Less Stress Surgery – A Guided Imagery Relaxation Program

To Help You Prepare for and Recover from Surgery

A Guided Imagery

Painless Recovery. As a result of listening to this tape, I recovered from 5 hours of surgery with virtually no pain. My doctor prescribed Vicodin every four hours and I ended up taking only 4 tablets. This tape is such a wonderful healing tool, not only before, but after surgery as well. My incision healed so fast, I was taking my usual 3 mile walks in 10 days. This tape is a “must have” if you are anticipating any type of surgery!

Susan Vukson from Irvine, California

If you or a loved one requires surgery, studies show that you can …

* Decrease your anxiety,
* Reduce your post-operative pain,
* Speed your recovery from surgery,
* Minimize your blood loss &
* Improve your wound healing.

The latest research in the field of mind/body medicine and behavioral anesthesia shows that listening to a specially produced guided imagery relaxation tape prior to surgery can result in less pain, decreased blood loss, less anxiety, shorter hospital stay and improved wound healing.

Always go to an expert.

In conjunction with NeilMD.com and the Mastering Stress Series of books, audios, videos and online courses, respected and Board Certified Family Practitioner Neil F. Neimark, M.D. has produced a guided imagery relaxation tape to help you maximize your healthy recovery from surgery, minimize your pain and reduce your psychological distress.

Let us talk you through your surgery.

Utilizing the latest research in behavioral anesthesia, we will help prepare your body for the stresses of surgery through the use of “specific physiologic instructions” which teach your body how to respond better to the difficulties and demands of surgery.

Who can put a price on a speedy and healthy recovery from surgery?

Your purchase is backed by our life-time money back guarantee.

If for any reason, you are not satisfied with your purchase, just email us at Support@NeilMD.com and you will be issued a prompt refund of your purchase price!

With Less Stress Surgery – A Guided Imagery Relaxation Program – here’s what you get:

The Less Stress Surgery Guided Imagery Relaxation MP3 file,  a 22 -minute guided audio to the relaxing sound of ocean waves, containing specific physiologic instructions to help you achieve all the healing benefits needed to recover quickly from your surgery.

The Special Report, “Your Pre-op Checklist: Top 10 Things You Can Do to Prepare for Your Upcoming Surgery” to be properly prepared for your upcoming surgery in every way: physically, mentally, emotionally and spiritually.

The Special Report, “The Scientific Evidence: How Guided Imagery Can Improve Your Surgical Outcomes” In this report, you will find a concise summary of all the research behind the statements made by Neil F. Neimark, M.D. on this website.

The Special Report, “How to Get Rock Solid Support from Friends and Loved Ones” to help you enlist the healing support of your friends and family to help speed your recovery.

The Special Report “The Healing Power of Gratitude” in order to help you achieve a healthy spiritual state of mind in order to improve your recovery.


This tape provides the edge you need to face any surgery. Enduring almost constant pain over the past twenty years, I finally made the decision to have a second back surgery. Although the techniques and results have made major strides in 20 years, it was still a difficult decision. Unfortunately, everyone wants to tell you they know someone who had back surgery and the results were disastrous. A good friend who recently had surgery, suggested Dr. Neimark’s tape. The tape helped me to focus on the positive aspects my surgery would provide and to see myself on the road to recovery. It enabled me to mentally work through each step of the surgery and I became a positive and contributing factor in the successful outcome. With this encouragement I can say I am now on my way to a full recovery. I credit Dr. Neimark’s tape for giving me the mental and physical edge. I would highly recommend this tape for anyone preparing for surgery.

