Interactive guided imagery

1. Introduction

Version followed: Interactive Guided Imagery℠ (IGI) as the Academy for Guided Imagery (AGI) currently lays out its Basic and Professional certification curriculum. The guide also uses the nine-script sequence in Martin L. Rossman's Guided Imagery for Self-Healing (2nd ed., H J Kramer / New World Library; 2010 ebook) and the Rossman & Bresler (1995) EMDR conference abstract. Only the publisher's script list for the book was available; its full text is not drawn on, so step detail is largely [synthesis] and is marked as such.

What it is: IGI is a service-marked, client-led way of working with mental imagery. Physician Martin Rossman and pain specialist David Bresler developed it from the 1970s and formalised it through the Academy for Guided Imagery, whose copyright dates from 1988. Most secondary accounts give 1989 as the founding year [uncertain]. [source: AGI, What is IGI; GoodTherapy; Holistic Primary Care]

IGI is a framework and training tradition, not a manualised protocol with a fixed session count. AGI names Jungian active imagination, hypnosis, NLP and psychosynthesis as influences. It certifies licensed and other health professionals as "Imagery Guides". [source: AGI, What is IGI; AGI Full Certification]

Core idea of change, as its authors frame it: imagery is a natural way the nervous system stores, processes and retrieves information. Rossman and Bresler describe it as drawing on both conscious and unconscious resources. In a relaxed, focused state the client lets an image of a symptom, problem or wise inner figure form, then talks with it. Insights come from the client's own imagery rather than from the guide. They are then "grounded" into concrete action. Rossman and Bresler held that the more control the client has over pace and direction, the faster the progress and the lower the resistance. [source: Rossman & Bresler 1995 abstract; AGI, What is IGI]

Scope in this guide: IGI is presented as psychological support, coping and insight work by a clinician acting within their competence. Where it is used with people who are ill, it runs alongside medical assessment and treatment and never replaces them. AGI and practitioner pages make claims about symptom resolution in physical disease. These are uncontrolled anecdotes and must not be offered to clients as treatment of physical disease. [source: Holistic Primary Care; AGI, What is IGI] [synthesis]

2. Framework

The sources give no fixed phases or session counts. AGI case material refers only to "a series of sessions" [uncertain]. The phase structure below orders the content in two ways: the Rossman script sequence and the AGI training sequence. The training sequence runs Basic Imagery → Inner Advisor → Evocative Imagery → Grounding → Dialoguing with Symptoms, then Resistance/Parts → Children → Adult Survivors → Illness → Loss → Regression, Inner Child, Purpose. The ordering is [synthesis] built on those sources. [source: Rossman 2010 publisher page; AGI Full Certification]

Levels of interactivity. Rossman and Bresler (1995) describe three levels of guided work. They run from passive suggestion, where the guide supplies the imagery, to fully interactive work, where the client controls pace and direction. IGI deliberately works at the interactive end. Scripted or recorded imagery is used mainly for skills and home practice. [source: Rossman & Bresler 1995 abstract]

Typical session format (secondary source; 40–70 min) [source: GoodTherapy] [uncertain as an AGI standard]:

Preparation and intention: 5–10 min
Relaxation induction: 5–10 min
Imagery work: 15–25 min
Return to alertness and integration: 5–10 min
Discussion and home-practice plan: 10–15 min

Phase 0: Assessment, screening, consent (session 1)

Goals: obtain the medical diagnosis and confirm medical care is in place for any physical complaint; screen for contraindications (§4.1); agree goals; explain imagery and client control. AGI's foundation course lists "diagnostic and prognostic assessments", but their content is not drawn on here [uncertain]. [source: Holistic Primary Care; AGI FIGI page]
Move on when: there is no exclusion, or a plan for stabilisation is agreed; consent is given; medical status is known. [synthesis]

Phase 1: Imagery skills (about sessions 1–3) [synthesis on count]

Goals: explore how this client images (visual, auditory, kinaesthetic and so on); teach basic and conditioned relaxation and deepening; establish a safe or special place; teach stopping and re-alerting.
Rossman scripts covered: Exploring Your Imagery Abilities; Basic Relaxation Skills; Deepening Techniques. [source: Rossman 2010 publisher page]
Move on when: the client can enter and leave a relaxed focused state on request; reports images in at least one sense; can use the safe place to settle; is practising at home. [synthesis]

Phase 2: Receptive and insight work (variable)

Goals: let images of the problem or symptom arise; dialogue with them; meet an Inner Advisor; use evocative imagery to reach a needed feeling state.
Rossman scripts: Your Healing Imagery; Meeting Your Inner Advisor; Symptoms are Symbols. AGI Basic Certification and Preceptorship 1 cover Inner Advisor, Dialoguing With Symptoms and Evocative Imagery. [source: Rossman 2010 publisher page; AGI Full Certification]
Move on when: a usable insight, need or option has emerged and the client can state it in ordinary words. [synthesis]

Phase 3: Grounding (usually at the end of every insight session)

Goals: turn insight into specific, realistic action and check for obstacles. Rossman script: Grounding Your Insight. AGI teaches this as "turning insights into real-world actions". [source: Rossman 2010 publisher page; AGI FIGI page]
Move on when: the plan has been tried and reviewed. If action stalls repeatedly, go to resistance work. [synthesis]

Phase 4: Resistance, parts and specialist applications (as needed; advanced training)

