This blog describes a structured imagery that evokes past memories of joy and health and integrates them into a relaxation practice to support healing. First, a look at the logic for the practice and then the process of creating your own personal imagery script. A sample audio file is included as a model for creating your MP3 file. The blog is adapted from Peper, E., Gibney, K.H. & Holt. C. (2002). Make Health Happen: Training Yourself to Create Wellness. Dubuque, IA: Kendall-Hunt.
“I enjoyed regressing back into my childhood, remembered playing in the rain, making paper sailboats with my brother…. Placing my fingers in a bowl of water and stroking a paper sailboat enabled me to participate in the total experience… I felt tingling sensations all over my body, like tiny bundles of energy exploding inside of me. By the end of the week the simple word “rain” could induce these sensations inside my whole being.”–Student
Daydreaming! We all know how to do it. When we daydream, we feel, sense, hear, and taste our daydream—the image becomes tangible, as if we are living it. A well-developed relaxation image can also include colors, scents, sounds, flavors, temperature, and so forth. Evoking a past memory image of wholeness may contribute significant to healing, as illustrated in Pavlov’s experience with controlled conditioning and with self-healing.
THE POWER OF CONDITIONING
Most of us are probably familiar with the classical conditioning experiment of the famous Russian physiologist, Ivan Pavlov, who taught dogs to salivate on cue when they heard a bell ring—even when no food was provided. Pavlov accomplished this by giving the dogs food immediately after ringing a bell. Eventually, the dogs became conditioned to expect the food with the bell and simply hearing the bell ring would induce salivation (shown in Figure 1).
Figure 1. The process of classical conditioning. (Figure adapted from: https://opentextbc.ca/introductiontopsychology/chapter/7-1-learning-by-association-classical-conditioning/)
The conditioning effects of imagery can have an effect on health as well as physiology as reflected in an anecdote told by Theodore Melnechuk about Ivan Pavlov. As an old man, he became quite ill with heart disease and his doctors had no hope of curing him. They took his family aside and told them that the end was near. Pavlov himself, however, was not disheartened. He asked the nurse who was caring for him to bring him a bowl of warm water with a little dirt or mud in it. All day, as he lay in bed, he dabbled one hand in the water, with a dreamy, faraway look on his face. His family was quite sure that he had taken leave of his wits and would die soon. However, the next morning he announced that he felt fine, ate a large breakfast, and sat out in the sun awhile. By the end of the day, when the doctor came to check on him, there was no trace of the heart condition. When asked to explain what he had done, he said that he had reasoned that if he could recall a time when he was completely carefree and happy, it might have some healing benefit for him. As a young boy, he used to spend his summers playing with his friends in a shallow swimming hole in a nearby river. The memory of the warm, slightly muddy water was delightful to him. With his knowledge of the power of conditioned stimuli, he reasoned that having a physical reminder of that water might help him evoke that experience and those blissful feelings, and bring some of those memories into the present time. Using this strategy, he harnessed positive memory and the associated emotions that evoked the associated body changes to bring about his healing.
We all performs many conditioned behaviors every day. Some of these behaviors can have implications for our health and wellness. There may be aspects of allergic reactions that are conditioned. For example, the literature reports that a woman who was allergic to roses developed a severe allergic reaction to a very realistic-looking paper rose, even though she was not allergic to paper. Her body reacted as if the paper rose was real. (Mackenzie, 1886; Vits et al, 2011).
Conditioning can also affect our immune system. When rats were injected with a powerful immune-suppressing drug, while being fed saccharin-flavored water, their immune function showed an immediate drop. After the drug and saccharine water were paired a number of times, the rats were then given just the saccharin water and a harmless injection of salt water. Their immune cells responded exactly as if they had received the drug! The reverse ability, increasing immune cell function, has been shown to be influenced through conditioning (Ader, Cohen & Felten, 1995; Ader and Cohen, 1993).
Belief can also play a role in these scenarios. Bernie Siegel, MD,(2011) has recounted the story of a woman scheduled for chemotherapy who was first given a saline solution, and cautioned that it could cause hair loss. Although this is an unlikely result of a saline injection, given her belief, her hair fell out.
Actions, thoughts, and images affect our physiology.
We often anticipate, react, and form conclusions with incomplete information. Thoughts and images affect our physiology and even our immune system. Re-evoking a positive memory and living in that memory could potentially improve your health. In a remarkable study by a Harvard psychologist, Ellen Langer, eight men in their 70s lived together for one week, recreating aspects of the world that they had experienced more than 20 years earlier. They were instructed to act as they had in 1959, while the control group was instructed to focus entirely on the present time.
In the experimental group, all the physical cues were reminiscent of the culture twenty years earlier. Black and white television and magazines were from 1959. There were no mirrors to remind them of their current age—only photos on the wall of their younger selves. After a week in which the participants acted as if they were younger and the cues around them evoked their younger selves, 63% of the experimental group had improved their cognitive performance as compared with 44% of the control group. Among participants in the experimental group, even their physical health had improved. Independent raters who looked at the before and after pictures of these participants rated their appearance a little younger than the photos taken before the experiment (Langer, 2009; Grierson, 2014; Friedman, 2015). It is possible that by acting and thinking younger, we actually stay younger!
The limits of our belief are the limits of our experience. This concept underlies the remarkable power of placebo. If one believes a drug or a procedure is helpful, that can have a powerful healing effect (Peper & Harvey, 2017; also see the blog, How effective is treatment? The importance of active placebos).