Brian Righetti from Lake Forest, California

A “Must Have” tape if your facing any kind of Surgery. My search for “something” started right here and I ordered this tape to help me deal with facing a second surgery within a five month period. I wish I had had this tape before the first surgery. Not only did this tape relieve any pre-surgical anxieties, by playing this a week before surgery, but my gastroenterologist allowed me to play my tape both before & during surgery as well as in recovery. Being cut from sternum to belly button was by far the most invasive surgery I’d ever had. I was up & walking within the first 4-5 hours. I continued to get up almost unassisted the first day; I walked the hallways in total length numerous times the second day; and I came home on the third day, two days ahead of schedule! I had very little pain and only slight discomfort the first day home. I have never had that kind of amazing recovery before. My surgical team and the nursing staff were completely amazed that someone 47 would have no complications and a speedy, healthy recovery so quickly. Needless to say, they all heard “my story” about this tape. I’m am a Certified Clinical Hypnotherapist with a Holistic Healing Practice. Even so, well all need help from time to time from fellow healers like Dr Neimark. For this tape I am eternally grateful & will continue to recommend this tape to friends, family members and my clientele.

Marlene L. Jones from Columbus, Ohio

You Can Heal Faster & With Less Pain After Surgery

Here’s How It Works!

Thank you for interest in the Less Stress Surgery guided imagery relaxation tape and the Less Stress Surgery Relaxation System.

My name is Dr. Neil Neimark and I am a family physician who treats patients just like you, every day, who are searching for ways to improve their outcomes from surgery and minimize their stress and fears prior to surgery.

I graduated Cum Laude from The Ohio State University College of Medicine in 1981 and after completing my residency in Family Medicine, I went on to finish a fellowship in Academic Medicine, specializing in the Mind/Body Connection.

I love my work and I consider it a privilege to be able to participate in the care and healing of my patients. I have always believed in the importance of a vital doctor/patient relationship and believe that the body heals best in an environment of mutual trust and faith between the doctor and the patient and the treatment plan. I will be right there with you through your pre-op and post-op recovery guiding your body to a healthy recovery.

I created the Less Stress Surgery Guided Relaxation System because my patients wanted an opportunity to exert some level of self-care and control in a situation where most of them felt afraid and at the mercy of forces outside of themselves.

You Can Improve your Outcome From Surgery

Less Stress Surgery is a guided imagery relaxation tape based on evidence from literally hundreds of studies, which shows quite conclusively that you can improve your outcome from surgery. In addition to listening to the guided relaxation tape (for one week prior to and one week following surgery), you will also receive a critical summary of the most important scientific findings regarding the importance of your being prepared for surgery and simple steps you can take to get your body ready.

Make Sure To Follow This Pre-Op Checklist for A Speedier & Healthier Recovery from Surgery

Below this section, you will be able to read my Special Report, in which I so to great lengths to distill the massive amounts of information on mind/body research on surgery down to 10 simple steps that you can take to significantly improve your outcome from surgery entitled, “Ten Things You Absolutely Need to Know Before Having Surgery.” Following these 10 steps will put you in the best state of mind and body for a speedy and healthy recovery from surgery.

The last step speaks of the importance of a properly produced guided imagery tape to help your mind and body be ready and prepared for surgery. A simple relaxation tape alone will not help and evidence suggests, may actually make things worse. That’s why I produced the Less Stress Surgery Guided Imagery Relaxation Program to exacting scientific standards.

The Benefits of Guided Imagery in Preparing and Recovering from Surgery

When you listen to the guided imagery tape (just once or twice a day for the week prior to surgery and for one week following surgery) you will be training your body through the use of specific physiologic instructions, to respond optimally to the physical stresses, difficulties and demands of surgery. By listening to the tape, you will learn how to:

  • Alter the blood flow to different parts of your body, resulting in less blood loss.
  • Increase intestinal motility after surgery, resulting in less nausea.
  • Boost your body’s natural endorphins, resulting in less pain.
  • Mobilize your body’s white blood cells and antibodies, resulting in less risk of infection.
  • Completely relax your body and mind, resulting in less anxiety and a state of calm readiness for surgery.

I believe that health is both a science and an art. In order to increase your capacity to fight off disease and speed your recovery from surgery, you must reach out for the best that medical science has to offer andreach within to mobilize your own internal resources for healing.

