Music Therapy

1991, Vol. 10, No. 1, 22-45

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

The Role of Guided Imagery and Music
in Diagnosing Physical Illness or Trauma-
ALISON E.SHORT
MUSIC THERAPIST, GROTTA CENTER,
WESTORANGE, NEWJERSEY

This article addresses the use of the Bonny Method of Guided

Imagery and Music (GIM) with problems of a bodily nature,
including physical illness or trauma. Connections between mind
and body are outlined from the literature. The technique of GIM
is described, its clinical application to physical illness and
trauma is outlined and explained, and excerpts from three indica­
tive case studies are presented. GIM-produced imagery sequen­
ces are discussed and analyzed in detail with regard to the nature
and possibilities of preliminary diagnostic information concern­
ing the physical status of the client. Of the three casespresented,
the first addresses recalled memories of physical/sexual trauma
elicited by the imagery; the second addresses current acute pain
and possible cancer recurrence; the third deals with the ongoing
physical status of a client in remission from cancer. In all cases,
links between imagery and the body are established and inter­
pretations made regarding physical status. The article concludes
with ethical considerations, implications for treatment, and sug­
gestions for further investigation in the use of the Bonny Method
of Guided Imagery and Music with physical illness or trauma.

Introduction

Many authors and philosophers have discussed the healing power of

music (Lynch, 1987), yet the prelude to healing, both physical and
psychological, is an awareness of what needs to be healed. This article
focuses on this first step of locating and defining the problem, that is,
diagnosis. Specifically, it addresses avenues of diagnosis offered by
material arising from responses to the depth-oriented music therapy
technique of Guided Imagery and Music (GIM) asthey relate to the body,

22
 The Roleof Guided Imagery and Music in Diagnosis 23

such as in cases of physical illness or trauma. GIM, fully named the Bonny
Method of Guided Imagery and Music, is an innovative method that allows
image-related material from many different levels of the individual’s
functioning to come to conscious awareness, where it can be acknow­

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

ledged and integrated. This technique offers opportunities to explore
links between mind and body, which can lead to the possibility of
preliminary diagnostic information about the physical status of the
client.
Traditionally, Western thinking has considered the mind and body to
be separate. This idea stems from the seventeenth century when Descar­
tes (1629)and other philosopher-scientistsbegan to conceive of cognitive
function as separate from bodily sensation and feeling. This idea of
separateness has largely prevailed until the present day in Western
philosophy. In contrast, some non-western philosophies, particularly
philosophies from Eastern cultures, have considered mind and body to
be closely interrelated. In Buddhism, for example, constant awareness
of the body, feelings, mind, and ideas in the attainment of wisdom is
addressed within the eightfold path of the fourth Noble Truth (Bishop
& Darton, 1987). A leader in integrating aspects of Eastern and Western
thought, Wilber (1979) considers the separation of mind and body to be
in the nature of a split in the psyche and suggests that this split is one of
a succession of barriers to be overcome during personal growth.
However, conceptualizing the mind and body as separate has practi­
cal advantages. Mathematical logic and scientific thought are obvious
developments that have profited from this separation. Modern medical
research has successfully isolated many of the dreaded diseases of the
past by focusing on the physical (bodily) aspects of disease and has
found reliable procedures and treatments for alleviating or curing dis­
ease. By investigating, isolating, and treating disorders of the human
mind, psychology and psychotherapy have offered hope to myriads of
people caught in impossible situations and have helped them live their
lives more fully.
Yet, as Western culture has continued to address existing traumatic
diseases, such as cancer andheart disease, contributions of research from
the areas of both mind and body have begun to overlap. Information
from the mind, as it relates to the body, and from the body, as it relates
to the mind, are more and more frequently viewed together as evidence
of illness and, it is hoped, as aids to the recovery process. To illustrate
these processes, it is useful to consider contributions of mind and body
research in the general area of stress. Figure 1 diagrammatically depicts
the possible pathways through which information may flow between
mind and body.
24 Short

MEMORIES

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

Figure 1.
Representation of pathways connecting mind and body,
with input from memory-related material.

Stress has been considered a problem associated with the mind and
its subsequent effects on the body. Manifestations of stress have recently
been studied by monitoring specific patterns of physical (bodily) activa­
tion, leading to a detailed understanding of complex responses such as
those engendered by the sympathetic nervous system (Chaplin, 1985).
The technique of biofeedback, one of the newer clinical techniques
that has emerged from this research, deliberately encourages patients to
use their minds to alter bodily functions such as heart rate and skin
reactivity (Chaplin, 1985).The fact that stress reduction techniques such
 The Role of Guided Imagery and Music in Diagnosis 25

as biofeedback have led to reductions in the degree and nature of

physical symptoms has led to the consideration of stress as a contribut­
ing factor in major illness, such as as heart disease and cancer.