CREATE YOUR OWN VISUALIZATION
Begin by remembering a time when you felt happy, healthy, and whole. Draw inspiration from Pavlov, who evoked happy memories from his childhood, apparently dramatically changing his health. To develop your personal visualization, set aside the time to recreate a healing memory. Remember a time in your life when you felt healthy and joyous (possibly from your childhood). For some, this might be time in nature or with your family or with friends.
Once you remember the event, re-experience it as if you were there right now. Evoke as many senses as possible. Think of the memory and any associations such as an old teddy bear, a shell from the beach, a favorite song, a certain perfume or some other tangible aspect of the experience. The goal is to recreate the experience as if it was current reality. Olfactory and gustatory cues can be especially powerful. If possible include the actual objects and cues associated with that memory—articles, pictures, music, songs, fragrances, or even food.
Sounds, scents, or touching and objects from that era of your life can deepen your ability to recreate and experience the quality of that memory—to actually be in the memory. These sensory reminders will help to evoke the memory and increase the felt experience. You might find it helpful to review Ellen Langer’s experiment, recreating an environment from twenty years earlier. The actual cues will deepen the experience, just as aromas often evoke specific memories and emotions.
The underlying principle is that memories are associated with conditioned stimuli that evoke the physiological state(s) in the body present when the memory was created.
Once you have created a vivid memory that engenders a sense of wholeness, develop a detailed description of your memory to help you evoke that experience. (For some, the memory calls up a timeless setting—relaxing on a warm beach, sitting in front of the fire on a winter evening, or sailing on a calm day. For others, the sense of trust may be associated with a specific person—someone you love—being with your grandmother, helping your mother bake a cake, or going fishing with your dad.). As you recreate the experience, engage all your senses (images, fragrance, tastes, textures, sounds, kinetics). Stay in your image: see it, smell it, taste it, touch it, hear it, be it and allow the experience to deepen.
Begin by writing up your imagery. Then record the introduction the structured relaxation and follow it with a description that evokes the memory as an MP3 audiofile. Use the following three-step process to create the script for your personal relaxation.
- Describe a time in your past when you felt joy, peace, love, or a sense of integration and wholeness.
- Identify the specific cues or stimuli associated with that memory.
- Write out a detailed description that will evoke your personal memory.
CREATING YOUR AUDIO FILE
In this approach, there are three components to your script: first, a relaxation practice to ease you into your visualization, then the visualization of your memory, closing with a brief script that brings you back into the present moment.
Begin the recording with progressive relaxation—use your favorite process for relaxing, or apply the script included here.
Generally tense the muscles for about 5 to 8 seconds and let go for 15 to 20 seconds as indicated by the …. While tightening and relaxing the muscles, sense the muscle sensations with passive attention. Tense only the muscles that you are instructed to tighten and continue to breathe while tensing and relaxing the muscles. If your attention wanders, gently bring it back to feeling the sensations in the specific muscles that you are instructed to tighten or relax.
First, find a comfortable position for relaxation… To fully relax your face, squeeze your eyes shut tight, press your lips and teeth together, and wrinkle up your nose… feel the tightness in your whole face… Now let it go completely and relax… Allow your face to soften, feel the eyes sinking in their sockets, and your breath to flow effortlessly in and out…
Tense both arms by making fists, and extend them straight ahead, while continuing to breathe deeply… study the tension… Now relax and let your arms drop as if you were a rag doll… To relax your shoulders, hunch them toward your ears and tighten your neck, while keeping the rest of your body loose and relaxed… Continue to breathe easily… Allow your shoulders to drop… Feel the weight of your arms… Feel the relaxation flowing from your shoulders, down your arms into your hands and out your fingers…
Now your stomach. Then let go and relax… Arch your back and feel the tightness in the back. Let go and relax….Allow your body to sink comfortably into the surface on which you are resting… Finally, tighten your butt, thighs, calves, and feet by pressing your heels down into the surface where you are lying, curling your toes and squeezing your knees together… Feel the tension as you continue to breathe, keeping your upper body relaxed… Now let go and relax… Allow relaxation to flow through your legs… Be aware of the sensations of letting go…
Feel the deepening relaxation, the calmness and the serenity… Feel each exhalation flowing down and through your arms, chest, and legs… Let the feelings of relaxation and heaviness deepen as you relax more… Notice the developing sense of inner peace… a calm indifference to external events… Let the feelings of relaxation, calmness, and serenity deepen for a few minutes. After a few minutes, evoke your memory of wholeness.
Insert your imagery script here.
Finish with the brief closing script
Allow yourself to just stay in this special place all your own… and know that you can return to this peaceful sanctuary any time you choose to do so. When you are ready to release the imagery, take a deep breath, gently stretch your body, and open your eyes.
Record these this whole script on your cell phone as an MP3 file.
When you record, it often takes a few tries before the pacing is correct. You may find it helpful to listen to the following audio file as a model for to create your own.
LISTENING TO YOUR VISUALIZATION
Create a sanctuary for yourself by turning off your cellphone, adjusting the heat to a comfortable temperature, and ensuring that you will have uninterrupted quiet time for 20 to 30 minutes. Loosen any constricting clothing or jewelry, your glasses, and so on. Settle into a comfortable chair, bed, or setting where you can easily relax. Enjoy letting yourself drift into and relive the memory experience.
