Grape Seed Extract

Grape Seed

Grape seed extract is the primary commercial source of a group of powerful antioxidants known as oligomeric proanthocyanidins (OPCs), also generically called pycnogenol, a class of flavonoids. Laboratory studies have indicated OPCs are much more effective than vitamin C and vitamin E in neutralizing free oxygen radicals, which contribute to organ degeneration and aging in humans.

The primary sources of OPCs are pine bark extract and grape seed extract. However, the grape seed extract is more widely recommended for its lower cost and because it contains an antioxidant not found in pine bark.

General use

Grape seed extract is a mixture of complex compounds. It has a wide range of therapeutic uses, from preventing cancer and cardiovascular disease to alleviating symptoms of allergies, ulcers, and cataracts. Its antioxidant properties are believed to help slow the aging process.

Procyanidins, a group of compounds found in the extract, are thought to increase the effectiveness of other antioxidants, especially vitamin C and vitamin E, by helping them regenerate after neutralizing free radicals in the blood and tissue. OPCs in the extract are water-soluble, making them easily absorbed by the body.

They also are able to cross the stubborn blood-brain barrier, providing antioxidant protection to the brain and nervous system. Most of the research on grape seed extract has been done in Europe, so many of its reported benefits have not been reviewed or approved by the U.S. Food and Drug Administration. It is available as an over-the-counter supplement.

According to Varro E. Tyler, dean emeritus of the Purdue University School of Pharmacy and Pharmacal Sciences, the procyanidin compounds found in grape seed extract are useful in treating vascular disorders They also are antioxidants, or freeradical scavengers, that help prevent some age-related cancers and atherosclerosis.

Grape seed extract is a relatively new supplement in the United States, although it has been used in Europe for several decades. Its antioxidant properties were realized in the 1980s with the socalled French paradox, in which researchers discovered that the French had low rates of heart disease even though their diet was high in cholesterol.

This was credited to their widespread consumption of red wine. Further research led to the OPCs concentrated in grape seeds. More recent research suggests that grape seed extract may work at the genetic level, activating a gene that stops oxidation of bad cholesterol. A 2003 study found that grape seed extract worked well in replacing estrogen and blunting hypertension in postmenopausal women.

Cardiovascular disease

European studies have shown procyanidins to be useful in treating blood vessel disorders, such as fragile capillaries and poor circulation in the veins. Components bind to the walls of the capillaries, making them less likely to break down with the effects of aging. In one European study, researchers found that treatment with grape seed extract quickly relieved a chronic condition of poor circulation in the veins.

Grape seed extract also has been beneficial in treating edema, an excessive accumulation of fluid in tissue. Another use of grape seed extract is reducing blood pressure in people with hypertension. A study published in 1998 by cardiovascular researchers at the University of California, Davis, found that flavonoids in the extract helped increase flow in blood vessels, contributing to better regulation of blood pressure.


A study published in 1998 by a team of researchers at Creighton University, Georgetown University Medical Center, and the University of Nebraska at Omaha, reported that grape seed extract significantly inhibited and sometimes killed human cancer cells, while promoting the growth of normal healthy cells.

The extract was effective in killing 34–48% of breast, lung, and stomach cancer cells. It was not effective in destroying leukemia cells. Other studies have shown grape seed extract, combined with other antioxidants, can reduce the overall risk of developing cancer.

Respiratory conditions

Grape seed extract has been found to be beneficial in treating several respiratory conditions, including asthma, emphysema, allergies, and sinusitis. Pycnogenol helps inhibit the production of histamines, which decreases sensitivity to pollens and food allergens, thereby reducing allergic reactions.

Other conditions

OPCs in grape seed extract have shown effectiveness in treating a variety of other conditions. As an antiinflammatory, it helps prevent swelling of joints, heals damaged tissue, and eases pain in people with arthritis. Studies have shown OPCs can stop cataract progression, treat and prevent glaucoma, and aid in treating several types of retinal disease.

One of the extract’s most popular uses is in treating the effects of aging, including preventing wrinkles by protecting the skin against ultraviolet radiation damage from sunburn, improving skin elasticity and tone, and helping reduce the appearance of scars and stretch marks. A wide range of anecdotal reports tell of grape seed extract helping treat or reduce the effects of headaches, hemorrhoids, diabetes, prostate enlargement, and cellulite, although no clinical research supports these claims.