Goals: understand and reconcile inner conflict through resistance, parts, sub-personalities, ego states and polarities.
Specialist adaptations: children, adult survivors of childhood trauma, chronic and life-threatening illness, death and loss. Regression with the Inner Advisor, Inner Child/Essential Self and purpose work are also taught here.
Rossman script: Learning From Your Resistance.
These are certification-level skills. AGI presents trauma work as challenging even for experienced therapists. [source: AGI Full Certification; Rossman 2010 publisher page]

Phase 5: Consolidation and ending

Goals: an image of wellness or desired future; an independent self-practice routine (recordings); a review of gains and a relapse plan.
Rossman script: Your Image of Wellness. [source: Rossman 2010 publisher page; VA Whole Health]
End when: goals are met and the client uses imagery on their own. [synthesis]

3. Guiding principles

The client leads; the guide follows. Ask open questions and let the client set pace and direction. Rossman and Bresler linked more client control to faster progress and less resistance. [source: Rossman & Bresler 1995 abstract; Holistic Primary Care; VA Whole Health]
Guide, not therapist, inside the imagery. AGI teaches a distinct "Imagery Guide" role that empowers clients to take part in their own healing. In practice, use few interpretations and many invitations, and leave your clinical formulation outside the imagery. [source: AGI Full Certification (ATS-1A)] [synthesis on practice]
Images carry information. AGI holds that intuitions, emotions, memories and beliefs often show up more clearly as images than as words. Treat each image as the client's meaningful experience and explore it rather than correcting it. [source: AGI, What is IGI]
Symptoms can be approached as symbols. Invite the client to give a symptom or problem an image and ask what it needs or means. Use this alongside medical care, never instead of it. [source: Rossman 2010 publisher page; Holistic Primary Care]
Diagnosis first. The main risk named for imagery is that it replaces accurate diagnosis and treatment. Confirm medical assessment before symptom imagery. [source: Holistic Primary Care]
Inner resources, client-owned. AGI describes clients building relationships with images that represent inner wisdom. Credit insights to the client, not to the guide or the technique. [source: AGI, What is IGI] [synthesis on practice]
Insight is not enough; ground it. Every insight session ends with concrete next steps. [source: AGI FIGI page; Rossman 2010 publisher page]
Resistance is information. Explore a block ("what is in the way?") rather than pushing past it. [source: Rossman 2010 publisher page; AGI Full Certification]
Safety and support before depth. Rossman and Bresler present the Inner Advisor as a support system for clients with PTSD, used to prevent or reduce flooding. Install resources before you approach distressing material. [source: Rossman & Bresler 1995 abstract]
Multisensory and individual. People differ in which senses they image with. Accept "feeling" or "knowing" as fully valid imagery. [source: VA Whole Health; GoodTherapy]
Practice between sessions. Record or recommend imagery for home use so that the client builds mastery. [source: VA Whole Health]
Work within competence. AGI's trauma, child and illness modules are advanced, and AGI recommends that trainees have their own therapist. Use advanced techniques only with matching training and supervision. [source: AGI Full Certification]
Consent and transparency. Explain what will happen, that the client can stop at any time, and that nothing is done covertly. [synthesis, per clinical hypnosis ethics]
No memory recovery. Treat images that look like memories as the client's present experience, not as historical fact. Never use imagery to uncover or verify past events. [synthesis; brief requirement]

4. Intervention inventory

The inventory covers every technique named in the AGI curriculum pages and the nine Rossman scripts, plus the adjunct procedures the sources mention. Step-by-step wording is a paraphrase. Where the AGI or Rossman procedure is not drawn on, the steps are general practice marked [synthesis]. All example language is illustrative and is not Rossman's or AGI's scripts.

4.1 Assessment, screening and informed consent

Purpose / when: Before any imagery. AGI's foundation course names "diagnostic and prognostic assessments", but their content is not drawn on here [uncertain]. [source: AGI FIGI page]
Steps:
1. Confirm the medical diagnosis and the current treatment of any physical symptom. The main risk of imagery is that it replaces diagnosis and treatment. [source: Holistic Primary Care]
2. Screen and adjust as follows. [source: Holistic Primary Care; VA Whole Health; GoodTherapy]
  - Active psychosis, hallucinations, delusions or poor reality testing: avoid, or use only with specialist expertise.
  - Delirium, dementia or severe cognitive impairment: avoid.
  - Dissociative disorders and borderline personality disorder: Holistic Primary Care calls these not absolute contraindications but needing relevant expertise.
  - Unprocessed trauma that may surface: prepare and stabilise first.
  - Religious objection to imagery: respect it and offer alternatives.
3. Add these screens [synthesis]: current suicidality or self-harm (standard risk assessment first); substance intoxication; epilepsy triggered by relaxation or breathing work (medical check); severe asthma or panic with breath-focus (avoid deep-breathing cues); recent bereavement or crisis (stabilising imagery only).
4. Explain imagery, client control and the right to stop. State that nothing is done covertly and that imagery is not a cure for physical disease.
5. Agree goals and how progress will be judged. Record consent.
Example language (illustrative): "You stay in charge throughout. You'll hear me, you can talk, and you can open your eyes and stop whenever you want. This works alongside your medical care, not instead of it."
Watch for: fear of losing control, beliefs that imagery is "mind control", magical expectations of a cure. Correct these before starting.