This guided imagery relaxation tape will help you draw upon the quite remarkable healing resources that already lie deep within you. This is what Walter Cannon, M.D., the Harvard physiologist, calls, “the wisdom of the body.” When you tap into your own internal healing resources, you optimize your chances for a speedy and healthy recovery, with less pain, less stress, less blood loss, quicker recovery and better wound healing.

Wishing you the best of health in your upcoming surgery,



Neil F. Neimark, M.D.

Ten Things You Absolutely Need to Know Before Having Surgery.

In Only One Week, YOU Can Be Ready For Surgery And Able To Experience These Astonishing Results:

  • 38% Less Post-Operative Pain
  • 45% Less Blood Loss
  • Less Anxiety
  • A Shorter Hospital Stay
  • Improved Wound Healing

 1. Be prepared–physically, mentally and emotionally–for your surgery. Extensive research tells us that the more prepared you are (in terms of knowing what to expect before, during and after the operation) the more smoothly and rapidly you will recover. By preparing yourself physically, mentally and emotionally you will minimize the potential complications you face, and most likely be able to speed your recovery, shorten your hospital stay, minimize your need for pain medications and reduce your anxiety before and after surgery. How do you prepare physically? Eat healthy, wholesome foods prior to the surgery. Consider taking a multivitamin and additional Vitamin C (1000mg a day) and Zinc (50mg a day). With your doctors’ approval, get light exercise on a regular basis like a brisk walk or light calisthenics. How do you prepare mentally? Adopt the right mindset about why your participation is critical to a healthy outcome. You will read more about this in item # 8 below. How do you prepare yourself emotionally? Get the support of friends and family. Read inspirational literature, pray or meditate. You can read more about this in item #7 and #9 below.

2. Learn as much as you can about your surgery beforehand. Ask your surgeon questions about what to expect in terms of recovery, potential complications and things you can do to prepare yourself. The more you know what to expect, the greater your ability to prepare for potential complications, pain and recovery. There is no question and the research clearly confirms that the more you know about your surgery, the greater opportunity there is for a speedy and healthy recovery. Talk to friends who’ve had the same operation. Seek information from the internet and learn all that you can.

3. Work closely with your surgical team. Communicate your needs, questions and concerns assertively but with respect. Don’t be afraid to discuss all aspects of your treatment. The research clearly shows that the more prepared you are for surgery, the better your recovery will be. You may feel overwhelmed and out of control at the prospect of having surgery, but it is essential that you communicate your needs and fears honestly and openly to your surgeon and/or their nursing staff or educational staff. This is no time to take a back seat. Though you will be turning over your care to the skills of your surgeon, you are in charge of your state of mind prior to entering surgery.

4. Don’t hesitate to get a second opinion before any major elective surgery. Many insurance companies require this. It is essential to your preparedness and ability to recover from surgery to know everything you can about your operation. There are often many different approaches and surgical techniques that can be done, so if you have any concerns at all, please get a second opinion. It is more than worth the extra time and expense.

5. Choose a surgeon you trust. If you are uncomfortable with something your surgeon says or does, ask questions and express your concerns. Most surgeons are happy to discuss things with you before the operation and their nursing staff is usually well prepared to answer all your questions. But you must be proactive and ask. This is no time to be shy or passive. All research shows that the more actively you participate in your surgery, the healthier your recovery will be. If you address your concerns with your surgeon and you are still uncomfortable with their answers, then seek a second opinion or consider choosing a different surgeon. Your health, your recover and your very life may depend upon it.

6. Ask your surgeon ahead of time if you’re likely to need a transfusion. If you are, inquire about autologous blood donation, wehre you donate your own blood several weeks before the surgery.

7. Enlist the support of friends, family and loved ones to help reassure you emotionally and put you in a healthier frame of mind. Medical research shows clearly that social support is a key factor in activating our healing system, which is essential to healing post-operatively. If you are really frightened at the prospect of surgery, it is advisable to meet with a therapist or psychologist prior to surgery to discuss any irrational fears or anxieties you may have.