Grape seed extract generally is available in 50 mg (milligram) and 100 mg capsules. The acceptable adult daily dosage has been estimated at up to 150-200 mg, or 50 mg per 50 lb (22.7 kg) of body weight. In Europe, OPCs usually are prescribed at 300 mg a day to treat medical conditions such as varicose veins, edema, allergies, inflammation, and skin aging.

The extract contains varying amounts of proanthocyanics, although the label should indicate about 75–80% proanthocyanidins to be effective. Research in the United States and Europe has shown it is most effective when used in combination with other antioxidants, especially vitamin C and vitamin E. Grape seed extract is fully absorbed by the body within one hour after consumption. One-half the original dose is still functional within the body after seven hours.

In 2003, a liquid grape seed extract was made available in the United States. This version can be used in a number of beverages, including bottled water, without changing their taste. A 2003 trial at Ohio State University found that lotions made with grape seed extract helped cuts heal more quickly than they would on their own. The lotion helped improve blood flow to the wound site.


There are no known precautions associated with grape seed extract. However, persons with serious conditions such as cancer, diabetes, and cardiovascular disease should not substitute grape seed extract for their existing treatments without first consulting with their doctor. There is no clinical evidence that grape seed extract can cure any of these conditions.

Since grape seed extract is water-soluble, any excess intake that is not used by the body is eliminated in the urine. Studies have shown it is not carcinogenic, does not cause birth defects, and does not cause cells to mutate. Pregnant women and those with autoimmune conditions should probably avoid grape seed extracts. It is best to check with a clinician to ensure the safest dosage is being taken, as reports may vary on the latest research.

Side effects

Nausea and upset stomach have been reported on occasion. More rarely, allergic reactions in the form of temporary skin rashes have occurred in persons sensitive to grape products. There are no reported serious side effects associated with taking grape seed extract. It is non-toxic, even at high dosages.


There are no reported negative interactions associated with grape seed extract. However, several studies done in the United States and Europe show the extract has a positive reaction with vitamin C and vitamin E. Studies have shown that OPCs in grape seed extract are as much as 50 times more potent than those in vitamin E and up to 20 times more potent than OPCs in vitamin C.

Grape Skin

Grape Skin

Grape skin, the outer layer of the grape (Vitisvinifera), is either green, red, or purplish-black in color. The skin, stem, seeds, and juice of the grape are used in making wine. Although the skin, stem, and seeds are often used in making the nutritional supplement, grape skin extract, the extract sometimes contains grape skin only. Generally, the skin of red grapes is used in making nutritional supplements.


In 1535, sailors on Jacques Cartier’s expedition to Canada became seriously ill with scurvy, a vitamin deficiency. This degenerative disease of connective tissues was caused by the lack of vitamins in the typical seafarer’s diet—a menu of dried meat and biscuits. The crew was saved by the advice of a Native American, who recommended drinking tea made from the bark of a particular species of pine tree. In the 1930s, researchers discovered that the ascorbic acid (vitamin C) in fruits and vegetables prevented scurvy.

The pine extract, however, contained very little vitamin C. For more than 50 years, European biochemists have been researching the seafarers’ more likely rescuer— a family of antioxidant polyphenols (acid compounds) called pycnogenols, whose primary active compounds are pigments called oligomeric proanthocyanidins (OPCs). French chemist Jack Masquelier isolated OPCs from peanut skins in 1947 and coined the term “pycnogenols” to describe the unique class of polyphenols to which OPCs belong.

Although people have been drinking wine for centuries, scientific research into the health benefits of products derived from red grapes began in Europe in the mid to late twentieth century. Supplemental OPCs have been used in Europe since 1950 to treat weak blood capillaries, postsurgical edema (swelling), cirrhosis (liver disease), varicose veins, and diabetic retinopathy (eye disease resulting from diabetes).

Early identification of OPCs as useful for treating capillary fragility gave researchers some indication of their potential value in connective tissue disorders. However, this limited focus tended to overlook the additional therapeutic possibilities of OPCs and, until the latter part of the twentieth century, distracted scientists from investigating broader uses for OPCs.

Aside from pine bark, OPCs are concentrated in grape seeds and skins, wine, green and black teas, beans, and the skins of many fruits. Generally, the more intense the color, the more OPCs in the food, which explains why red wine has a greater health benefit than white wine. When red wine is made, the “must” is used—the skins, seeds, and stems.