Many participants report that this practice is an exceptionally relaxing and nurturing experience, one that supports regeneration. You’ll probably find that the more you practice, the more the relaxation deepens. You may find it helpful to keep notes and observe how you feel after each practice. Although it may feel strange to listen to your own voice, most people find that after a while it becomes more comfortable. After listening to it for a few times, you may want to rerecord the script. Finally, generalize this practice by smiling and evoking the memory scene as much as you desire during the day.
Additional strategies to enhance the relaxation
- Have a massage or take a warm shower or soak and then do the practice. Compare your level of relaxation afterwards to the result of using the audio alone.
- Practice gentle stretches to loosen tight muscles or “shake out” your arms and legs just before doing your relaxation practice.
- Draw or paint the relaxing image or actually go to the location where your memory occurred (if possible) and do your practice. Or practice outdoors in the most relaxing place you can find. Nature can be a great healer.
- Create an atmosphere that helps to evoke and augment your relaxation image (e.g., play background music or use fragrances that you associated with the image).
- Inability to evoke a memory of wholeness. When this occurs, it is as if one draws a blank. This is common, especially if one has experienced abuse or feels depressed. In that case, use the image presented in the script or make one up and create a totally imaginary peaceful image.
- Positive memories of wholeness evoke a bitter/sweet feeling. This occurs when images of wholeness include a loved one who has passed on or who is no longer in your life. On the one hand, this may call up strongly positive feelings, but it may evoke a sense of loss and sadness. If this occurs, simply chose a different memory or create a different script. Let the memory of loss go. Accept your experience and your feelings as much as possible, and know that at least you have been loved. For your image, it may be easier to focus on a natural setting you love—one you associate with peace and tranquility.
- Lack of experience with places in nature. Some people have only urban experiences and find nature alien. See what comes up for you. Does your favorite memory as a city kid recall a day of freedom on your bike or skateboarding, or an afternoon with your playmates? Perhaps you have treasured memories as a teen or an adult of long walks in the city or time spent with close friends. You also have the option of creating new images such as sitting by a fireplace, in a walled garden, or some other scene of peace and safety.
- Difficulty using progressive relaxation. If you’re having trouble isolating a muscle: touch it, stroke it with your hands, and then tense it fully (without strain) and feel the tension in your hands; feel the difference with your hands as you let go of the tension. Or, you may tighten only as much as is needed to feel the tension.
- The desire to stay in the imagery and not wanting to return to reality. If the imagery is much more pleasant than the present, use this process as a stimulus to reorganize your life and set new goals and priorities.
Ader, R. & Cohen, N. (1993). Psychoneuroimmunology, Conditioning,_and_Stress. Annual Review of Psychology, 44(1), 53-85.
Ader, R., Cohen, N. and Felten, D. (1995) Psychoneuroimmunology: Interactions between the Nervous System and the Immune System. The Lancet, 345, 99-103.
Grierson, B. (2014). What if age is nothing more than a mind-set? New York Times Magazine. October 22.
Langer, E. (2009). Counterclockwise: Mindful Health and the Power of Possibility . New York: Ballantine Books.
McKenzie, J. (1886). The production of the so-called rose effect by means of an artificial rose, with remarks and historical notes. Am. J. Med. Sci. 91, 45–57
Peper, E., Gibney, K.H. & Holt. C. (2002). Make Health Happen: Training Yourself to Create Wellness . Dubuque, IA: Kendall-Hunt. ISBN-13: 978-0787293314
Peper, E. & Harvey, R. (2017). The fallacy of placebo controlled clinical trials: Are positive outcomes the result of indirect treatment side effects? NeuroRegulation. 4(3–4), 102–113. doi:10.15540/nr.4.3-4.102
Siegel, B. (2011, May). Remarkable recoveries. Retrieved from: http://berniesiegelmd.com/resources/articles/remarkable-recoveries/
Most of us are aware that thoughts affect our body; however, we often overlook the impact of this effect. To demonstrate the power of visualization, participants are guided through a lemon imagery. In a study with 131 college students, 94% report an increase in salivation which is a parasympathetic nervous system response. The participants now know–not believe–that visualization affects physiology. Once salivation has been experienced, participants may apply other visualization techniques to change their physiology and behavior. Through visualization we communicate with our autonomic nervous system which can provide a matrix for self-healing and enhanced performance. In addition, the guided practice shows that almost everyone holds their breath when asked to tighten their muscles and some people have difficulty relaxing after tightening. Once aware, the person can and continue to breathe and relax the muscles. Enjoy the guided exercise, Mindbody connection: Lemon Imagery.
*I thank Paul Godina, Jung Lee and Lena Stampfli for participating in the videos.
Adapted from Peper, E., Gibney, K.H. & Holt. C. (2002). Make Health Happen: Training Yourself to Create Wellness. Dubuque, IA: Kendall-Hunt
“It was the best meet of my life.” -Jo Aita
Setting a personal best and winning the Gold medal is a remarkable feat. Jo Aita, age 46 and weighing 58 kg, set the Masters World Records and Masters Games Records in Snatch, Clean & Jerk and Total Olympic weight lifting at the World Masters Games in Auckland, New Zealand, April 26th, 2017. She lifted 71 kg in the Snatch and 86 kg in the Clean and Jerk Olympic lifts in the 45-49-year-old age group (see video in figure 1). What makes this more remarkable is that her combined lifts were 3 kilograms more than her life-time best in previous competition. She refuted the conventional wisdom that weight lifters peak in their mid to late twenties. There is hope for improvement as aging may not mean we have to decline.