8. Prepare yourself mentally for surgery by having the right mindset. The best approach to preparing for surgery is described by psychologist Henry Bennett Ph.D., who says, ‘. . . think of yourself as an athlete training for a major event, rather than as a passive body being handed over to the surgical team.’ This participation in your own healing activates your healing system and better prepares you to reduce the difficulties and maximize the benefits of your upcoming surgical procedure.

9. Take 15 minutes every day for the week prior to your surgery to nurture yourself and have some quiet time for reflection. Stop being super-Mom, super-Dad, super-Kid, super-Friend or super-Lover and just take some time to relax and get in a quiet frame of mind. Meditate, pray or take a walk in nature. Take at least 15 minutes every day for the week prior to your surgery just to take care of yourself. Though the prospect of surgery is frightening, it can become an opportunity for quiet reflection and reassessing your goals and priorities in life.

10. Use a guided imagery tape prior to surgery, after surgery and–if possible–during the surgery itself. Recent studies verify that listening to a properly prepared guided imagery cassette tape prior to surgery can help bring about positive post-surgical outcomes in patients, including: 1) decreased blood loss during surgery, 2) a shorter hospital stay, 3) less anxiety 4) faster wound healing and 5) decreased need for post-operative pain medication.

It is critical to know that not all guided imagery tapes are alike. Research has shown that simple relaxation tapes can actually make things worse. Your guided imagery tape must use what is called ‘specific physiologic instructions,’ which give your body specific information it needs to help augment the healing process.

A Gift of Health. This tape helped me so much through my last surgery. I played it many times prior to the surgery and asked the doctors if I could have it played during my surgery and they agreed. My recovery time beat all others who have had the same type of surgery! While I was in the hospital recovering, I was able to play the tape and focus my pain literally “outside my body”. I did not need to have as much pain medication as they thought I would need. I would truly recommend this tape for anyone going through major surgery.

Theresa E. Sawicki from Lititz, Pennsylvania

Excellent Tool! I used Dr Neimark’s tape prior to undergoing Gastric Bypass Surgery. I believe that it helped me immeasurably. Not only was my pain level very manageable, but I left the hospital a day early. My recovery has been nothing short of remarkable! Thanks Dr Neimark!

Gina Hankerd from Corona, California

It sure helped! I went in for major surgery and was fortunate to get Dr. Neimark’s tape on Less Stress Surgery. There are a few points Dr. Neimark mentioned that was very helpful. 1. Think of your blood flow moving away from the area of the surgery. I did this and I had very little blood loss. 2. When you have discomfort (pain) make your mind think of good experiences. This worked great for me. I thought of my wife and kids. 3. When you wake up from surgery start thinking of your favorite foods. This will get your intestine’s working faster. I dreamed about cheesecake! It sure helped. I would recommend anyone going through surgery to listen to Dr. Neimark’s tape.

John Corey from Santa Ana, California

Indispensable in preparing for and recovering from surgery. This is not just another “feel good relaxation tape”. Going into surgery without it, is like going into war unarmed. When informed that I would have to have both breasts removed, my emotions ran from shock and fear to anger and helplessness. Listening to the tape changed my attitude. Now I was taking an active part in how my surgery would go, as well as my recovery time. My anxiety pre-surgery decreased. Blood loss during the surgery was minimal. Most importantly, post surgery I experienced no nausea, and tolerable pain. Don’t be a victim of your surgical experience. Dr. Neimark’s tape made a believer out of my surgeon and the entire medical staff. If you or someone you love is facing surgery, get this tape. It actually helps you give your body specific directions to decrease anxiety, minimize blood loss, control nausea, pain, and healing. I can’t recommend it highly enough.

Madelaine Skenderian from Irvine, California

What If It Doesn’t Work For Me?

I know how hard it is to make a decision to purchase something from someone you’ve never met before. You don’t really know me from a stranger.

What if it’s a hoax? What if it’s just a bunch of medical babble?