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

The opposite relationship may also be seen, asin psychological stress
resulting from a physical disorder (Magni, Schifano, De Dominicis, &
Belloni, 1988).In fact, the mental change that may take place in a person
enduring long-term disability is a good example of a physically-induced
psychological problem. Progress and attitudes of tuberculosis patients
in ahospital setting indicate that psychological problems, such as severe
adjustment and anxiety related disorders, can result from a physical
problem (Vernier, Barrell, Cummings, Dickerson, & Hooper, 1961,cited
in Goldenson, 1972). Problems following surgical procedures may in­
clude anxiety or panic reactions, such as “phantom phenomena” in
amputees or mentally traumatic reactions in children undergoing ton­
sillectomies and other operations.

In the process of therapy, repressed memories may emerge.They may

relate not only to mental but also to physical issues and traumatic
experiences. For example, the diagnostic criteria for Post-traumatic
Stress Syndrome (American Psychiatric Association, 1987) include
“recurrent and intrusive memories of a traumatic event” (p.250). Trau­
matic memories of physically related events have been linked to
psychosomaticsymptoms; it hasbeen stated that repressed material may
have effected a deep “splitting” of parts of the body from the mind
(Johnson, 1987). Working with emerging memories of severe trauma
appears to be a very direct method of accessing and assessing the scope
and nature of trauma to both mind and body. However, if a person has
repressed these memories for a long time as a protective mechanism,
recall of them may evoke strong feelings in both mind and body.
Competent professional assistance on both a physical and emotional
level is an essential requirement at this point.
The arrows in Figure 1 indicate the pathways of information flowing
between different parts of the person. These pathways are reversible
connections, from mind to body and body to mind. The input to this
system from deep-and often repressed-memories may then enter and
flow through the mind and body pathways. This conceptual model
suggests that any information from the mind may be transferred to the
body and, likewise, knowledge from the body maybe transferred to the
26 Short

mind. The amount of transfer may vary, with some information being
retained as well as transferred. Clinical application of this model
demands consideration.
Traditionally, in defining a complex physical and emotional problem,

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

the medical clinician may address primarily the body and rely on the
transfer via the pathways to interact with the mental state of the client.
This may involve a standard medical diagnosis and treatment, such as
surgery and medication, and may then require subsequent therapy for
mental implications of the treatment. Alternatively, the psychological­
ly-oriented clinician may consider addressing the mind-related aspect
of the problem by using psychotherapeutic skills. Psychotherapeutic
techniques have a major impact on specifying and dealing with
problems on a mental and emotional level, and in extended form may
be of valuable assistance in assessing the physical status of the body.
In contrast, the clinician may seek methods of accessing the connect­
ing pathways themselves, as outlined by the arrows between the mind
and body in Figure 1. By accessing the connecting pathways, there
would seem to be the potential of reaching a broader diagnosis and a
morebalanced approach to both mind and body. (It should be noted that
this is not a recommendation to ignore traditional approaches to the
body and mind; it is always prudent to respect and incorporate, where
possible, these approaches as necessary for ongoing diagnosis and treat­
ment of the client.)
What could these mind-body pathways consist of? How can we
access these pathways? Techniques that seem to link mind and body
may include, but are not limited to, mind-altering drugs, meditation,
hypnosis, and dreams. Each of these has particular applications within
the therapeutic framework, yet may also have limitations for ongoing
depth-oriented work in the linking of mind and body. Considering the
efficacy of memory in linking mind and body, another pathway emer­
ges, extending far beyond memories-the field of imagery.
Johnson (1987) claims that in contrast to the advanced hierarchical
memory encoding system used in everyday life, primitive, visually­
based, and often sensorimotor-related memory encoding may occur in
situations of extreme and traumatic stress.Johnson also notes that since
the creative arts are more likely to use imagery-based and nonverbal
media, they seem to be especially well-suited to accessing and dealing
with this primitive memory system. Imagery and its effects on the body
have been investigated by many studies. For example, ithas been shown
by Jacobson (1942) that a person holding an image of running in their
mind will exhibit small but measurable amounts of muscle contraction
in those muscles associated with running. The deep significance of
 The Roleof Guided Imagery and Music in Diagnosis 27

imagery is summed up by Samuels and Samuels (1975), who state that,

“Through [a selection of bodily] pathways, an image held in the mind
can literally affect every cell in the body” (p.66).
Clinical applications of imagery in treatment have been developed by

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

many researchers. In most instances the imagery has been directed by
the therapist, either narrowly to focus on a particular area, such as the
client’s childhood home, or broadly to encompass a general topic such
as “brook” or “mountain.” This latter occurs in the case of Guided
Affective Imagery, where the client is encouraged to daydream on
specific themes that are offered by the therapist (Leuner, 1969). In
contrast to material directed by the therapist, Siegel (1986) suggests that
imagery spontaneously produced by the client may be the most useful
in treatment and cites the artwork of cancer patients as an example of
spontaneous image-related material. In the Bonny Method of Guided
Imagery and Music, ongoing spontaneously-produced imagery occurs
in response to carefully programmed and selected music. This clinical
method encourages many aspects of the imagery to emerge, to be
addressed, and to be transformed, allowing for dynamic change while
the person experiences the imagery.