The must is left in the mixture for a long period of time as the wine ferments and the OPCs emerge, giving red wine its characteristic flavor and color. In the case of white wine, however, the must is taken out early, so the wine neither darkens nor absorbs as many OPCs. Grape juice also contains OPCs. However, researchers have found that grape juice may not confer the same health benefits as red wine.

Biologic components

Red grape skins contain an array of bioflavonoids (quercetin, catechins, flavonols, and anthocyanidins) and nonbioflavonoid polyphenols (acid derivatives). One important nonbioflavonoid in grape skin is called resveratrol. Resveratrol is a plant-specific enzyme that exists in 72 plant species, such as grapes, peanuts, and pine trees. Grapes are the most abundant source of this health-promoting enzyme.

Resveratrol’s presence in the plant is induced by stress, injury, infection or ultraviolet irradiation. It is thought that the injury to the grape skin, produced during the wine-making process, significantly increases resveratrol levels. The relatively high quantities of the enzyme in the grape skins are thought to help the plant resist fungal infections, diseases, adverse weather, and insect or animal attack.

General use

There are many possible therapeutic applications of the resveratrol in red grape skin. In clinical studies, resveratrol demonstrated equivalent or better anti-inflammatory effects compared to the well-established anti-inflammatory drugs phenylbutazone and indomethacin. In animal studies, resveratrol inhibited both the acute and chronic phases of inflammation.

In humans, some researchers have found that resveratrol thins the blood more effectively than aspirin, which is often used to decrease the risk of a heart attack. In fact, the phrase “French paradox” refers to the idea that although French men consume a high-fat diet, they have one-third as many heart attacks as American men. Moreover, French men have high cholesterol and blood pressure levels similar to their American counterparts. Researchers have discovered that the main reason for this phenomenon is the OPCs from the grape skin, not the alcohol content, in the red wine that the French drink.

Preliminary tests in animals also indicate that resveratrol may interfere with the development of cancer in three ways: by blocking the action of cancer-causing agents, by inhibiting the development and growth of tumors, and by causing precancerous cells to revert to normal.

Although researchers are uncertain about how much resveratrol is needed to produce beneficial effects in humans, supplementation with red grape skin extract or consuming a glass or two of red wine may prevent or alleviate the following conditions:
  • aging 
  • bruising (capillary fragility) 
  • cancer (cancer-inhibiting effects) 
  • diabetes 
  • fungal infection 
  • heart disease (hardening of the arteries and high cholesterol) 
  • inflammation (including bursitis and tendonitis) 
  • Raynaud’s syndrome (a blood vessel disorder) 
  • varicose veins 
  • vision problems (including cataracts and glaucoma) 
  • wound healing


Red grape skin extract is prepared in capsule form as a nutritional supplement. For adult maintenance, the therapeutic range is thought to be 200–600 mg at 30% anthocyanins (OPCs), although guidelines have not been definitively established.

The resveratrol found in red grape skin and its extract is also found in red wine and concord grape juice. However, grape juice has been found to have fewer benefits than red wine, due to the technique for processing the grapes. For example, grape juice has only one-third the anti-clotting properties of red wine.


Although research is limited, scientific investigators have not issued any precautions regarding the use of grape skin or grape skin extract. However, people should be aware of the known side effects of red wine and resveratrol.

Side effects

There are many potential side effects to consuming excessive quantities of red wine (such as allergic reactions to sulfites, intoxication, and liver damage) in order to obtain the health benefits of resveratrol. Each individual must weigh the risks versus the benefits of consuming alcohol.

However, resveratrol itself is also a phytoestrogen (plant estrogen). The estrogenic properties of this chemical may play a role in the beneficial cardiovascular effects in red wine. These positive effects include increasing high-density lipoprotein (HDL), the “good cholesterol.”

On the other hand, it has been noted that drinking red wine may support the proliferation of certain breast cancer cells that require estrogen for growth. Thus, resveratrol may have undesirable side effects in some people, including those women with a history of breast cancer or postmenopausal women taking hormone replacement therapy.


Scientific investigation on the interactions of grape skin or grape skin extract with drugs, foods, or diseases is very limited and inconclusive. However, if the resveratrol in grape skin is consumed in red wine, a wide range of adverse interactions with drugs and foods may result. It is advisable to consult a physician before consuming alcohol in combination with any type of prescription or over-the-counter medication.