4.2 Exploring imagery abilities

Purpose / when: Session 1 or 2. Find out which senses the client images with and normalise individual differences. This is Rossman's first script; the script itself is not drawn on here. [source: Rossman 2010 publisher page; VA Whole Health]
Steps [synthesis]:
1. With eyes open or closed, ask the client to recall a familiar, neutral or pleasant scene (for example, their kitchen) or object (a piece of fruit).
2. Ask in turn about sight, sound, smell, taste, touch and movement.
3. Note which senses are strong. Name "just knowing" or "feeling it" as valid imagery.
4. Show the mind–body link with a sensory image, such as tasting a lemon. Bresler's site uses this example. [source: Bresler Center]
Example language (illustrative): "Some people see pictures, some hear or feel things, some just sense them. Whatever comes for you is the right way."
Watch for: performance anxiety ("I can't visualise"). Reframe it and work through the strongest sense. It is working when the client reports something in some sense and is curious about it.

4.3 Basic relaxation and conditioned relaxation

Purpose / when: Every session, as the entry to imagery. It is also a self-regulation skill in its own right. Rossman script 2 (Basic Relaxation Skills). In Rossman and Bresler (1995), "Conditioned Relaxation" is a cued relaxation response that can also support EMDR (§4.16). The exact conditioning procedure is not drawn on here [uncertain]. [source: Rossman 2010 publisher page; Rossman & Bresler 1995 abstract]
Steps [synthesis]:
1. Comfortable posture; eyes closed or soft gaze.
2. Slow, natural breathing. Invite the client to let each out-breath be a little longer.
3. Progressive relaxation: guide attention region by region, inviting each to soften. Use progressive tense-and-release only if it is not painful.
4. Pair the relaxed state with a cue the client chooses, such as a word, an image or a touch of thumb and finger. Practise the cue daily so it becomes a quick shortcut.
5. Re-alert: count up or invite movement, open the eyes and orient to the room.
Example language (illustrative): "Let your breath find its own pace… each time you breathe out, let a little more tension go… when you feel settled, quietly say your word to yourself."
Watch for: relaxation-induced anxiety (increasing breath focus or bodily awareness can raise panic). If it appears, switch to eyes-open, external-focus grounding. It is working when there is visible slowing, the client reports calm, and the cue works faster with practice.

4.4 Deepening techniques

Purpose / when: After basic relaxation, to strengthen absorption before receptive work. Rossman script 3; the specific methods are not drawn on here [uncertain]. [source: Rossman 2010 publisher page]
Steps [synthesis]:
1. Use a descent image (stairs, a path down to a valley) or a counting-down sequence. Pair each step with "a little more settled".
2. Offer choice ("perhaps a stairway, a path or a lift").
3. Check depth by asking the client to rate how settled they feel, or by ideomotor nod. Clients do not need deep states for IGI.
Example language (illustrative): "With each step down, notice yourself becoming a little more settled and a little more absorbed."
Watch for: drowsiness or sleep, which GoodTherapy lists as a common effect. Lighten the state by keeping the client talking. Dissociative drift (numbness, unreality, losing contact with your voice) means stop deepening and ground.

4.5 Safe or special place

Purpose / when: An early resource for calming, a base to return to during difficult work, and a home-practice anchor. It appears in VA, GoodTherapy and Bresler Center accounts. As an IGI-specific step it is [uncertain]; Rossman's scripts are not drawn on here.
Steps:
1. After relaxation, invite the client to let a place come to mind where they feel safe, calm and at ease. It can be real or imagined. [source: VA Whole Health]
2. Explore it through all the senses: sights, sounds, smells, temperature, textures. [source: VA Whole Health; Bresler Center]
3. Invite the client to notice how their body feels there and to anchor the feeling with a cue. [synthesis]
4. Agree it as the place to return to if anything becomes too much. [synthesis]
5. Re-alert and debrief.
Example language (illustrative): "Let a place come to you where you feel completely safe and at ease. It might be somewhere you know, or somewhere new… What do you notice around you?"
Watch for: a place that turns unsafe (intrusions, people appearing). Offer to adjust it or to choose another, and avoid places linked to trauma. Some trauma survivors cannot yet imagine safety; use "a little calmer" or an external object instead [synthesis]. It is working when the client settles reliably and uses it independently.

4.6 Healing imagery (comfort and coping imagery)

Purpose / when: Rossman script 4, "Your Healing Imagery". In this guide it is framed as coping and comfort imagery for symptoms (pain, nausea, anxiety around procedures). It is used after medical assessment and alongside medical treatment, and is never presented as treating disease. [source: Rossman 2010 publisher page; GoodTherapy] [synthesis on framing]
Steps [synthesis]:
1. Relax, then invite an image of the discomfort: its shape, colour, size, texture.
2. Invite an image of comfort or soothing, chosen by the client (coolness, softening, light, a caring presence).
3. Let the client imagine the comfort meeting the discomfort and notice any change. Accept no change as information.
4. Rate distress or pain before and after (0–10).
5. Record or teach it for home use.
Example language (illustrative): "If that discomfort had a shape or colour, what would it be?… And what image might bring it some comfort?"
Watch for: client beliefs that imagery will cure the illness, and self-blame if the illness progresses ("I didn't visualise well enough"). Say plainly that imagery supports coping and comfort and does not determine the course of disease [synthesis]. It is working when distress or symptom-burden ratings fall and the client has a greater sense of control.