I know you’ve already got a lot on your mind with your upcoming surgery. So let me address your concerns:

  • Even though you don’t know me, I promise you, I really do exist. Feel free to call my office at 949.502.5656 and speak to my nurse Cathy with any questions you may have. She has been my personal nurse for over 20 years now and she has heard firsthand the stories of all the patients who have benefited from the Less Stress Surgery System.
  • There’s no hoax here. I am more than happy to provide you with a report of all the scientific references for everything I say in this letter and my report. As my daughter Arianna used to say when she was 5 years old,  “I’m not joking. For real!”

But I Still Can’t Make Up My Mind. I Just Don’t Know If I Will Take The Time To Listen To The Tape.

It’s true it will take about 20 minutes to listen to the guided imagery tape. And you need to listen once or twice a day for the week prior to surgery and the week after surgery. But I promise you, it is the most relaxing time you will have.

The imagery is calming and peaceful with the sounds of the ocean in the background. All you need to do is sit back and allow your mind to relax and let your body respond to the specific physiologic instructionsthat I will be leading you through.

Though you are actively engaging your mind in the process and tapping into your body’s inner wisdom, it is not physical, stressful or difficult in any way, whatsoever.

Isn’t There Some Way I Can Know For Sure That I Will Really Benefit And Not Be Wasting My Hard-Earned Money?

That’s a really great question! Let me ask you something in return:


Would that help you make a decision now?

What if there were a way for you to know for sure that you were spending your money wisely?

Successful surgical outcomes do not happen by chance. Your surgeon will do their part and you must do yours.

Helping you to have a successful surgical outcome is my main motivation and to prove it to you, I want you to know that you have ABSOLUTELY NOTHING TO LOSE with this guarantee:

I offer a FULL ONE YEAR GUARANTEE, so just look at as a rental.  Just rent The Less Stress Surgery Guided Relaxation System And USE IT For Your Entire Surgical Experience. I will charge your credit card as a hold against the rental. You will get all the bonuses to keep.

Anytime up to 1 full year after your operation, if for any reason, you feel you did not benefit from listening to the audio file and following my advice, then you owe nothing and I will refund every penny you spent, no questions asked. Just email me at DrN@LessStressSurgery.com, fax my office at 949.502.5647 or call my nurse Cathy at the office at 949.502.5656 for a full, “no questions asked” refund of every penny that I spent.

I understand that this guided relaxation program is a digital file that I can listen to on my computer OR synchronize to my MP3 Player OR write to CD and listen to on a CD Player. I also understand that there is no physical CD or tape that comes with this order. In this way, I can make as many copies for my personal use as I like and I can begin listening immediately.

I also agree that Dr. Neimark has not made any promises or guarantees, whether stated or implied, that I will produce any specific result in my physical, mental or emotional health as a result of listening to this program.

Finally, I understand that my purchase is covered by Dr. Neimark’s 100% satisfaction guarantee. If I’m not satisfied I can cancel and get a refund on my purchase price at any time from the time of my surgery.

Thanks so much. I want to let you know that your tape has helped my brother tremendously. Gene has been in a wheelchair since 1985. He has had many, many operations for his back, bed sores and as of just a few days ago he had his second leg amputated due to a bone infection. I found your web site a few weeks ago and when I found out he was going to have surgery I ordered your information. He has had trouble in the past with anesthesia. This time he has breezed through (in comparison) to his four surgeries. He didn’t get sick and got to eat within 2-3 hours after. He really has done extremely well and raves about the tape to the medical staff. He could be your poster boy. Thanks again so much. I hope you can get your message out there to the medical community. My brother, my family and I will sure be helping. Thanks so much.!!

Vickie N. from Madison, Wisconsin

The Scientific Evidence on Guided Imagery in Improving Surgical Outcomes

Norman Cousins, the great humanitarian and author once said that “the highest exercise of a physician’s skill is to prescribe not just out of a little black bag but out of his or her knowledge of the human healing system.” Advances in mind/body research are now showing us the specific ways in which we can reach beyond our “little black bags” and help patients activate their own internal healing system. These advances allow us a measure of coping and self-care that can greatly improve our physical and psychological well being.