Green tea

Green tea

Green tea is produced from the leaves of the Camellia sinensis, or tea plant. Oolong and black tea are also produced from the plant, but are processed and oxidized in different manners. Of the three, green tea contains the highest levels of polyphenols, the antioxidant substance that is believed to be beneficial in protecting against both cancer and atherosclerosis.

The tea plant is actually a variation of evergreen bush, with glossy green leaves and small white to pink flowers. The plants can reach a height of 30–40 ft (9–12 m) or taller in the wild, but are generally kept to a height of 6 ft (1.2 m) or less on the tea plantations and gardens where they are grown in China, Argentina, Japan, India, Indonesia, Kenya, Malawi, Sri Lanka, Turkey, Pakistan, Bangladesh, and Tanzania. Tea plants are cultivated in countries where warm, rainy growing conditions are abundant, and are also frequently grown in high altitude areas.

When tea plants reach maturity at three or four years of age, the young leaves and leaf buds—the parts of the plant highest in polyphenols—are harvested. Green tea is produced by steaming or roasting the leaves as soon as they are picked, and then rolling and drying the tea leaves to remove any moisture.

Approximately 2.5 million tons of tea are grown and produced worldwide on an annual basis. Written records date the use of the plant as a beverage since at least the tenth century B.C. in China, and it is thought to be close to 5,000 years old. Tea is the most consumed beverage worldwide (after water). It is also one of the most popular herbal infusions in existence—drunk regularly by over half the world population.

The polyphenols in green tea that act as antioxidants may actually inhibit the growth of existing cancer cells. In some animal studies, injections of tea extracts reduced the size of cancerous tumors in animals. The active agent that is thought to have this effect is an antioxidant, epigallocatechin-3-gallate (EGCG).

Recent clinical studies have also indicated that regular use of green tea may reduce the risk of certain types of cancer, including oral, skin, prostate, colon, stomach, and rectal. In one clinical trial, patients with pre-cancerous mouth lesions who were treated with green and black tea extracts achieved a 38% decrease in the number of pre-cancerous cells. Late in 2001, researchers acknowledged one reason for green tea’s anticancer effect, but further human studies are needed to clearly define its role in cancer prevention.

The antioxidants in green tea may also be helpful in lowering cholesterol and preventing hardening of the arteries and ischemic heart disease. Low flavonoid intake has been linked to atherosclerosis in several studies. The data from one 1999 study, which followed more than 3,400 tea-drinking residents of Rotterdam, the Netherlands, concluded that regular, long-term tea consumption can have a protective effect against severe atherosclerosis.

Tea plantation
Tea leaves

Another preliminary study published in 1999 in the American Journal of Clinical Nutrition found that green tea extract may increase energy levels and promote fat oxidation, and consequently, may be a useful tool in weight control. A recent study, reported on in early 2002, showed that topically applied green tea extracts can reduce harmful effects of radiation from the sun. Further study might show that green tea polyphenol applications can help prevent sunburns.

In addition to polyphenols, green tea contains several minerals, including fluoride and aluminum. The fluoride in green tea may be useful in fighting tooth decay. Green tea is also an antibacterial agent, and can help to prevent gingivitis and periodontal disease by killing E. coli and streptococcus bacteria. This antibacterial action can also be effective in treating halitosis, or bad breath, by killing odor-causing bacteria.

As an herbal remedy, green tea is often recommended to ease stomach discomfort, vomiting, and to stop diarrhea. The antibacterial action of tea is useful in treating infections and wounds.


Green tea leaves and tea bags can be purchased at most grocery, drug, and health food stores. It is graded by leaf size, with tea containing whole leaves and leaf tips considered the highest quality tea. Tea grades include Broken Orange, Pekoe, Broken Pekoe Souchong, Broken Orange Pekoe, Fannings, and Dust.

Although green tea is grown from a single plant, slight variations in tea processing (usually in the way the tea is rolled) have created a number of varieties of green tea. Popular green tea varieties include Gunpowder, Hyson, Dragonwell, Sencha, and Matcha.

Tea leaves should be kept in an air-tight container to retain flavor and prevent odors and moisture from being absorbed by the tea. It should also be stored in a cool place for no longer than six months before use.

The most common method of preparing green tea is as an infusion. The tea is mixed with boiling water, steeped for several minutes, and then strained or removed from the infusion before drinking. Approximately two teaspoons of loose tea, or a single tea bag, should be used for each cup of boiling water. A strainer, tea ball, or infuser can be used to immerse loose tea in the boiling water before steeping and separating it.