4.7 The Inner Advisor

Purpose / when: IGI's signature technique. It is Rossman script 5 and the subject of a full AGI course (ATS-1B) and of Preceptorship 1. Rossman and Bresler (1995) describe the Advisor as a wise, compassionate inner figure, used as an inner support for clients with PTSD and to prevent flooding. It is used for insight, decisions, support and safety. [source: Rossman 2010 publisher page; AGI Full Certification; Rossman & Bresler 1995 abstract]
Steps (the sequence is [synthesis]; the elements of finding the Advisor and developing dialogue are [source: Rossman & Bresler 1995 abstract]):
1. Relax, then go to the safe place.
2. Invite a figure who is wise, kind and caring to appear. It may be a person, an animal, a light or a presence. Let it come rather than choosing it consciously.
3. Check its quality: does it feel caring and wise? If it seems critical or frightening, thank it and invite another.
4. Let the client greet it and ask whether it is willing to talk.
5. The client asks their question. The guide asks the client to report the reply in words, gesture, image or feeling.
6. Continue the dialogue. The guide prompts with follow-up questions ("Ask what it would like you to understand…").
7. Ask whether there is anything else; thank the Advisor; agree how to contact it again.
8. Re-alert, then debrief what was learned. Move to grounding (§4.10).
Example language (illustrative): "Let an image come of a figure who is wise and caring, and who knows you well… When it's there, let me know what you notice." / "What would you like to ask? … And how does it answer?"
Watch for: AGI's advanced Inner Advisor course addresses "common problems" with clients, which are not drawn on here [uncertain]. Likely problems [synthesis]:
- No figure appears: accept a felt sense or voice, or try again next session.
- A punitive or critical figure appears: it is probably not the Advisor; it may be a part worth exploring later in parts work.
- The Advisor gives extreme or harmful directives: these are never acted on and are discussed in debrief.
- In clients prone to psychosis, a voice-like Advisor may blur reality testing: this is a contraindication.
- It is working when the dialogue yields fresh, client-owned perspectives that feel kind and plausible.

4.8 Dialoguing with symptoms ("Symptoms are Symbols")

Purpose / when: Rossman script 6 and an AGI Preceptorship 1 topic. Use it to explore the meaning, needs and messages a client attaches to a symptom or problem (pain, tension, anxiety, a habit). It supports coping, self-understanding and behaviour change, alongside medical care after diagnosis. [source: Rossman 2010 publisher page; AGI Full Certification; Holistic Primary Care]
Steps:
1. Progressive relaxation. [source: Holistic Primary Care]
2. Ask the client to focus on the symptom and let an image arise that represents it. [source: Holistic Primary Care]
3. Explore the image: what it looks like, what it is doing, how the client feels towards it. [synthesis]
4. Invite the image to speak in a way the client can understand. Ask why it does what it does, and what it wants or needs. [source: Holistic Primary Care]
5. Ask what it would need in order to ease. Ask what it offers or protects the client from. [synthesis]
6. Track how emotions and sensations shift during the dialogue. The client's response to the image's answer is clinically meaningful. [source: Holistic Primary Care]
7. Close with thanks. Re-alert. Ground (§4.10). Revisit in later sessions to find recurring patterns. [source: Holistic Primary Care]
Example language (illustrative): "Let your attention go to that tightness, and let an image come that could stand for it… If it could speak, what would it say it's doing there?"
Watch for: the image's message is the client's own meaning, not a medical diagnosis or prognosis. If the dialogue suggests a new or changing medical symptom, refer for medical review [synthesis]. Strong affect or betrayal themes may surface; explore them respectfully and refer for psychotherapy if you are working in a non-therapy role. [source: Holistic Primary Care] It is working when there is a felt shift, a new understanding, and an action the client can take.

4.9 Evocative imagery

Purpose / when: Part of AGI Basic Certification and Preceptorship 1. AGI describes it as imagery that evokes feelings to support transformation or day-to-day relief. Use it to reach a needed resource state, such as calm, courage, self-compassion or confidence, before a challenge or when the client is stuck in a negative state. The detailed AGI procedure is not drawn on here [uncertain]. [source: AGI, What is IGI; AGI Full Certification]
Steps [synthesis]:
1. Name the feeling the client needs ("steady", "brave").
2. After relaxation, invite a memory, image, place or figure in which that quality is present. The client's own ordinary experiences are fine.
3. Amplify it through the senses and the body: where it is felt, its colour or temperature.
4. Anchor it with a cue. Then imagine carrying the quality into the upcoming situation.
5. Re-alert; rate the feeling; plan when to use the cue.
Example language (illustrative): "Let an image or moment come where you felt even a little bit of that steadiness… notice where in your body you feel it."
Watch for: recalled "good" memories that turn painful. Switch to an imagined or symbolic source. It is working when the felt state rises and the client can call it up on cue.

4.10 Grounding (turning insight into action)

Purpose / when: Close every insight session. In IGI, "grounding" means making insight practical. This is Rossman script 7, "Grounding Your Insight", and AGI's "turning insights into real-world actions". It is distinct from trauma-type sensory grounding, covered in §4.23. [source: Rossman 2010 publisher page; AGI FIGI page; AGI Full Certification]
Steps [synthesis]:
1. Ask the client to say the insight in one or two sentences, in ordinary language.
2. Ask what they could do differently as a result. Get specific: what, when, where, with whom.
3. Scale it down to a first step small enough to be sure of doing.
4. Imagine doing the step and notice any hesitation or obstacles. If there is a strong block, note it for resistance work (§4.11).
5. Agree how they will remember it and report back. Review next session.
Example language (illustrative): "What's one thing you could actually do this week that honours what you learned today?" / "Picture yourself doing it… what gets in the way?"
Watch for: vague or grandiose plans; insights that the client will not or cannot act on; plans that conflict with medical advice (redirect). It is working when steps are carried out and reviewed.