In this special report, we will review the latest research on mind/body interventions which are capable of speeding our recovery after surgery, minimizing post-operative pain, decreasing blood loss and reducing anxiety. This research draws upon new understandings in our knowledge of the human healing system.

We can improve our outcome from surgery.

There is now an abundance of research showing that pre-operative mind/body interventions (the use of guided imagery, auto suggestion, specific physiologic instruction or affirmation, etc.) are consistently effective in improving medical and psychological outcomes after surgery.

In his recent review article, Henry Dreher, author and scholar, states that “several hundred studies involving thousands of patients confirm that relatively simple behavioral interventions prior to surgery can demonstrably improve postoperative outcomes in such measures as reduced need for pain medication, shorter hospital stays, less blood loss, and fewer surgical complications.” (Dreher H 1998 Mind-body interventions for surgery: evidence and exigency. Advances in Mind-Body Medicine 14, 207-222.)

What are these simple mind/body (behavioral) interventions?

The vast majority of studies done in this area use what researcher Elizabeth Devine calls “psychoeducational” interventions. These usually involve a nurse, psychologist or doctor providing patients with health-related information (preparatory information), teaching patients skills and exercises likely to reduce discomfort and complications (rehabilitative and coping skills), and giving patients psychosocial support. These preoperative interventions take about 30 to 45 minutes to administer.

In her meta-analysis of over 102 studies, Devine concludes that “based on the research reviewed, psychoeducational interventions reliably facilitate the recovery of surgical patients.” The greatest benefits were found in the reduction of medical complications, quicker return to normal activities after surgery, reduced patient pain and improved psychological well-being.

More recent work by Henry Bennett, Ph.D., the leading pioneer and researcher in the field of behavioral anesthesia, reveals that even simple physiologic instruction (administered in a short 15 minute session) provides excellent outcomes from surgery.

Which of these interventions work best?

Those techniques that involve both educational AND emotional support seem to work best. As the field of behavioral anesthesia advances, however, what becomes clear is that many forms of traditional relaxation tapes and techniques do NOT confer the desired medical benefits. In fact, in certain cases, simple relaxation techniques actually make things worse than no pre-operative intervention. Why is this?

The most likely explanation comes to us from Dr. Bennett himself. Dr. Bennett hypothesizes that surgery is a stressful and demanding psychological and physiological event. As such, surgery requires preparation and training, no different than an athlete preparing to run a marathon. Simply “relaxing” prior to surgery is akin to having an athlete “relax” prior to a race without actually training, preparing and building up stamina and strength. The athlete is unlikely to do well. A much better outcome is expected for the athlete who trains hard, rehearses the course in their mind, knows the difficulties to expect and is prepared physically and mentally for the race.

A thorough review of the literature demonstrates that Bennett’s hypothesis is true: the best outcomes from pre-operative mind/body interventions are derived when the intervention involves specific “training” of the body and mind, through specific physiologic instructions that prepare the body for the rigors of surgery. This involves teaching patients certain skills that prepare and ready them for surgery.

Specifically we teach patients that they can learn to control the relaxation of their muscles, thereby altering blood flow to the surgical site. We teach patients that they can increase the return of intestinal motility by thinking of certain foods or sounds which stimulate the gut. We teach patients that they can improve their immune function by imagining their white cells moving towards the surgical site to clean the debris of the body.

What is the evidence that specific physiologic instructions work?

One of Dr. Bennett’s early studies examined the effect of simple preoperative instructions in decreasing blood loss during spinal surgery. Surgical procedures involving fusions or instrumentation of the spine are typically bloody surgeries, often requiring transfusions. In this particular study, 94 patients scheduled for spinal surgery were randomly assigned to one of three groups.