Bonny Method of Guided Imagery and Music (GIM)

The technique of Guided Imagery and Music was first developed by
Helen L. Bonny at the Maryland Psychiatric Research Center in the early
1970s. This method, now fully named the Bonny Method of Guided
Imagery and Music, is officially defined by the Association for Music
and Imagery as:

A music-centered, transformational therapy, which uses

specifically programmed classical music to stimulate and
support a dynamic unfolding of inner experiences in service
of physical, psychological and spiritual wholeness.
The GIM therapist/guide maintains an active dialogue
with the listener throughout the session, providing en­
couragement and focus for the emotions, images, physical
sensations, memories and thoughts which occur. (Associa­
tion for Music and Imagery, 1990)

The GIM session typically begins with therapeutic discussion (named

the “prelude” by Summer, 1988), followed by an induction (usually a
relaxation procedure and a focusing image), leading to the music and
28 Short

imagery segment, usually 30 to 45 minutes in duration. The induction is

chosen by the GIM therapist to relate to the client’s therapeutic issues,
to both the physical and emotional states, and to the music to be played.
The induction promotes a smooth transition from a normal waking state

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

to the altered state of consciousness necessary for effective use of the
GIM method. During the music segment, the GIM therapist, in conjunc­
tion with the music itself, assists in deepening and moving the imagery
forward in a manner that encourages spontaneous experience of the
imagery by the client. The GIM therapist makes resonant verbal inter­
ventions--often in the form of specific or open-ended questions, sup­
portive comments, or reflective statements--to which the client may or
may not respond, according to needs at that moment. At the completion
of the music and imagery segment, time is allotted for processing and
integration of insights and awarenesses. A time space of 2 hours is
usually allowed for the entire session, although this may vary consider­
ably. A verbatim transcript is usually taken during the music and
imagery segment by the GIM therapist, who seeks to notate all relevant
data.
The technique of GIM is practiced within a therapeutically non­
demanding, accepting, and image-enhancing situation. No experience
or musical training is required of the client in order to derive substantial
benefits from the GIM session. The therapist, however, requires consid­
erable training to become professionally accredited in GIM.’
During active listening in the music and imagery segment of the GIM
session, many types of imagery may emerge for the client. These may
include (a) reminiscence and association; (b) affective awareness; (c) inter­
actional imagery; (d) somatic and kinesthetic sensations; (e) auditory
imagery; (f) abstract and concrete visual imagery; (g) photographic
images; and (h) transpersonal and spiritual experiences (Short, 1989).
These types of images may alternate and interweave throughout the
course of each music and imagery segment, while the depth of
psychological work being undertaken by the client may oscillate be­
tween the profound and the seemingly superfluous, with many grada­
tions in between. The interpretation of imagery cannot be successfully
 TheRoleof Guided Imagery and Music in Diagnosis 29

addressed via cause-and-effect, rational methods, but needs to be ap­

proached by the imagination and intuition of the observer, exercised in
a careful and professional manner. Any symbolic image may have
implications at various levels of experience and must be considered

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

within its imagery context.
In the technique of Guided Imagery and Music, the music is carefully
selected by the therapist, according to the psychological and emotional
needs of each client. A standard set of over 20 precisely formulated GIM
tapes (see Bonny, 1978) is used in many configurations by the GIM
therapist. Each cassettetape is programmed in such a way as to use the
music to enhance exploration of the client’s issues on many levels of the
client’s inner psyche. The careful programming of music, which is
multilayered in character, seemsto allow for psychodynamic movement
at different levels chosen consciously or unconsciously by the client
(Bonny, 1989).Since each client’s background and issues are unique, the
same musical selection played to a cross-section of clients may produce
differing responses. Ventre (1990) has attempted to determine the way
in which the individual elements of the music affect the overall imagery
process. Further research is needed into the function of the music as it is
used in the Bonny Method of Guided Imagery and Music.