A second method of infusion is to mix loose tea with cold water first, bring the mixture to a boil in a pan or teapot, and then separate the tea from the infusion with a strainer before drinking.

Flavonoids—polyphenols with antioxidative properties— are released into the infusion as the tea steeps. The longer the steeping time, the more flavonoids are released by the tea leaves, although most will infuse into the water during the first five minutes of brewing. Longer steeping time also results in a higher caffeine content in the brewed tea.

Green tea leaves can be used in a poultice for treating insect bites and other skin irritations. Green tea leaves are chopped and boiled in water for two to three minutes. After the excess water is squeezed from the leaves, the green tea is applied to the area to be treated and wrapped in a bandage. Green tea also makes an effective astringent, and tea-soaked cloth or tea leaf poultice may help renew tired and puffy eyes.

The antibacterial activity of green tea also makes it appropriate for use in compresses for cuts and abrasions. A quick compress can be made by soaking a pad or bandage in hot tea, wringing out the excess fluid, and holding the pad firmly against the wound. Once the compress cools, the process can be repeated.


The U.S. Food and Drug Administration (FDA) includes tea on their list of “Generally Recognized As Safe” substances. However, pregnant women and women who breast feed should consider limiting their intake of green tea because of its caffeine content. Tea can pass into breast milk and cause sleep disorders in nursing infants. Decaffeinated green tea is available that contains only trace amounts (5 mg or less) of caffeine. Women should check with their healthcare professional about drinking tea when pregnant or nursing.

Tea can stimulate the production of gastric acid, and individuals with ulcers may want to avoid drinking green tea for this reason. Those taking warfarin or any bloodthinning drugs should first consult with the physicians before consuming green tea, as it may counter the effects of the drug.

Side effects

Green tea contains caffeine, a central nervous system (CNS) stimulant that can cause restlessness, irritability, difficulty sleeping, tremor, heart palpitations, loss of appetite, and upset stomach. To avoid side effects, caffeine intake should be limited to 300 mg or less a day (the equivalent of 4–8 cups of brewed hot tea). Caffeinefree green tea preparations are available commercially.

The tannin in tea can cause nausea when drunk on an empty stomach and inhibit the absorption of nonheme iron. Individuals with iron-deficiency anemia who take iron supplements should avoid drinking green tea several hours before and after taking supplements. Iron absorption with tea can be increased by consuming foods rich in vitamin C with tea, such as a slice of lemon.



The mukul myrrh tree, or Commiphora mukul, is small, thorny, and usually devoid of foliage. It grows naturally throughout India and Arabia. Guggul is the gum resin that comes from this tree, which belongs to the same genus as myrrh and has some similar components and actions. Guggul resin contains steroids, diterpenoids, alipathic esters, and carbohydrates. These factors appear to work together to exert the beneficial effects of this botanical.

Guggul has been traditionally used in Ayurvedic medicine to treat arthritis, inflammation, bone fractures, overweight, and disorders of lipid metabolism. One ancient Ayurvedic reference describes the power of guggul to treat “coating and obstruction of channels.” This description stimulated further research into the properties of this botanical medicine for preventing and treating atherosclerosis, as well as other conditions resulting from high levels of lipids in the body.

General use

Guggul has been recommended for the treatment of arthritis, hypercholesterolemia, nodulocystic acne, and overweight. It is one of the primary therapeutic substances used in Ayurvedic medicine to prevent atherosclerosis, as well as one of the most promising herbs or supplements for the prevention and treatment of this condition. Studies in animals have documented not only the protective effects of guggul against atherosclerosis, but have shown actual regression of the condition in animals that already had it.

The active portion of the plant is the gum resin, which contains guggulsterone, a steroid compound. It appears to be effective in lowering blood levels of both total cholesterol and low-density lipoprotein (LDL) cholesterol. In trials lasting one to three months, cholesterol levels were reduced by 14–27% and triglycerides by 22–30%. These results are equal to or better than those of some conventional medications used to lower cholesterol, but with fewer side effects.

There are several hypotheses to account for the effectiveness of guggul in decreasing serum lipids. It may decrease the production of cholesterol in the liver. Excretion of cholesterol and bile acids are increased, so that less fat and cholesterol are absorbed. Guggul also increases the production of thyroid hormones, which lower the levels of serum lipids. The lowering of serum lipids is what consequently decreases the risk of atherosclerosis.