Figure 1. Video of Jo Aita successful lift at the World Masters Games in Auckland, NZ., April 26, 2017.
There are many factors–and many more which we do not know–which contribute to this achievement such as genetics, diligent training and superb coaching at the Max’ Gym in Oakland as a member of Team Juggernauts. In the last three years, Jo Aita also incorporated biofeedback and visualization training to help optimize her performance. This report summarizes how breathing and electromyography feedback combined with imagery may have contributed to achieving her personal best. As Jo Aita stated, “I recommend this to everyone and hope that you can work with athletes in my gym.”
Components of the 30 sessions of biofeedback, internal language and visualization training program
The training was started in September 2014 to reduce anxiety and improve performance. The components embedded in the training are listed sequentially; however, training did not occur sequentially. They were dynamically interwoven throughout the many sessions and augmented with homework practices, as well as storytelling of other people achieving success using similar approaches. The major components included:
1. Mastering effortless slow diaphragmatic breathing in which the abdomen expanded during inhalations and constricted during exhalation. The respiration feedback and training was recorded with BioGraph Infinity respiration sensors and recorded from the abdomen and upper chest. Her homework included monitoring situations where she held her breath and then anticipate breath holding by continuing to breathe. She also practiced slower breathing with heart rate variability feedback from a Stress Eraser. Practicing these allowed her to become centered and regenerate more quickly. As she stated, “It helped me during the day when I am anxious to calm down.” Throughout the training, the focus was to use breathing to rapidly regenerate after exertion especially after training.
2. Learning to relax her shoulder muscles with electromyography (EMG) feedback to regenerate and learn awareness of minimal trapezius muscle tension. She could use this awareness to identify her emotional reactivity (Peper, Booiman, Lin, & Shaffer, 2014). Often emotional reactivity increases muscle tension. She learned to relax here muscles quickly after muscle contractions to allow regeneration
3. Experiencing how cognition affect performance. This was initially demonstrated by arm resistance test. In this experiential practice, she extended her arm and attempted to resist the downward pressure applied to her wrist while she recalled either a hopeless, helpless, powerless or defeated memory or an empowered positive memory (for detailed description see, Gorter and Peper, pp 186-188, 2011). When she recalled the powerless memory she was significantly weaker than when she recalled the empowering memory. This experience demonstrated to her the power of her thoughts.
4. Rewriting failure into success. Each time she missed the lift, she would think, “I should not have done that,” or “I was doubtful or nervous during competition,” she shifted her focus to:
- Accepting what happened by acknowledging she did the best she could have done under the circumstances.
- Exploring how she could have done it differently and imagine herself doing it in the new optimum way.
- Using the trigger of the beginning thought of failure or defeat to evoke the new empowering memory thus interrupting the chained behavior.
The underlying concept was that what we mentally rehearse is what we may become and that our thoughts affect performance which she previously experienced by the arm resistance test. If you keep thinking about a defeat you are training the physiological pattern of defeat. This practice of transforming self-defeating thoughts into empowering thoughts can be applied to all phases of one’s life and was continued throughout the training sessions. The focus was to acknowledge and realize that whatever you did, it was the only thing you could have done because you did not yet have the skills to do it differently. She would then create a new strategy of mental rehearsal that lead to a positive outcome (for detailed description of this practice see Peper, Harvey, Lin, & Duvvuri, 2014).
5. Identifying whether imagery rehearsal is somatically connected. It is our bias that imagery rehearsal is useful if the body responds in a similar pattern when the person images the task as it would during an actual activity (Hall, 2001; Peper et al, 2015). The concurrent physiological activity would indicate that the person is experientially involved in the task and not just observing as a witness/second party.
Her performance is weightlifting and this would involve major muscle activity. Surface EMG was recorded from muscles that would be activated during the actual performance of the task to identify if they would be activated during mental rehearsal. The muscle activity during mental rehearsal is usually at a much smaller amplitude than that occurred during actual physical performance; however, should follow a similar timing sequence. In our experience there are three responses:
- Muscle activity in the appropriate muscles that are in the same timing as in and actual performance. This implies that mental rehearsal is actually training the motor pattern and facilitate performance. Thus continue practicing with mental rehearsal.
- Muscle activity in the appropriate muscles are not generally in the same timing sequence as the actual performance. This may mean that the person was performing too slow or was skipping sequences in the mental rehearsal and mental training may not be useful. The person needs to master and exhibit the same muscle pattern during mental rehearsal as during actual performance of the task.
- No muscle activity or inappropriate muscle activity during the during the mental rehearsal. This implies that during mental rehearsal there is no motor pattern training and the approach would not be useful unless the person learned to activate appropriate motor activity. It is possible that some people who have experienced past traumas may have coped by shutting off feelings and sensations in their bodies.
When Jo Aita initially practiced mental rehearsal while being monitored with surface EMG recorded with Myoscan Pro sensors (filter set narrow 100-200Hz) from the right and left upper trapezius muscles, there was no corresponding muscle activity as shown in Figure 2. Although she imaged, she did not feel/experience the lifting. The training focused upon reconnecting imagery and body experience.