Diagnosis and Physical Illness or Trauma

Diagnosis is defined as an “analysis of conditions, physical or mental,
as a means of recognizing disease” (Webster’sDictionary, 1978, p. 87).
Diagnosis of a medical condition may take many forms, such as the
annotation of physical signs and symptoms and the use of laboratory
equipment (Dorhd’s Illustrated MedicalDictionary, 1968).It would seem
that diagnosis is usually considered to be an externally objective and
often equipment-related procedure, with medical tests forming the crux
of diagnosis for physical illness. Thus, the body is the focus of attention.
However, it is interesting to consider whether the imagery associated
with the pathway linking mind and body could be used in some way as
a projective diagnostic tool. This could be in a manner complementary
to, and not exclusive of, standard medical and psychological procedures.
In fact, practicing in 1933,Jung (1968) found that by using the imagery
of a client’s dream, he could correctly diagnose a problem with blocked
cerebrospinal fluid.
Siegel (1986) has found that pictorial imagery may give information
about the prognosis and progress of the disease for particular cancer
patients, in particular giving information about the bulk of the cancer
30 Short

and the aggressiveness of the white blood cells, as well as a symbolic

representation of the progress of treatment. Even more specifically,
Achterberg (1985) discusses assessment of images with a view toward
diagnosis: Disease images are evaluated with regard to the image’s

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

vividness, strength, and ability to persist; imagery for personal defenses
is evaluated in terms of the vividness of the description and the effec­
tiveness of the image’s action; diagnostic conclusions can then be drawn
from this wealth of information. Lockhart (1983) concludes that “bodily
organs and processes have the capacity to stimulate the production of
psychic images, meaningfully related[italics added] to the type of physical
disturbance and its location” (p. 158).
These works indicate that imagery may, indeed, be a suitable tool to
be applied during diagnosis. It is the premise of this article that the
dynamic and spontaneous style of imagery generated during GIM is
ideal for use in a diagnostic application. The following hypotheses
formally outline potential applications:

1. If there has been a severe physical trauma retained in

memory, it may surface through the imagery process
during a series of GIM sessions, with direct implications
for the body.

2. Images of either the past or the present may contain char­

acteristics of the original trauma or illness, thus giving
information about the event.

3. The ability of the GIM therapist to respectfully intervene

as appropriate in the ongoing dynamic imagery sequence
may elicit additional information regarding the physical
status of the client.

4. The ability of the image to change and interact may give

further information about the current physical status of the
client.

5. The information and diagnosis gained by using the GIM

method can be validated by other means, such as medical
examinations and self-disclosure by the client, as ap­
propriate for the particular client.

Clinical application of these premises regarding GIM-produced im­

agery requires observation of the client and of the client’s style of
 The Roleof Guided Imagery and Music in Diagnosis 31

imagery, gained over several GIM sessions. The experienced GIM prac­
titioner merges this knowledge with an internal interpretation of the
imagery, as it occurs, to recognize subtle (and often unusual) imagery
changes in the client's imagery that may reveal body-related information

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

of significance. There may be one or more imagery sequence(s) that
would suggest an appropriate imagery-related preliminary diagnosis.
The following three casesdemonstrate how imagery obtained using the
GIM method may lead to specific preliminary diagnoses regarding
physical status of clients.
The casesare presented by providing excerpts of imagery in conjunc­
tion with various sections of the music. In these examples the imagery
that occurred before and after the cited excerpts was deemed relatively
unrelated. Each imagery response summarizedhere was acomplete unit
of imagery addressing an issue at a certain level. The clients were not
constrained to remain with any particular type or depth of imagery,
which is a fundamental principle of the Bonny Method.

Case One
In the first case, imagery unexpectedly began to carry indications of
physical trauma in a physically healthy client. This imagery seemed to
be the result of long-repressed memories of physical/ sexual abuse. This
case offers a classic example of the use of color imagery in conjunction
with the music and of the type of imagery that should immediately alert
the GIM therapist to the possibility of an abusive situation.
The client, Brenda, came for GIM sessions as a result of attending a
workshop on music and imagery. She had recently been recalling many
memories from her past. Adding to her active recall was the fact that her
parents had just moved from her childhood home, a move that she was
having difficulty accepting. Brenda seemed to be actively reviewing her
past experiences, stretching back toward her childhood. Many of her
memories indicated that something significant (but unknown) had hap­
pened in the past, something that now required attention. Brenda was a
physically healthy woman in her forties who often seemed anxious,
holding tension in her voice. Difficulty expressing her feelings, especial­
ly anger, and difficulty relating to her body were cues that this past
material might relate to her physical body. Brenda’s body concept was
poor and her self-esteem low. She spent a disproportionate amount of
her time in the service of others.
In her sixth GIM session, Brenda initiated a lengthy discussion about
appropriate outlets for expressing her strong feelings, especially anger,
32 Short

in a physical manner. She mentioned again that she had had many new
memories of the past, so this material was obviously still active. At the
end of the previous session, Brenda had had a clear image of opening a
box, and in the pre-music discussion of her sixth GIM session, Brenda

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

stated, “Now that I’ve opened it, it’s there,” an indication that the box
and its contents would have to be addressed in some way, although she
had no idea what the box might contain. This may be interpreted as
paralleling the myth of Pandora’s box, especially in regard to unex­
pected material arising from the unconscious (Cirlot, 1971).
Part way through the music and imagery segment of her sixth session,
the following sequence of imagery emerged for Brenda?