4.11 Learning from resistance

Purpose / when: Rossman script 8, and covered in AGI ATS-2A/2B. Use it when grounding stalls, when there is ambivalence about change, or when the client repeatedly does not follow through. Resistance is treated as a message. The procedure is not drawn on here [uncertain]. [source: Rossman 2010 publisher page; AGI Full Certification]
Steps [synthesis]:
1. After relaxation, imagine taking the planned step and notice where resistance shows up (body, feeling, image).
2. Invite an image of the resistance.
3. Dialogue: what is it protecting? what is it afraid would happen? what does it need?
4. Look for a way to meet its concern, then renegotiate the plan.
5. Optionally, consult the Inner Advisor about the conflict.
Example language (illustrative): "Let an image come for the part of you that hesitates… what is it worried would happen if you went ahead?"
Watch for: framing that blames the client. Keep it curious. It is working when the plan becomes more realistic and follow-through improves.

4.12 Parts work: sub-personalities, ego states, polarities and conflict resolution

Purpose / when: AGI ATS-2A covers resistance, parts, sub-personalities and ego states, to help clients identify, understand and reconcile inner conflict. ATS-2B covers parts, polarities and conflict resolution. Rossman and Bresler (1995) also list conflict-resolution techniques. Use it for ambivalence, inner criticism or competing needs. The detailed procedures are not drawn on here [uncertain]. [source: AGI Full Certification; Rossman & Bresler 1995 abstract]
Steps [synthesis]:
1. Name the two sides of the conflict ("the part that wants to rest" and "the part that pushes").
2. After relaxation, invite an image for each and describe it.
3. Have the client dialogue with each in turn: what it wants, what it fears, and its positive intention.
4. Let the parts speak to each other, with the guide moderating. Look for shared aims.
5. Negotiate an arrangement both can accept. Optionally, ask the Inner Advisor to mediate.
6. Ground the agreement in behaviour.
Example language (illustrative): "What does this part want for you? … And what is it afraid would happen if it stopped?"
Watch for: in clients with dissociative disorders, parts imagery needs specialist expertise. Avoid it, or use it only within trauma-informed stabilised care. It is working when polarisation softens and decisions become possible.

4.13 Imagery for habits, addictive behaviours and motivation

Purpose / when: AGI ATS-2B covers "overcoming resistance in addictions and habit control", and AGI lists diet, smoking and alcohol under resistance work. Rossman and Bresler (1995) list motivation among IGI uses. Use it as an adjunct within standard addiction or smoking-cessation care, including medical and pharmacological support, not in place of it. [source: AGI Full Certification; AGI, What is IGI; Rossman & Bresler 1995 abstract]
Steps [synthesis]: combine the following.
- Dialogue with the image of the urge or habit (§4.8 structure): what it gives and what it costs.
- Parts work between the "wanting" and "quitting" sides (§4.12).
- Evocative imagery of the desired state (§4.9).
- Future rehearsal of high-risk situations, with a coping plan grounded in action (§4.10).
Example language (illustrative): "Let an image come for the urge… what does it want for you? … Is there another way it could get that?"
Watch for: withdrawal states, intoxication and alcohol dependence that needs medical detox. These need medical management first. No weight targets in eating-related work. It is working when urges are understood and managed and the behaviour plan holds.

4.14 Image of wellness (desired-outcome imagery)

Purpose / when: Rossman script 9, "Your Image of Wellness". Use it for motivation, orientation to goals and consolidation late in therapy. [source: Rossman 2010 publisher page]
Steps [synthesis]:
1. After relaxation, invite an image of oneself living well. With illness, this means living as well as possible with or after it.
2. Explore it through the senses: activities, relationships, how the body and mood feel.
3. Ask what this future self knows or does that helps.
4. Ground it in present steps.
Example language (illustrative): "Let an image come of yourself living the way you'd most like to… what are you doing? how do you feel?"
Watch for: in progressive or terminal illness, avoid images that imply cure as the measure of success; choose values, connection and comfort instead. Grief may arise. It is working when the client is motivated and has concrete steps.

4.15 Performance and rehearsal imagery

Purpose / when: Rehearse a skill or situation, such as public speaking, sport, a medical procedure or an assertive conversation. VA and Bresler list it among guided imagery uses. It is directive rather than interactive, and its status as a core IGI technique is [uncertain]. [source: VA Whole Health; Bresler Center]
Steps [synthesis]:
1. Relax.
2. Imagine the situation from the start, in sensory detail, handling it well.
3. Include a likely difficulty and the coping response.
4. Repeat. Practise at home before the event.
Example language (illustrative): "See yourself walking in… notice your feet on the floor, your breath steady… and when the hard question comes, notice how you pause and answer."
Watch for: anticipatory anxiety rising during rehearsal. Pause, go to the resource, then resume. It is working when anxiety ratings drop across repetitions and the client performs better.