Figure 2. Left and right upper trapezius EMG showed no increase in activity while Jo Aita mentally imaged performing her lift.
6. Integrating imagery and body experience with EMG. After identifying that imagery did not elicit concurrent muscle activity, the training focused on developing the imagery muscle connection. The training consisted of:
- Monitoring EMG activity from her right and left quadriceps and right and left upper trapezius muscle and have her simulate her actually lifting in practice and competition by going through the complete sequence which included standing and waiting till her name was called, caulking her hands, performing a ritual activity to be ready to lift the weights, lifting the weights, and releasing them. The pattern is shown in Figure 3.
Figure 3. Simulating the actual Snatch and Jerk lift (Clean is lifting the weights to the chest and punching Jerk is pushing the weigh upward is labelled).
- Practicing imagery by going through the same procedure and purposely slightly activating the movements which were necessary to lift the weight. As she stated, “I learned to do mental rehearsal in a more structured way and visualized the total sequence from chalking up to doing all six lifts”. This was monitored by the EMG to see that there occurred EMG activation of the muscles. This was repeated numerous times till, the activation occurred in imagery as shown in Figure 4.
Figure 4. EMG activity during mental rehearsal.
She then reported that imagery was a real experience.
7. Training mental rehearsal and imagery for peak performance (Cumming, Hall, & Shambrook, 2004). The major components of the mental rehearsal focused upon performing perfectly, visualizing lifting more weight easily than actually lifted in the gym, performing in the gym as she would during competing, practicing performing when interruptions occurred, and punching the weight through the ceiling.
- Performing perfectly. During the day she would mentally rehearse practicing lifting perfectly. In addition, as part of her readiness routine she would image performing the lift perfectly.
- Practicing recovery and being centered when interruptions would occur. For example, she was asked to role play competition and waiting for the judge to give the signal to start, I delayed giving her the signal to begin and told her the weights had to be adjusted because they had miss-loaded the bar. This way there would be no novelty during actual competition. This concept of coping with the unexpected was illustrated by Michael Phelps swimming the 200-meter butterfly in 2012 Being Olympics when his googles filled up with water when he dove in. Michael still won his 10th gold medal even though he swam part of the race blind (Fanning, E., June 25, 2012). He could do this because numerous time in the past, his coach had purposely trained Michael to swim with leaking googles
- Imagining lifting 10 kg more while competing. The concept of feeling/imagining yourself performing more that you can do at this moment creates the possibility for improvement since the limits of imagination may limit the experience/performance. As she reported, “This was incredibly helpful last year in competition when I needed to lift more than I had done before to qualify for the American Open, so I had mentally done it so often, then I just did it and made the qualifying lift.”
- Feeling your arms extending way up into the ceiling. Extending beyond your mental boundary of the test allows more power because the body tends to stop at the boundary. For example, when running 100 meters you want to see the finish line at least ten meters beyond the actual finish line this way you continue to run at maximum speed through the finish. If you focus on the actual finish line, you often slow down before reaching it. I told her how we used this concept with young male gymnasts to be able to do the iron cross for the first time by thinking of their arms being an iron beam and extending through the rings into the wall. In the case of lifting, you want to feel yourself punching the weight through the ceiling instead of just driving it upward. This portion of the lift when punching up into the ceiling is call the Jerk. This concept was experientially demonstrated by the following Aikido exercise of the iron arm.
Two people pair up and face each other. One stretches his arm straight out and rests the wrist and back of the palm on the shoulder of his partner. The partner put both hands on the elbow and then then pulls down trying to bend the elbow while his partner is try resist the downward force and try not to bend it as shown in Figure 5.
Figure 5. Testing the effect of imagery on resisting downward pull at the elbow with wrist facing palm up.
Then relax, and repeat the same exercise except the person imagines that his arm is like a metal bar extending from their shoulders out through his hand into the wall. Once the person is imaging this, then the partner again attempts to bend the arm.
In almost all cases, when the person imagines the arm extending like an iron bar into the wall, it is much stronger and much more difficult to bend. Jo integrated this felt imagery in her lifting during practice and she experienced increased strength while imagining/feeling the iron bar and reported that she had the “best Jerks in her life.”
Achieving a new world and personal record at age 46 in the master’s competition is a remarkable tribute to the athlete’s dedication and coaching. Although I (EP) may think I contributed, and hopefully what I taught was beneficial, in the end it is the athlete herself who has to perform in the competition–she is alone stands on the platform to lift the weights. When I (EP) asked whether the biofeedback visualization training was useful, Jo inequitably said, “Yes, and I would recommend this approach and training to everyone!” Watch the in-depth interview with Jo Aita in which she describes her experience of integrating imagery techniques and biofeedback to enhance performance on May 26, 2017.
What is interesting to ask is, how come a 46-year-old woman could lift 3 kg more than at any other time during her competitive career of Olympic lifting? It gives hope that loss of strength that commonly occurs as we age may be due less to aging than to learned disuse, injuries and lack of recovery. Most important factors are personal motivation and hope—you want to perform your best and know/believe that it is possible (Wilson and Peper, 2011). As Jo stated, “It helped for me to focus on doing my personal best.” I love Olympic lifting, I like taking care of my body, and I like feeling strong.” Finally, Jo is a recent athlete in her sport. She started lifting when she was 33 and competed one year later. She then took time out to give birth to her son and in a couple of months came back quickly and continued to become stronger. As she stated, “I always wanted to get stronger no matter what my age was.”