MUSIC: BACH “PARTITA IN B MINOR: SARABANDE,”

ORCHESTRAL VERSION
1. I made a bad choice, but its okay. You see things so
different. [Cough.]
2. Can you give that bad choice a color?
Red. But I see yellow coming in, pushing away the red.
It’s floating, covering the red.
3. Can the red say something to the yellow?
I don’t know. The red became me. I’m on the ground.
The yellow is trying to cover me. [Anxious tone of voice.]
4. I’m telling the yellow to go away and leave me alone.
[Quiet tone of voice.]
5. But the yellow is trying to protect me. The yellow backs off.

Brenda’s imagery began on a purely “thinking” level, with language

in the past tense indicating memory-related material [l]. Her cough may
be seen as evidence of involvement of the physical level of her body. At
this point, it was not known what the “bad choice” was about, but it was
obviously important and needed pursuing. The GIM therapist used an
intervention [2] that was designed to change perspective and assist the
client in bringing the imagery to a deeper level. In fact, Brenda was
immediately able to add color to her imagery, introducing images of
deep significance that entailed movement [2]. This was a style different
from any of Brenda’s previous GIM imagery, with a senseof immediacy
and an increased rate of change in the imagery sequence, indicating that

For all verbatim quotations of session material, interventions by the GIM

therapist areshown initalics. The imagery is referencedby numbers for easein
referral in later discussion.
 The Role of Guided Imagery and Music in Diagnosis 33

something significant was happening.

In fact, choice of colors is particularly significant in the interpretation
of GIM work. Red is often considered a color for the self and the life force
(i.e., blood that sustains one), whereas yellow is often a color repre­

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

senting strong masculine energy, or a male person (Cox &Bush, 1990).
The music during this imagery had many contrasting textures. There
was a musical correlate for the contrasting and opposing colors of red
and yellow: The particular arrangement of the “Partita” consisted of
light and fragile-sounding solo flute playing a simple melody against a
deep harmonic texture of strings and reeds.
The yellow pushing away and covering the red, assuming power by
being on top [2], suggested that some manner of masculine energy, a
male person, had overpowered the client’s self. More information was
required. The GIM therapist’s next intervention [3] was designed to
promoteinteraction between the dichotomy of the two colors. The music
at this point was also supporting dialogue, with contrasts in instrumen­
tation, musical figures, and melodic and harmonic material. A “broken”
chord accompaniment also supported a senseof something opening up,
perhaps echoing the client’s earlier discussed image of opening a box
and addressing its contents.
The classic stalling phrase of “I don’t know” [3] was employed by the
client as the imagery continued to change in another direction. Then
Brenda began to identify with the red as herself and her body [3]. Her
choice of words and an anxious tone of voice indicated that she was
being acted upon in away that was obviously intrusive, smothering, and
frightening. At this point, the GIM therapist concluded that this was
probably an image of a physically/sexually abusive event.
Brenda’s method of defending against the yellowwas not convincing:
The “pushing” by the yellow color [2] was not adequately countered by
simply “telling it to go away” [4]. Given the aggressive energy of the red,
she should have been countering in a physical manner in order to
equalize and dissipate the contrasting energies. Also, it can be seen that
the red/yellow imagery stalled and did not respond to verbal com­
munication [3]. The passive tone of voice did not match the aggressive
nature of the yellow color and seemed to indicate that Brenda felt asense
of powerlessness at this point.
A change of perspective followed, as Brenda began to identify with
the yellow [5], stating that the yellow color that she had been trying to
fight off was in fact trying to protect her (“From what?” one asks). This
identifying reaction, where the victim may begin to identify with the
aggressor, is common, for example, as in post-traumatic stress disorder.
Using this defense mechanism, Brenda reinterpreted the scenario in a
34 Short

way that was more acceptable to her rational self. The imagery moved
from a deep to a lighter level. The anxiety-producing yellow receded,
forming a temporary close to this imagery sequence; the client had dealt
with as much as she could for the time being.