One of the most important ways that gugulipid lowers cholesterol may be by stimulating the liver to remove LDLs from the bloodstream. The effect on high-density lipoprotein (HDL) cholesterol is undetermined, as two studies yielded different conclusions. To lower cholesterol, one recommended dose of gugulipid is 100–500 mg taken daily. This dosage contains 25 mg of guggulsterone. It may take a month or so for the full effect to be experienced. Similar doses of gugulipid are used to promote weight loss.

The thyroid gland is stimulated by guggulsterone. This effect may play a role both in the ability of the substance to decrease cholesterol levels and to promote weight loss by increasing the body’s rate of metabolism.

Commiphora mukul
Commiphora mukul / Guggul plant

Guggulsterone has significant anti-inflammatory properties, although they are somewhat overshadowed by its effects on lipid metabolism. This finding supports its traditional use in the treatment of rheumatoid arthritis and other inflammatory conditions. Studies have shown guggulsterone to be at least as effective as the conventional medications phenylbutazone and ibuprofen (Advil, Motrin) for both acute and chronic types of inflammation in animal models.

Platelet stickiness appears to be reduced by guggul, which is desirable for decreasing the risk of coronary artery disease. Guggul may also promote fibrinolysis (dissolving the fibrin in blood clots) and act as an antioxidant. More research is warranted for these properties. They have potential benefits in the prevention of strokes and embolisms.

Studies have shown guggulsterone to have approximately the same effectiveness as the antibiotic tetracycline for the treatment of nodulocystic acne. It decreases inflammation and lowers the risk of recurrence of the condition. Guggul is also thought to have astringent, antiseptic, and antisuppurative (preventing pus formation) qualities that lend themselves to the treatment of this severe, and sometimes scarring, form of acne.


In India, guggul has been a standard and approved treatment for high cholesterol since 1986. Guggul is most often available in tablet or capsule form, as a purified extract. Formulations should have a standardized concentration of guggulsterone. Most extracts contain from 5–10% guggulsterone. It is readily available in the United States, but available only by prescription, if at all, in the United Kingdom.

Gugulipid is also a component of some combination nutritional products that are being promoted for the support of normal metabolism of cholesterol and triglycerides. Other components may include inositol hexaniacinate, chromium, and vitamin antioxidants.


Studies in both humans and animals have demonstrated a wide margin of safety and negligible toxicity for guggul, although some cases of liver toxicity have been reported for very high doses. Although it is apparently not toxic to the embryo or fetus either, guggul gum resin should not be used during pregnancy or lactation as it is thought to be a uterine stimulant.

Patients who are taking prescribed medications for heart disease should use caution in taking this herb.

Side effects

Crude extracts of guggul are more likely to produce side effects than purer products. In the past, effects included loss of appetite, abdominal pain, diarrhea, and rashes. In studies using purer extracts, significant adverse effects have not occurred. Headache and mild nausea are sometimes reported.


Guggul can be problematic for people being treated for thyroid conditions. Since guggul stimulates production of thyroid hormone, it may alter the dosage requirements for thyroid replacement medication. It can also reduce the availability and effectiveness of the heart medications propranolol (Inderal) and diltiazem (Cardizem). Patients should consult a health care practitioner before taking guggul along with any other herbs or medications.

Guided Imagery

Guided Imagery

Guided imagery is the use of relaxation and mental visualization to improve mood and/or physical wellbeing.


The connection between the mind and physical health has been well documented and extensively studied. Positive mental imagery can promote relaxation and reduce stress, improve mood, control high blood pressure, alleviate pain, boost the immune system, and lower cholesterol and blood sugar levels. Through guided imagery techniques, patients can learn to control functions normally controlled by the autonomic nervous system, such as heart rate, blood pressure, respiratory rate, and body temperature.

One of the biggest benefits of using guided imagery as a therapeutic tool is its availability. Imagery can be used virtually anywhere, anytime. It is also an equal opportunity therapy. Although some initial training in the technique may be required, guided imagery is accessible to virtually everyone regardless of economic status, education, or geographical location.

Guided imagery also gives individuals a sense of empowerment, or control. The technique is induced by a therapist who guides the patient. The resulting mental imagery used is solely a product of the individual’s imagination. Some individuals have difficulty imagining. They may not get actual clear images but perhaps vague feelings about the guided journey. However, these individuals’ brains and nervous systems responses seem to be the same as those with more detailed imaginings.