From a performance perspective it is interesting that she lifted more than ever before. Would it be possible that she is similar to many performers who achieve maximum performance after about 10 to 15 years of dedicated training? As she gets older, she improves her skills, increases efficiency of here muscles and neural connections. Is a possible that loss of performance as we age less due to aging than loss of motivation after years of practice, competition and achieving your goal. At that point life may offer other challenges and new opportunities.
* This blog was adapted and expanded from: Peper, E. & Aita, J. (2017). Winning the Gold in Weightlifting Using Biofeedback, Imagery and Cognitive Change. Biofeedback, 45(4), 77–82. DOI: 10.5298/1081-5937-45.4.01 https://biofeedbackhealth.files.wordpress.com/2018/02/a-winning-the-gold-in-weightlifting-published.pdf
Cumming, J., Hall, C., & Shambrook, C. (2004). The influence of an imagery workshop on athletes’ use of imagery. Athletic insight, 6(1), 52-73.
Fanning, E. (June 25, 2012). 50 stunning Olympic Moments No 42: Michael Phelps goes big in Being. Downloaded May 30, 2017 from https://www.theguardian.com/sport/blog/2012/jun/25/50-stunning-olympic-moments-michael-phelps
Gorter, R. & Peper, E. (2011). Fighting Cancer-A Non Toxic Approach to Treatment. Berkeley: North Atlantic.
Hall, C. (2001). Imagery in sport and exercise. In R. Singer, H. Hausenblas, & C. Janelle (Eds.), Handbook of Sport Psychology (pp. 529 – 549). New York, NY: John Wiley & Sons, Inc.
Peper, E., Harvey, R., Lin, I-M, & Duvvuri, P. (2014). Increase productivity, decrease procrastination and increase energy. Biofeedback, 42(2), 82-87.
Peper, E., Booiman, A., Lin, I-M., & Shaffer, F. (2014). Making the Unaware Aware-Surface Electromyography to Unmask Tension and Teach Awareness. Biofeedback.42(1), 16-23.
 Correspondence: Erik Peper, Ph.D., Institute for Holistic Health Studies, Department of Health Education, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132. email: firstname.lastname@example.org; web: www.biofeedbackhealth.org; blog: www.peperperspective.com
 We thank Dr. Sue Wilson for her helpful and constructive feedback.
 We purposely use the word “may” because it is a case report and not a controlled study. Coaches, sport psychologist, or anyone who has had contact with an athlete who does extremely well usually claims that their suggestions were the magic ingredient; however, it could be synchronicity and not due to the actual skills taught. It may be due to unidentified factors or covert factors embedded in the coaching or teaching such as transforming hope and belief.
 Be aware that when people learn to reconnect with their body or learns slow diaphragmatic breathing and allow their lower abdomen to relax and expand, it is possible that past traumatic memories could be released. This release is a healthy process and we usually adapt an Autogenic Therapy/Training perspective by which the person accepts, allows discharge and continues with the task at hand.
It was late in the afternoon and I was tired. A knock on my office door. One of my students came in and started to read to me from a card. “I want to thank you for all your help in my self-healing project…I didn’t know the improvements were possible for me in a span of 5 weeks…. I thank you so much for encouraging and supporting me…. I have taken back control of myself and continue to make new discoveries about my identity and find my own happiness and fulfillment… Thank you so much.”
I was deeply touched and my eyes started to fill with tears. At that moment, I felt so appreciated. We hugged. My tiredness disappeared and I felt at peace.
In a world where we are constantly bombarded by negative, fearful stories and images, we forget that our response to these stories impacts our health. When people watch fear eliciting videos, their heart rate increases and their whole body responds with a defense reaction as if they are personally being threatened (Kreibig, Wilhelm, Roth, & Gross, 2007). Afterwards, we may continue to interpret and react to new stimuli as if they are the same as what happened in the video. For example, while watching a horror movie, we may hold our breath, perspire and feel our heart racing; however, when we leave the theatre and walk down the street by ourselves, we continue to be afraid and react to stimuli as if what happened in video will now happen to us.
When we feel threatened, our body responds to defend itself. It reduces the blood flow to the gastrointestinal tract where digestion is taking place and sends it to large muscles so that we can run and fight. When threatened, most of our resources shifted to the processes that promote survival while withdrawing it from processes that do not lead to immediate survival such as digestion or regeneration (Sapolsky, 2004). From an evolutionary perspective, why spent resources to heal yourself, enhance your immune system or digest your food when you will become someone else’s lunch!
The more we feel threatened, the more we will interpret the events around us negatively. We become more stressed, defensive, and pessimistic. If this response occurs frequently, it contributes to increased morbidity and mortality. We may not be in control of external or personal event; however, we may be able to learn how to change our reactions to these events. It is our reactions and interpretations of the event that contributes to our ongoing stress responses. The stressor can be labeled as crisis or opportunity.
Mobilize your own healing when you take charge. When 92 students as part of a class at San Francisco State University practiced self-healing skill, most reported significant improvements in their health as shown in Figure 1.
Figure 1. Average self-reported improvement after practicing self-healing skills for at least four weeks. (Reproduced with permission from Tseng, Abili, Peper, & Harvey, 2016).