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

In the ensuing discussion, after the music and imagery segment,
Brenda revealed a traumatic incident that had occurred some 20 years
previously at college. For a period of 3 hours, she had been trapped in a
physically and sexually abusive situation of date-rape, in a room with
three other couples. Brenda had been able to avoid actual intercourse by
defending herself with repeated crying episodes. Recalling these
memories was extremely painful, and they were difficult to talk about.
Given the intensity of feeling evoked by this memory during the GIM
session, the GIM therapist concluded that this was probably one of the
few times, if not the first time, that Brenda had talked about this trauma
since it had occurred. The initial assessment by the GIM therapist
provided an apparently accurate preliminary diagnosis based on the
imagery’s implications. As a consequence of this diagnosis, post-music
therapeutic discussion between client and therapist was greatly en­
hanced. It allowed the GIM therapist to anticipate which issues were
likely to arise and thus encourage the client toward therapeutic growth
in a timely manner.

Case Two
In contrast to the recalled memories of traumatic physical/sexual
abuse in the first case,apparent symptoms of acute physical illness were
present in the second case. The imagery produced during the GIM
session was assessedin light of the information known about the client’s
physical health. Images involving not only color but also light in
relationship to the body suggested a preliminary GIM-related diagnosis
that there was no recurrence of a feared illness. This diagnosis was
subsequently confirmed by a medical examination.
The client, Belinda, was in her early forties. She had had ovarian
cancer 15 years previous, with a recurrence 13 months prior to starting
GIM sessions. The latter recurrence of cancer had been particularly
traumatic for her and had resulted in testing, surgery, high doses of
chemotherapy, and repeated surgery. Treatment terminated 5 months
prior to commencing GIM sessions;officially, she had a “complete cure.”
Nevertheless, she still held deep-seated doubts about her health, stating,
“That’s what they said lasttime, and then it [thecancer] recurred.” While
undergoing chemotherapy, a very difficult period during which she
 The Roleof Guided Imagery and Music in Diagnosis 35

suffered severe nausea, Belinda had sought professional

psychotherapeutic help. Sheexpressed that she had found it unsatisfac­
tory because it ignored her current illness and focused largely on issues
with her mother. Commencing GIM sessions 5 months after termination

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

of chemotherapy, Belinda voluntarily defined her greatest problem
during chemotherapy treatment asa need to come to terms with her own
mortality, and she felt that she had still not achieved resolution. Belinda
had had some previous experience with imagery processes: During her
cancer treatment, she had used imagery for relaxation in a cancer sup­
port group.
Belinda’s imagery typically had many tactile characteristics in addi­
tion to visual images. Her imagery flowed freely, and she did not appear
to have difficulty in relating to her body.
Entering her eighth GIM session, Belinda stated that she was worried
about a severe pain in her abdomen that had persisted since the previous
day. This pain seemed to her to be at the same site as her cancer, and it
accentuated her unresolved fears about cancer recurrence.
Given the client’s symptoms and the possibility of cancer recurrence,
it was valid to question what types of imagery might occur and what
significance the imagery might have. At this point, it is useful to refer to
Reid’s (1988) comments:

In a metaphoric approach, knowing occurs through the

grasping of relationships and analogies provided by the
symbolic value of things. Any apperception of form,
whether of an external or internal (i.e., ideational) object, has
potential symbolic value in addition to its ordinary concep­
tual ones within a shared, empirically-based reality. This
symbolic value has the function of pointing to or towards
something beyond its usual or ordinary meaning en­
gendered by its presence. (p. 21)

If disease were present to a significant extent, then the imagery could

be expected to show some type of aberration; something unusual or “out
of joint” would surface in the imagery sequence. One would expect that
the aberration would most likely be focused in the abdominal region,
since that was the site of the stated problem in this case. The GIM
therapist planned to note carefully not only imagery that was related to
the body, but also any imagery that contained unusual characteristics,
in order to assessit for possible diagnostic implications.
Appropriate interventions by the GIM therapist, designed to gather
more information within the imagery sequence, had potential to give
36 Short

further clues about the abdominal region. The therapist’s assumption

was that if no disease were present, no aberrations in the imagery would
be found, especially with regard to the abdominal region.
It should be noted that the abdominal pain itself had the potential to

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

affect the client’s ability to relax and enter the imagery experience, but
it was unlikely to have significant effects during the imagery sequence,
beyond perhaps bringing the client out of her altered state of conscious­
ness. Belinda was very experienced in using imagery, from her cancer
support group and previous GIM sessions, and so was not likely to have
a problem with the pain distracting her from the imagery process. She
had not taken any medication for the pain, and thus there were no
complicating effects on her imagery process from pharmaceutical
agents.
As Belinda settled for the induction, the pain in her abdomen was still
extant. Her imagery progressed, and Belinda reported lying on a stage,
with mixed colors of light falling on her from a stained glass window. A
blue color became prominent.