4.16 IGI combined with EMDR

Purpose / when: Rossman and Bresler (1995) suggest that EMDR therapists:
- use Conditioned Relaxation during eye movements to improve the "clearing" process;
- enlist the Inner Advisor to prevent or reduce flooding, traumatic insight and "regression panic". This is for EMDR-trained clinicians only, within the standard EMDR protocol and its readiness criteria. [source: Rossman & Bresler 1995 abstract]
Steps (only the elements are from the source; the integration steps are [synthesis]):
1. In EMDR preparation, install conditioned relaxation (§4.3) and the Inner Advisor (§4.7) as resources.
2. During processing, if distress spikes beyond the window of tolerance, cue relaxation or invite the client to bring in the Advisor for support. Then return to standard EMDR procedures.
3. Close incomplete sessions with the safe place or the Advisor, plus standard EMDR closure.
Example language (illustrative): "Let your Advisor be there with you as you notice that… and when you're ready, just notice what comes next."
Watch for: whether adding imagery interweaves changes standard EMDR fidelity. Follow the current EMDR protocol and your EMDR training [uncertain: 1995 abstract only].

4.17 IGI with children

Purpose / when: AGI ATS-3A adapts IGI for children. It covers developmental and behavioural issues, grief and trauma, anxiety about medical procedures, and stress, pain and illness. The adaptations themselves are not drawn on here [uncertain]. [source: AGI Full Certification]
Steps [synthesis]:
1. Get parental or guardian consent and the child's assent, and check medical input for any physical symptom.
2. Keep it short (a few minutes). Eyes open is fine. Use play, drawing and story.
3. Use a favourite place or a helper figure (an animal, a superhero) in place of formal relaxation.
4. For procedures, rehearse with a coping image (a "comfort switch", a favourite place) and practise beforehand.
5. Let the child draw the image of the worry or pain and talk to it.
6. Teach the parent to cue the practice at home.
Example language (illustrative): "If your tummy ache were an animal, what animal would it be? … What would it like to tell you?"
Watch for: suggestibility in children. Never lead content about past events. Disclosures of abuse trigger safeguarding duties. It is working when the child is engaged, distress falls and the child uses the skill unprompted.

4.18 Imagery with adult survivors of childhood trauma

Purpose / when: AGI ATS-3B teaches skills for supporting adults with the struggles that childhood trauma produces, and calls this work challenging even for very experienced therapists. Rossman and Bresler (1995) list trauma among IGI uses and use the Inner Advisor to prevent flooding. The sources give no dosing or readiness criteria. What follows applies standard phase-oriented trauma practice and is [synthesis]. [source: AGI Full Certification; Rossman & Bresler 1995 abstract]
Readiness criteria [synthesis]:
- Stable living situation; no current abuse.
- No active suicidality or self-harm crisis, and no uncontrolled substance misuse.
- The client can use at least two self-regulation skills (conditioned relaxation, safe place or Inner Advisor, sensory grounding) and return to the present on request.
- Dissociation has been screened. Clients with a dissociative disorder need a specialist.
- The client has a reliable therapeutic relationship and informed consent.
Steps [synthesis]:
1. Stabilisation phase: install resources first (§§4.3, 4.5, 4.7, 4.9).
2. Work with present-day effects (triggers, beliefs, body sensations) through images and the Advisor, before any approach to past material.
3. If distressing material is approached, dose it:
  - one theme per session;
  - keep distress within the window of tolerance (for example, SUD no higher than about 6–7 out of 10, checked every few minutes);
  - give the client control over distance (watching from far away, through a window, with the Advisor present);
  - stop well before the end of the session.
4. Leave at least 15 minutes for closure: safe place, sensory grounding (§4.23), debrief and a containment image for what remains.
5. Do a between-session safety check and arrange contact if needed.
Example language (illustrative): "You decide how close to come to this… you can keep it on a screen far away, and your Advisor is right beside you. Tell me your number."
Watch for: flooding, dissociation (glazed eyes, delayed responses, numbness) and "regression panic". Rossman and Bresler name both flooding and regression panic as risks. Respond with the steps in §5. Treat any emerging memory-like images as present experience. Do not interpret them as proof of past events and do not probe for "hidden" memories. It is working when triggers lose intensity, self-compassion grows and functioning improves.

4.19 Imagery in physical, chronic and life-threatening illness

Purpose / when: AGI ATS-4A covers pain management, navigating crises and "using imagery to support natural healing". FIGI lists "interpreting illness meanings". Rossman taught imagery to cancer patients to restore a sense of control and coping. In this guide these are psychological support and symptom-coping alongside medical treatment, never treatment of the disease. [source: AGI Full Certification; AGI FIGI page; Erickson Foundation session listing]
Steps [synthesis]: combine the following within the medical care plan, and liaise with the medical team.
- Relaxation and comfort imagery for pain, nausea or procedure anxiety (§§4.3, 4.6).
- Symptom dialogue to explore the meaning of illness, and fears and needs around treatment decisions (§4.8).
- Inner Advisor support for decisions and crises (§4.7).
- Rehearsal imagery before procedures (§4.15).
- Recordings for use in hospital.
Example language (illustrative): "This won't change your treatment plan, but it can help you feel more settled and more in charge of how you go through it."
Watch for:
- Clients delaying or refusing effective treatment in favour of imagery: discuss this directly and involve the medical team.
- Self-blame for illness or progression: name it and counter it.
- Fatigue: shorten sessions.
- Opioid sedation: lighter work.
- It is working when coping, distress, sense of control and treatment engagement improve.