A strategy that many students used was to interrupt their cascading automatic negative reactions. The moment they became aware of their negative thought and body slumping, they interrupted the process and practiced a very short relaxation or meditation technique.
Implement what the students have done by taking charge of your stress responses and depressive thoughts by 1) beginning the day with a relaxation technique, Relax Body-Mind, 2) interrupting the automatic response to stressors with a rapid stress reduction technique, Breathe and be a Tree, and 3) increasing vitality by the practice, Share Gratitude (Gorter & Peper, 2011).
Relax Body-Mind to start the day*
- Lie down or sit and close your eyes. During the practice if your attention wanders, just bring it back to that part of the body you are asked to tighten or let go.
- Wrinkle your face for ten seconds while continuing to breathe. Let go and relax for ten seconds.
- Bring your hands to your face with the fingers touching the forehead while continuing to breathe. While exhaling, pull your fingers down your face so that you feel your jaw being pulled down and relaxing. Drop your hands to your lap. Feel the sensations in your face and your fingers for ten seconds.
- Make a fist with your hands and lift them slightly up from your lap while continuing to breathe. Feel the sensations of tension in your hands, arms and shoulders for ten seconds. Let go and relax by allowing the arms to drop to your lap and relax. Feel the sensations change in your hands, arms and shoulders for ten seconds.
- Tighten your buttocks and flex your ankles so that the toes are reaching upwards to your knees. Hold for ten seconds while continuing to breathe. Let go and relax for ten seconds.
- Take a big breath while slightly arching your back away from the bed ore chair and expand your stomach while keeping your arms, neck, buttocks and legs relaxed. Hold the breath for twenty seconds. Exhale and let your back relax while allowing the breathing to continue evenly while sensing your body’s contact with the bed or chair for twenty seconds. Repeat three times.
- Gently shake your arms and legs for ten seconds while continuing to breathe. Let go and relax. Feel the tingling sensations in your arms and legs for 20 seconds.
- Evoke a past positive memory where you felt at peace and nurtured.
- Stretch and get up. Know you have done the first self-healing step of the day.
*Be gentle to yourself and stop the tightening or breath holding if it feels uncomfortable.
Breathe and be a Tree to dissipate stress and focus on growth
- Look at a tall tree and realize that you are like a tree that is rooted in the ground and reaching upward to the light. It continues to grow even though it has been buffeted by storms.
- When you become aware of being stressed, exhale slowly and inhale so that your stomach expands, the while slowly exhaling, look upward to the top of a real or imagined tree, admire the upper branches and leaves that are reaching towards the light and smile.
- Remember that even though you started to respond to a stressor, the stressor will pass just like storms battering the tree. By breathing and looking upward, accept what happened and know you are growing just like the tree.
- Think of someone who did something for you that impacted your life in a positive direction and whom you never properly thanked. This could be a neighbor, teacher, friend, parent, or other family members.
- Write a 300-word testimonial describing specifically what the person did and how it positively impacted you and changed the course of your life.
- Arrange an actual face-to-face meeting with the person. Tell them you would like to see him/her. If they are far away, arrange a Skype call where you can actually see and hear him/her. Do not do it by email or texting.
- Meet with the person and read the testimonial to her/him.
- It may seem awkward to read the testimonial, after you have done it, you will feel closer and more deeply connected to the person. Moreover, the person to whom you read the testimonial, will usually feel deeply touched. Both your hearts will open.
Gorter, R. & Peper, E. (2011). Fighting cancer: A nontoxic approach to treatment. Berkeley, CA: North Atlantic Books, 205-207.
Kreibig, S. D., Wilhelm, F. H., Roth, W. T., & Gross, J. J. (2007). Cardiovascular, electrodermal, and respiratory response patterns to fear‐and sadness‐inducing films. Psychophysiology, 44(5), 787-806.Kreibig, Sylvia D., Frank H. Wilhelm, Walton T. Roth, and James J. Gross. “Cardiovascular, electrodermal, and respiratory response patterns to fear‐and sadness‐inducing films.” Psychophysiology 44, no. 5 (2007): 787-806.
Sapolsky, R. (2004). Why Zebras Don’t Get Ulcers. New York: Owl Books
Seligman, M. (2014). The new era of positive psychology. Ted Talk. Retrieved, December 10, 2016. https://www.ted.com/talks/martin_seligman_on_the_state_of_psychology
Tseng, C., Abili, R., Peper, E., & Harvey, R. (2016). Reducing Acne-Stress and an integrated self-healing approach. Appl Psychophysiol Biofeedback, 4(4), 445.)
My arm did not move and yet the muscle tension from my forearm increased when I mentally rehearsed playing the piano. I did not notice anything. It really made me aware how my thoughts affect my body. –25 year old woman psychologist
Therapists and educators can demonstrate the mind/body interaction with physiological monitoring to change their clients’ illness beliefs and demonstrate how ruminating thoughts may affect mental and physical health (Peper, Shumay, Moss, & Sztembis, 2013). When clients see how their body’s physiological responses are affected by thoughts and emotions, they gain a perspective that allows them to KNOW that thoughts affect body—the objective physiological evidence is indisputable.