All three groups received a 15 minute intervention from a psychologist. The first group received information about neurological monitoring during spinal surgery. The second group was taught about neurological monitoring and was also taught to relax their muscles during the operation. The third group received all of the above instruction PLUS specific directions for moving blood away from the surgical incision site during the operation (in order to minimize blood loss) and then moving blood back toward the surgery site after the operation (in order to maximize wound healing).

The findings showed that patients in the third group were able to exert positive mental control over their blood loss during surgery. Patients in the third group lost an average of 500 cc of blood compared to 900 cc of blood loss in the first and second groups. These results held true even after controlling for the length of incision and the length of time under anesthesia.

It is important to understand that the technique for delivering these instructions to preoperative patients was direct and simple, involving no hypnosis or relaxed suggestible state. Patients were simply told in normal conversation about the importance of blood conservation with statements like “the blood will move away” from the area of surgery during the course of the operation. Then, after the operation, the blood will “return to the area”. All instructions were given in one 15-minute sitting.

This study dramatically illustrates the ability of the mind to convert our ideas and expectations into biochemical realities. The future will further elucidate the mechanisms by which these changes in physiology and biochemistry occur. But for now, results from studies such as the one above provide us encouragement in our ability to exert some measure of positive control in our lives, even in situations such as major surgery where we tend to feel out of control and somewhat helpless.

(For further information, please see: Bennett, HL Ph.D., Benson, DR M.D., Kuiken, DA M.D. Preoperative Instructions For Decreased Bleeding During Spine Surgery. Anesthesiology v.65, No. 3A, Sept. 1986.)

Guided imagery really works.

Another more recent study by psychologist Dr. Bennett involved the following design.

In a randomized, placebo-controlled, double-blind clinical trial, 335 surgical patients were randomly assigned to either a control group or one of four different audiotape programs: 1) Bennett’s informational instructions about the surgical procedure including specific post-op outcomes 2) a relaxation tape of soothing music with a voice-over about the difficulty of surgery and the healing potential of relaxation 3) a relaxation tape of tonal sounds alleged to “drive” the brain toward greater relaxation with a voice over prompting the patient into deeper relaxed states and 4) a guided imagery tape with emphasis on spiritual connectedness and metaphors regarding positive outcomes, like faster wound healing, less pain, no nausea, etc.

The patients were assigned to take the tapes home several days prior to surgery and listen to them as often as they liked. Most patients averaged four listenings. When compared with the control group, the first three tapes produced no significant benefits with regard to three measured outcomes (blood loss during surgery, length of hospital stay, and use of post-operative pain medication). The fourth tape of guided imagery (produced by a highly regarded therapist and imagery practitioner, Belleruth Naparstek) produced highly significant results on 2 of the 3 outcomes (less blood loss and less time spent in the hospital).

Interestingly, the patients who listened to the two relaxation tapes did WORSE than the control group on all 3 medical outcomes. This confirms Bennett’s view that tapes emphasizing relaxation alone do not necessarily produce desired benefits.

One possible explanation for this is akin to having someone “over-relax” prior to a difficult final exam at school. Far better test results would be expected if that student is properly “prepped” for the exam, knowing what to expect, the difficult test areas to be encountered, etc. Then, once properly prepared, a mild “relaxation” might be of benefit by inducing a state of “calm confidence” or “relaxed readiness”, where a state of panic and “over-stress” are avoided. In this way, we realize the greatest benefit when proper preparation is coupled with a measured amount of relaxation in order to optimize clarity, recall, relaxed readiness and calm confidence.

This appears to be the reason that only the guided imagery tape by Belleruth Naparstek provided positive outcomes. In her tape, she gave proper preparation about the effects of surgery on the body (using guided images to promote wound healing, minimize blood loss, less pain, no nausea, etc.) combined with a sense of relaxation, safety and calmness. Naparstek herself says the imagery is designed to “evoke spirit, to generate love and gratitude.”