MUSIC: BARBER, “ADAGIO FOR STRINGS”

1. I hold the blue in my hand, it’s alive. [Elated tone of voice.]
2. Can you take the color to other parts of your body?
I put it on my feet, my legs, I put it all over.
3. I can dance in the blue light, and I’ll be blue.
4. I feel good, very alive. I take the blue color into my heart
and I can live with it.
5. Is there anywhere e/se you would like to take the color?
Maybe I’ll take it and share it, I give it to the other dancers.

This imagery sequence began with a single entity, blue light [l]. This
was the first occurrence of the blue light in any of Belinda’s imagery.
Light may be interpreted as pertaining to creative forces and the spirit
(Cirlot, 1971). The blue color may have many meanings, but in this case,
given its coupling with the light, it may be interpreted as relating to
peace and the feminine, nurturing principle (Cooper, 1979).Just prior to
the climax of the “Adagio,” Belinda had an image of holding the blue
light in her hand, suggesting a sense of ownership. Her statement, “It’s
alive,” and her exhilarated tone of voice resonated with the upward
movement of the music in higher range surrounding the climax.
The GIM therapist’s intervention [2] was designed to assist Belinda
with an exploration of her body by suggesting that she move further
 TheRoleof Guided Imagery and Music in Diagnosis 37

from her already-mentioned hand. In addition to gaining information

relating to her body, the intervention served to test the unity and
consistency of the image. For example, colors other than blue could
potentially have arisen in different body parts. However, this did not

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

happen; the blue color seemed to equalize throughout her body [2].
Following a lengthy climactic silence, the musical sounds returned to
a lower tessitura of supportive chordal tones, which paralleled Belinda’s
focus on the lower part of her body before she “put [the color] all over.”
Movement emerged in the imagery in Belinda’s description of danc­
ing [3]; she took on the identity of the blue light [3], indicating her sense
of full ownership.
Belinda was able to take in the “good” feelings and nurture her body
[4]; she experienced a deep sense of aliveness. The blue light extended
to include her heart, an organ traditionally understood to be a center of
being and feeling (Cooper, 1979). This was musically supported by the
warm tone of violas playing espressivo.
At this point, there was a sense that Belinda was using the blue light
to enhance her inner bodily functions and to sustain her own life. Even
after another searching intervention by the GIM therapist [5], Belinda
did not seem to feel a need to address any other particular parts of her
body, beyond what she had already done [5], although the stepwise
motion in the music would have supported a methodical inventory.
Since the client had not directly mentioned her abdominal region, this
intervention allowed a double-check for aberrations in the flow of blue
light, Belinda’s creative life force, in her body.
The resultant lack of aberration or special attention to her abdominal
region seemed significant. Resistance or inexperience with imagery did
not seem to be operative here; Belinda had already demonstrated that
she was able to take the blue light to other named parts of her body. That
there was nothing unusual or disjointed in the imagery at this point, and
no particular focus on the abdominal region, gave substance to the GIM
therapist’s preliminary diagnosis that there was no cancer recurrence for
the client at this time, which was in direct contrast to Belinda’s pain and
expressed fears.
Following Belinda’s first mention of “other dancers” [5], the imagery
moved from an overtly intrapersonal to an interpersonal focus, with a
sense of community engendered by the dancers. The implication was
that Belinda had absorbed and equalized enough of the blue light/life­
force so that it could overflow outward to others. Theimagery sequence
subsequently moved to a different level of meaning.
In the post-music discussion Belinda spontaneously commented on
her own enhanced feelings of life as a result of this GIM session. This
38 Short

contrasted strongly with her previously expressed fear of the physical

threat that a recurrence of cancer represented.
Belinda’s abdominal pain returned by the end of the session, although
it had disappeared for a substantial period of time during the music and

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

imagery segment. The GIM therapist urged Belinda to seek medical
consultation without delay.
Three days later Belinda informed the GIM therapist that her on­
cologist had performed a thorough examination of her body, including
the abdominal region, and that he had restated his medical diagnosis
that she was completely cancer-free. This confirmed the preliminary
diagnostic indications suggested by the imagery sequence within the
GIM session. Belinda’s pain had subsided in the days following the GIM
session.