The concept that thoughts affect the body has been described by many researchers. For example, Whatmore and Kohli (1975) used the term “Representing efforts,” which are the efforts we bring forth within our self during thinking, remembering, anticipating, daydreaming and worrying. Similarly, Green, Green and Walters (1970, p.3) described a process of thoughts influencing human physiological reactions as the Psycho-physiological principle, where “every change in the physiological state is accompanied by an appropriate change in the mental-emotional state, conscious or unconscious, and conversely, every change in the mental-emotional state, conscious or unconscious, is accompanied by an appropriate change in the physiological state.”
The mind/body connection can be demonstrated through recording physiological signals. For example, when a volunteer had her skin conductance (SC) level monitored, and then another person was asked in the group to give the volunteer a kiss, there was an increase in skin conductance response just after the instruction was given even though the person did not actually kiss the volunteer. The volunteer was responding to the instructions that a kiss might occur, as shown in Figure 1.
Figure 1. The effect on SC level of hearing the instruction that someone will give her a kiss
For educators and psychotherapists, biofeedback can be used to demonstrate the connection between positive or negative mental rehearsal, thoughts or visualization or recalling memories and physiological responses. This process can be demonstrated with surface electromyography (SEMG) recorded from muscles that become activated when the person mentally rehearses a task as illustrated in the following case example.
The participant was a 25 year old female psychologist who had practiced playing the piano for more than 16 years. Muscle activity was recorded from her right forearm extensor muscles and displayed on a large screen so that other group participants could observe. The physiological data and video recording of the volunteer were simultaneously recorded. The volunteer was asked to relax, imagine playing a musical piece, relax, and again imagine playing a musical piece and relax.
Results. Each time she imagined playing the piano, the forearm extensor muscle tension increased, even though there was no observed finger and forearm movements, as shown in Figure 2.
Figure 2. The covert SEMG increase in forearm SEMG as the participant imagined playing the piano.
After the recording, the session was replayed so she could see herself and her movements on the screen simultaneously with the SEMG signal. She reported being totally unaware that she had activated her forearm muscles and, was totally surprised when she saw the recording of the SEMG activity while her forearm appeared to stay in a relaxed position.
Discussion.The physiological monitoring demonstrated that her body responded to here thoughts and imagtes. In the case example, the arm muscle tension increased in tension when she mentally rehearsed playing the piano. This participant like most other people was unaware that her body reacted.If the thought of piano playing increased forearm tension,what would thoughts of anger, resentment, hopelessness, kindness or love do to the body. This concrete physiological demonstration illustrated that changing your thoughts changes your physiology. .
Once the person is aware how thoughts affect their body, it may motivate the person to become aware and change their cognitions. They can now understand that interrupting negative ruminations and behavior patterns and rehearsing new behavior patterns, their health can be improved. We strongly recommend that cognitive behavioral therapists, educators, psychologists, and other therapeutic practitioners include biofeedback monitoring for demonstrating the links between cognitions and physiological reactions.
After such a demonstration, the therapist may point out that what happens in the office setting is likely the identical process that occurs when a person worries, has negative cognitions, continuously reviews personal failures, or makes judgmental statements such as “I should not have done ________.”
When individuals think a negative statement such as “I should not have…………”, they are mentally rehearsing what they should not do and are unintentionally strengthening the negative behavior even more. Instead, whenever people becomes aware of the beginning of the negative cognitions, they can learn to stop and transform their negative cognitions to positive cognitions. In this way they can rehearse what they would want to do instead of what they do not want to do (Peper, Gibney, & Holt, 2002).
The more you rehearse what you want to achieve, the more likely it is to occur. This strategy is useful to change clients’ illness beliefs and motivate them to transform their cognitions from what they do not want to what they want to do. In addition, it offers cognitive behavior therapists documented evidence—the biofeedback recording provides the data which is necessary for evidence based medicine.
Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.
–Victor E. Frankle
* Adapted from: Peper, E., Nemoto, S., Lin, I-M., & Harvey, R. (2015). Seeing is believing: Biofeedback a tool to enhance motivation for cognitive therapy. Biofeedback, 43(4), 168-172. DOI: 10.5298/1081-5937-43.4.03
Green, E.E., Green, A.M., & Walters, E.D. (1970). Voluntary control of internal states: Psychological and physiological. Journal of Transpersonal Psychology, 11, 1-26.
Peper, E., Gibney, K.H., & Holt. C. (2002). Make health happen: Training yourself to create wellness. Dubuque, IA: Kendall-Hunt.
Peper, E., Shumay, D. M., Moss, D. & Sztembis, R. (2013). The Power of Words, Biofeedback, and Somatic Feedback to Impact Illness Beliefs. Somatics .XVII(1), 4-8.
Whatmore, G.B., & Kohli, D. R. (1975). The physiopathology and treatment of functional disorders: Including anxiety states and depression and the role of biofeedback training. New York: Grune and Stratton, Inc.
Mind-Guided Body Scans for Awareness and Healing–Youtube Interview of Erik Peper, PhD by Larry Berkelhammer, PhDPosted: December 23, 2013
In this interview psychophysiology expert Dr. Erik Peper explains the ways how a body scan can facilitate awareness and healing. The discussion describes how the mind-guided body scan can be used to improve immune function and hold passive attention (mindfulness) to become centered. It explores the process of passive attentive process that is part of Autogenic Training and self-healing mental imagery. Mind-guided body scanning involves effortlessly observing and attending to body sensations through which we can observe our own physiological processes. Body scanning can be combined with imagery to be in a nonjudgmental state that supports self-healing and improves physiological functioning.