4.20 Death, dying, loss and transformation

Purpose / when: AGI ATS-4B covers addressing death as a taboo subject and dealing with loss. AGI lists "transformational" imagery for grief and loss. The procedures are not drawn on here [uncertain]. [source: AGI Full Certification; AGI, What is IGI]
Steps [synthesis]:
1. Assess grief, any complicated-grief features and suicide risk.
2. Use the safe place and the Advisor for support.
3. Offer an imagined conversation with the deceased person, or with the client's own fears about dying, entirely at the client's choice and pace. Include saying what was unsaid.
4. Close with a comfort or continuing-bond image and grounding.
Example language (illustrative): "If you'd like, you could imagine them here with you… is there something you'd want to say?"
Watch for: distress that overwhelms the client, and cultural or religious beliefs about contact with the dead. Ask first, and offer alternatives such as a letter or a symbol. It is working when the client feels relief, connection and acceptance.

4.21 Regression with the Inner Advisor; Inner Child and the Essential Self

Purpose / when: These are AGI Preceptorship 2 and Professional Certification techniques. AGI says regression work addresses limiting beliefs or "stored physical trauma". The procedures are not drawn on here [uncertain].
Safety position of this guide: do not use this work to retrieve, uncover or verify memories. Clinical hypnosis and imagery can create confident but inaccurate recollections. If it is used at all, use it only by clinicians with trauma training, after the readiness criteria in §4.18, and framed as work with present feelings and beliefs. [source: AGI Full Certification; AGI, What is IGI] [synthesis]
Steps [synthesis]:
1. Start from a present feeling or belief, not a search for an event.
2. With the Advisor present, invite an image of a younger self who carries that feeling. Whatever appears is treated as symbolic.
3. Have the adult self (and the Advisor) offer that younger self what they need now, such as comfort, protection or understanding.
4. Bring the younger self to the safe place. Ground and debrief.
Example language (illustrative): "Let an image come of a younger you who knows this feeling well… what does that little one need from you now?"
Watch for:
- Regression panic (Rossman & Bresler 1995): stop and re-orient.
- The client treating images as factual memories: name them as imagery experience.
- Pressure from the client to "find out what happened": decline, and explain why.
- Dissociation.
- It is working when the client is more self-compassionate and the present-day trigger loses intensity.

4.22 Search for purpose (life's purpose imagery)

Purpose / when: An AGI Preceptorship 2 and PCERT topic. Use it for meaning and direction, life transitions and illness-related re-evaluation. The procedure is not drawn on here [uncertain]. [source: AGI Full Certification]
Steps [synthesis]:
1. Relax, then ask the Inner Advisor or an image of a future self about what matters most.
2. Explore values, gifts and what the client wants to contribute.
3. Ground the insights in small steps.
Example language (illustrative): "Ask your Advisor: what matters most for me in this next part of my life?"
Watch for: overload in clients who are depressed or in crisis (keep it small); spiritual content (respect the client's own frame). It is working when the client can state clear values and act on them.

4.23 Re-alerting, sensory grounding and debrief (closing every session)

Purpose / when: End every imagery segment. This is part of standard session structure. [source: GoodTherapy; VA Whole Health] [synthesis on steps]
Steps [synthesis]:
1. Signal the close and give time to finish.
2. Thank or close any images (Advisor, symptom image).
3. Count up or invite stretching. Open the eyes and name things in the room.
4. Check alertness before the client drives.
5. Debrief: what stood out, how the client feels now, any distress remaining.
6. Grounding for action (§4.10).
7. Agree home practice.
Example language (illustrative): "In a moment I'll count from one to five, and you'll come back feeling alert and refreshed… Notice the chair, the light, the sounds in the room."
Watch for: lingering drowsiness, spaciness or distress. Extend grounding (feet on the floor, naming objects, cold water) and do not end the session until the client is oriented.

4.24 Recordings and self-practice

Purpose / when: From Phase 1 onwards. Build skills and independence. The VA notes practitioners may record sessions for home practice. Rossman's book provides scripts for self-use. [source: VA Whole Health; Rossman 2010 publisher page]
Steps:
1. Record the relaxation, safe place or Advisor segment, with consent. [source: VA Whole Health]
2. Agree frequency and timing (for example, daily, at a set time) and keep a brief log of use and effect. [synthesis]
3. Review the log every session. [synthesis]
Watch for: do not record material that could destabilise when heard alone (trauma or regression segments). Advise against listening while driving [synthesis]. It is working when the client practises regularly and can self-regulate.

5. Handling problems

The sources give only a few problem responses. They name these difficulties [source: GoodTherapy; Rossman & Bresler 1995 abstract; Holistic Primary Care]:

difficulty visualising;
temporary rise in anxiety when facing symptoms;
emotional release;
drowsiness and vivid dreams;
the need for ongoing practice;
triggering of trauma;
flooding and regression panic;
substituting imagery for medical care.

AGI's resistance and Inner Advisor courses cover "common problems", but their content is not drawn on here [uncertain]. Everything else below is [synthesis].