This study seems to confirm what Norman Cousins, the great scholar and humanitarian, says in his book Head First: The Biology of Hope, “.. the human mind converts ideas and expectations into biochemical realities.” Our mind seems to hold within it a natural pharmacy, or healing system, which when evoked and called upon, can bring about changes in our physiology, biochemistry and immunology; helping us to heal physically and to calm ourselves emotionally.

(For more complete information on the above study, see: Bennett HL 1996 A comparison of audiotaped preparations for surgery: evaluation and outcomes. Paper presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Tampa, FL. or read the account in: Dreher, Henry. 1998 Mind-body interventions for surgery: evidence and exigency. Advances in Mind-Body Medicine 14, 207-222.)

More support for guided imagery.

Even more support for the power of guided imagery comes from a published study at the Cleveland Clinic Foundation by Diane L. Tusek, R.N., B.S.N., and James M. Church, M.D. In this prospective, randomized trial, 130 patients undergoing their first elective colorectal surgery were divided into one of two groups: Group 1) received standard preoperative care and Group 2) listened to a guided imagery tape three days before surgery and in the recovery room; as well as a music-only tape during the surgery.

The results showed that those patients in the guided imagery group significantly reduced their anxiety, decreased their post-operative pain, used less narcotics to control their pain and had a greater measure of satisfaction with their surgery. This is further evidence supporting the power of guided imagery in influencing our physiology and biochemistry in a positive way post-surgically.

These results are important because they replicate many of the findings of Bennett’s guided imagery study. The researchers themselves conclude that the use of guided imagery “has a significant impact on preoperative and postoperative anxiety, pain, narcotic consumption, and patient satisfaction. Guided imagery is a simple, low-cost adjunct in the care of patients undergoing elective colorectal surgery.”

(For more information, see: Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum 1997;40:172-178)

How does guided imagery really work?

Recent advances in technology allow us to visualize blood flow changes to different parts of the brain by the use of sophisticated imaging equipment called P.E.T. scanners (Positron Emission Tomography). Researchers have shown that the same parts of the brain are activated whether people actually experience something or vividly imagine it.

(For further information, see: Kosslyn, S., N.M. Alpert, W.L. Thompson, V. Maljkovic, S.B. Weise, D.F. Chabris, S.E. Hamilton, S.L. Rauch, and F. S. Buonanno. “Visual Mental Imagery Activates Topographically Organized Visual Cortex: PET Investigations.” Journal of Cognitive Neuroscience 5 (1993): 263-87.)

In other words, picturing an image of a beautiful sunset activates the same area of the cerebral cortex (brain) as actually seeing a beautiful sunset. Listening to our favorite music triggers the same area of our brain as does imagining the music in our mind. Imagining the touch of a warm cotton shirt hot from the drier activates the same area of our brain as actually feeling the warm touch on our skin.

This information helps us to understand how visual imagery can actually influence our physical body and our biochemistry. Vivid imagery actually stimulates the same brain centers as the “real thing”, in turn sending signals to our limbic system (the “feeling center” of our brain), our autonomic nervous system (which controls our bodily functions like heart rate, blood pressure, perspiration, respiratory rate, etc.) and the endocrine system (the control center for all our hormones, including stress hormones like cortisol, adrenaline, norepinephrine and the like). We all know what it is like to awaken from a scary dream and feel our heart pounding, our muscles aching, our breathing quickened and our skin sweating. That is the power of the “imaginary” world of visualization and imagery.

One basic premise of mind/body medicine is that all our thoughts and feelings are chemical. When we imagine a soothing walk on a warm, sandy beach (a vivid thought and feeling), our body produces neuropeptides (chemical messengers for those thoughts and feelings) which in turn circulate throughout our body, exerting their influence (spreading their message) to the cells of our immune system, nervous system, endocrine system and the like. As demonstrated by the studies above, this is how our body converts our ideas and expectations into biochemical realities. When properly harnessed, we can utilize appropriate ideas, expectations and instructions to help us activate and augment our human healing system, thereby improving our surgical outcome.

Wishing you the best of health and a speedy recovery from your upcoming surgery.