted a dose of Valium to settle his nerves the night before surgery.
Which approach works better? Dr. Richard Ward, one of two surgeons who performed the transplant surgeries, said two days after the operations that both patients were doing great.
As far as guided imagery goes, "I don't know what it is," he said. "Clearly, people who are upbeat and think they are going to do well generally do better than people who are constantly victimized."
That is all guided imagery supporters can hope for, said Naparstek. "It doesn't require a full-fledged endorsement," she said. "If someone is willing to try it, that's OK with me."
Blue Shield's Rideout acknowledges that many doctors may be slow to embrace the approach and encourage patients to use it. To help them, Blue Shield sent a packet of research papers on guided imagery to 10,000 of its participating physicians in California.
Among them is a randomized study presented by the Cleveland Clinic in 1996 that found guided imagery significantly reduced anxiety, pain and need for painkillers in patients who had undergone colorectal surgery.
Another paper cited a 1986 study by former University of California, Davis, researcher Henry Bennett. The psychologist found that patients told before spinal surgery that it's important that blood moves away from the spine during the operation and that it returns to the spine after surgery experienced less blood loss than other surgery patients.
Still, critics are skeptical. Jamie Court, executive director of the Foundation for Taxpayer and Consumer Rights, said Blue Shield's guided imagery project seems to substitute frills for top-quality care.
"It fits the general trend of HMOs trying to create an illusion of safe care rather than put some money behind making that illusion a reality," he said.
Not that Court himself is opposed to alternative therapies. The prolific critic admits that to cope with the stress of running the watchdog organization, he has taken to practicing yoga.
GRAPHIC: Bee photograph/Lezlie Sterling Allen Hackett of Chico learned guided imagery to prepare for his kidney transplant surgery. Bee photographs/Lezlie Sterling Chico farmer Allen Hackett, above, relaxes using guided imagery. His son, David Hackett, at right, joins his father in the barn the day before donating a kidney to him. David says he did nothing special to prepare mentally for the surgery.
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