"I can't visualise" or nothing comes

Normalise the experience and switch to the client's strongest sense: sound, feeling or simply knowing. [source: GoodTherapy; VA Whole Health]
Use eyes-open work, drawing the image, or a real object as a starting point. Ask what they would imagine if they could. [synthesis]

Stuck dialogue (the image will not speak, or answers are "I don't know")

Accept non-verbal replies: gesture, a change in the image, a feeling.
Ask the image what it would need before it could talk, or bring in the Inner Advisor to help.
Lower the stakes: "just guess".
Return to the image next session. Repeated dialogues often build. [source: Holistic Primary Care on continuing dialogues] [synthesis]

Resistance or non-follow-through

Treat it as information and use §4.11 and §4.12. [source: Rossman 2010; AGI]
Check whether the plan was the client's or yours, and shrink it to a sure first step. [synthesis]
Check for practical barriers and low mood. Depression may need treatment in its own right. [synthesis]

Non-adherence to home practice

Shorten the practice (2–5 min) and link it to an existing routine.
Use the client's own recorded session.
Review the log without judgement and ask what made it hard. [synthesis]

Overwhelm, flooding or abreaction during imagery [source for the risk: Rossman & Bresler 1995; GoodTherapy] [synthesis for responses]

Slow down. Speak in a calm, slightly firmer voice.
Invite the client to put distance between themselves and the image: freeze it, shrink it, put it behind glass or on a far screen.
Bring in the Advisor or go to the safe place.
If distress keeps rising, stop the imagery. Ask the client to open their eyes and orient:
- name five things seen and touched;
- press the feet into the floor;
- slow the out-breath.
Once settled, debrief. Contain what remains (an image of a container or vault). Reduce the dose next time.
Check safety before the client leaves.

Dissociation (glazed or absent, slow to respond, numbness, "not real") [synthesis]

Stop the imagery. Use eyes open and the client's name. Ask orienting questions (date, place).
Use sensory anchors (texture, temperature, standing up) and movement.
Do not resume imagery that session.
Review dissociation screening and, if needed, refer to trauma or dissociation specialists. Use only stabilisation skills until then.

Regression panic (named by Rossman & Bresler 1995)

Re-orient to adult age and the present: "you are here, it is [year], you are an adult and safe" (illustrative).
Reconnect with the Advisor and ground.
Afterwards, stop regression work and return to stabilisation. [synthesis]

Frightening, hostile or intrusive images

Do not force a confrontation. Ask the client whether to keep a distance, end the image, or ask what it wants from a safe position.
A critical "Advisor" is not the Advisor. Thank it and invite another. [synthesis]
Bizarre, command-like or persistent images or voices outside sessions warrant psychosis screening and stopping imagery. [source: VA Whole Health; Holistic Primary Care on psychosis] [synthesis]

Drowsiness, sleep or post-session spaciness

Sit more upright, use lighter relaxation, keep the client talking during imagery, and use extended re-alerting before driving. [source: GoodTherapy on drowsiness] [synthesis]

Panic triggered by relaxation

Switch from breath and body focus to external sensory focus, open eyes and shorter segments. Use an active (walking) image. [synthesis]

Magical thinking, medical substitution or self-blame about illness [source for the risk: Holistic Primary Care] [synthesis for responses]

Restate that imagery supports coping and comfort and does not cure or replace treatment.
If the client is delaying or refusing effective treatment, discuss it openly, involve the medical team, and document it.
If the illness progresses, actively counter "I didn't imagine hard enough". Do not share or endorse anecdotal cure claims from practitioner websites.

Images taken as historical memories [synthesis]

Explain that imagery mixes memory, feeling, symbol and imagination.
Treat the material as meaningful present experience. Do not confirm or deny events.
Do not pursue "recovery". Do not support legal or confrontational decisions on the basis of imagery content.
Consider consultation.

Ruptures (feeling led, judged or exposed) [source for the client-control principle: Rossman & Bresler 1995; AGI ATS-1A] [synthesis]

Name the rupture and own any over-direction.
Return control to the client: they choose topics and the depth, and use eyes open.
Use more open questions and fewer suggestions.
Ask after each session what helped and what didn't.

Cultural or religious objections [source: VA Whole Health on conflicting beliefs] [synthesis]

Ask how imagery sits with the client's beliefs.
Let the client name the Advisor figure in their own tradition, or use "your own wise self".
Offer non-imagery alternatives.

Suicidal disclosure during imagery [synthesis]

Stop the imagery and ground the client.
Carry out a standard suicide risk assessment and safety planning, including lethal-means counselling (storage and removal).
Do not return to depth work until the client is stable.

Scope and competence problems [source: AGI Full Certification] [synthesis]

Trauma, child, dissociation and regression work needs matching training and supervision. AGI flags trauma work as challenging even for experienced clinicians.
If you are not qualified as a psychotherapist (for example, a coach or a nurse using IGI), refer the client for psychotherapy when you see:
- trauma symptoms;
- suicidality;
- dissociation;
- psychosis;
- persistent depression.

Sources

Sources:

Further reading (not drawn on beyond publisher or catalogue descriptions) [uncertain for step detail]:

Rossman, M. L. (2000; ebook 2010). Guided Imagery for Self-Healing (2nd ed.). H J Kramer / New World Library.
Rossman, M. L. (1987). Healing Yourself: A Step-by-Step Program for Better Health Through Imagery. Walker.
Rossman, M. L. (2003). Fighting Cancer from Within: How to Use the Power of Your Mind for Healing. Henry Holt.
Rossman, M. L. (2010). The Worry Solution. Crown.

Further reading (not drawn on): the AGI teachers page and the acadgi.com home page, the full text of Rossman's books, and the AGI course workbooks. All technique steps not tagged with a source are therefore [synthesis].

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