Patients who feel uncomfortable “opening up” in a traditional therapist-patient session may feel more at ease with a self-directed therapy like guided imagery.


Guided imagery is simply the use of one’s imagination to promote mental and physical health. It can be self-directed, where the individual puts himself into a relaxed state and creates his own images, or directed by others. When directed by others, an individual listens to a therapist, video, or audiotaped exercise that leads him through a relaxation and imagery exercise. Some therapists also use guided imagery in group settings.

Guided imagery is a two-part process. The first component involves reaching a state of deep relaxation through breathing and muscle relaxation techniques. During the relaxation phase, the person closes her eyes and focuses on the slow, in and out sensation of breathing. Or, she might focus on releasing the feelings of tension from her muscles, starting with the toes and working up to the top of the head. Relaxation tapes often feature soft music or tranquil, natural sounds such as rolling waves and chirping birds in order to promote feelings of relaxation.

Guided Imagery therapy

Once complete relaxation is achieved, the second component of the exercise is the imagery, or visualization, itself. There are a number of different types of guided imagery techniques, limited only by the imagination. Some commonly used types include relaxation imagery, healing imagery, pain control imagery, and mental rehearsal.

Relaxation imagery

Relaxation imagery involves conjuring up pleasant, relaxing images that rest the mind and body. These may be experiences that have already happened, or new situations.

Healing imagery

Patients coping with diseases and injuries can imagine cancer cells dying, wounds healing, and the body mending itself. Or, patients may picture themselves healthy, happy, and symptom-free. Another healing imagery technique is based on the idea of qi, or energy flow, an idea borrowed from traditional Chinese medicine. Chinese medicine practitioners believe that illness is the result of a blockage or slowing of energy flow in the body. Individuals may use guided imagery to imagine energy moving freely throughout the body as a metaphor for good health.

Pain control imagery

Individuals can control pain through several imagery techniques. One method is to produce a mental image of the pain and then transform that image into something less frightening and more manageable. Another is to imagine the pain disappearing, and the patient as completely pain-free. Or, one may imagine the pain as something over which he has complete control. For example, patients with back problems may imagine their pain as a high voltage electric current surging through their spine. As they use guided imagery techniques, they can picture themselves reaching for an electrical switch and turning down the power on the current to alleviate the pain.

Mental rehearsal

Mental rehearsal involves imagining a situation or scenario and its ideal outcome. It can be used to reduce anxiety about an upcoming situation, such as labor and delivery, surgery, or even a critical life event such as an important competition or a job interview. Individuals picture themselves going through each step of the anxiety- producing event and then successfully completing it.


For a successful guided imagery session, individuals should select a quiet, relaxing location where there is a comfortable place to sit or recline. If the guided imagery session is to be prompted with an audiotape or videotape, a stereo, VCR, or portable tape player should be available. Some people find that quiet background music improves their imagery sessions.

The session, which can last anywhere from a few minutes to an hour, should be uninterrupted. Taking the phone off the hook and asking family members for solitude can ensure a more successful and relaxing session.

Imagery combined with other relaxation techniques such as yoga, massage, or aromatherapy can greatly enhance the effects of these therapies. It can be done virtually anywhere.


Because of the state of extreme relaxation involved in guided imagery, individuals should never attempt to use guided imagery while driving or operating heavy machinery.

Side effects

Guided imagery can induce sleepiness, and some individuals may fall asleep during a session. Other than this, there are no known adverse side effects to guided imagery.

Research & general acceptance

Use of guided imagery is a widely accepted practice among mental healthcare providers and is gaining acceptance as a powerful pain control tool across a number of medical disciplines. Results of a study conducted at The Cleveland Clinic Foundation and published in 1999 found that cardiac surgery patients who used a guided imagery tape prior to surgery experienced less pain and anxiety. These patients also left the hospital earlier following surgery than patients who used pain medication only.

Another study conducted by Harvard Medical School researchers found that for more than 200 patients undergoing invasive vascular or renal surgery, guided imagery controlled pain and anxiety more effectively than medication alone.

Training & certification

Guided imagery is used by many licensed therapists, counselors, psychologists, and psychiatrists. There are many self-help books, audiotapes, and videos available that offer instruction in guided imagery techniques.