Case Three
In contrast to the first two caseswhere abstract images of color and
light were utilized, the third caseinvolves a client who, during the GIM
session, saw and verbally described images of actual cancer cells and
their interaction with her. The third client directly associated her specific
images with her fight against cancer. This “literal” imagery and the
client’s reactions combine to illustrate yet another example of ways in
which imagery within the GIM setting can suggest information about
the body in the manner of a preliminary diagnosis.
The client, Kathleen, had had breast cancer 2 years prior to commenc­
ing GIM sessions; her cancer had been successfully treated by breast
removal and chemotherapy. During chemotherapy, this client had used
an imagery technique that she had learned from books by Simonton,
Matthews-Simonton, and Creighton (1980) and Siegel (1986), with her
own taped music. Kathleen attended a total of 11irregularly spaced GIM
sessions over a period of 10 months. At the outset of GIM sessions, the
client stated that she was medically healthy.
Entering her seventh GIM session, Kathleen stated that memories of
her own past cancer experience had been triggered by the possibility that
Jane, one of her close friends, might have cancer. Also on Kathleen’s
mind were a recent upper respiratory infection and an unexplained
illness requiring hospitalization 8 months prior to this session. In both
situations, she had had difficulty deciding at what point to seek medical
attention. This was interpreted by the GIM therapist asan indication that
Kathleen had a problem relating to her body when ill.
Kathleen initially had difficulty settling comfortably for the induction
 The Role of Guided Imagery and Music in Diagnosis 39

and seemed unusually anxious, in contrast to her behavior in previous

GIM sessions. As the music commenced, her imagery began with a sense
of intrusion and feelings of fear related to a situation at her workplace,
but then changed to focus toward the issue of cancer.

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

MUSIC: RACHMANINOV, “ISLE OF THE DEAD”
I. I think my mind has drifted back to Jane and cancer.
2. I see cells, mutating in odd shapes and directions.
Dark globs, I can see the cell definition.
3. I don’t want them to touch my friend. [Anxioustone of voice.]
4. I’d like to stomp on them and squish them but I have
an underlying sense that you can’t stop them. [Physical
tremor.] I should have the score [i.e., music], to be ready.
5. I don’t want them coming from behind, where I can’t see
them. I have a shield in front, but they can do anything
behind. Things that creep up are the most terrible.
6. Is there any other way to defend yourself from behind?
No, there are some things that you can’t doanything about.
[depressed tone of voice.]

In a manner similar to the first case, Kathleen began this imagery

sequence with a “thinking” statement [l]. By relating the cancer to her
friend Jane, it became more acceptable for her to address her own
experiences with cancer. This is a successful distancing mechanism that
has been noted from clinical experience to occur often when clients are
approaching a difficult or emotionally-laden image.
Kathleen created an image of what the cancer looked like: dark globs
[2]. Her visual imagery of the cells seemed clear, concrete, and unam­
biguous. The movement of the cells gave the impression of aliveness,
which implied current, rather than past, involvement. The imagery
introduced the concept of multiplication of cells [2], the well-known
manner in which cancer generally progresses. The clarity of the cell
definition seemed to indicate that Kathleen was in close proximity to the
cells; this was not an image viewed from afar. The implied direct and
close relationship reinforced the idea that Kathleen’s own cancer was in
question, rather than that of her friend’s, The music at this point
resonated with her imagery, with dark colors and deep timbres in the
brass, rumbling sounds and a senseof “stirring the pot.” In particular, a
five-note descending leap in the horn melody had a sense of insistent
forward movement, of restlessness and prolonged effort.
40 Short

Kathleen’s statement of not wanting the cancer cells to touch her

friend [3] was analogous to not wanting the cancer cells to touch her own
body. Although it is not easy to pinpoint in time, Kathleen’s focus shifted
from her friend to herself. One clue to this shift was an increasing

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

emotional involvement, as shown by her words and tone of voice.
Kathleen had the impulse to defend herselfby physically destroying the
cells [4]. Wanting to stomp on the cells [4] implied the use of her feet. In
this case,bigger was not better: The relative sizes of dramatically larger
feet compared with microscopic cancer cells was unlikely to be com­
pletely effective in practice-there would always be some cells able to
escape and recolonize. This imbalance in the imagery was reflected in
Kathleen’s next comment, that the cells could not be stopped [4]. Her
physical tremor [4] seemed to indicate the presence of great fear and
direct involvement in the scenario, asdid her need to prepare and defend
herself using the musical score. Random upward sweeping figures in
the strings, sometimes connecting with downward motives, matched
the senseof “things creeping up unexpectedly” [4], thus providing little
room for escape. This contrasted with the repetitive, deep rumbling
timbres and musical figures that were heard at the beginning of the
imagery sequence. The location of the cells in Kathleen’s imagery shifted
from in front of her to behind [5], suggesting vulnerability and a fear of
the unknown. Even with a shield in front, with its potential for preser­
vation and protection (Cooper, 1979), Kathleen’s defense was incom­
plete from behind. The descriptive words she used implied again a great
depth of fear [5]. It is interesting to note that in Achterberg’s (1985)
clinical studies, “A truly poor outcome was forecast when the cancer
cells were seen as immutable, grasping or ineradicable” (p.192).
Kathleen did not use the GIM therapist’s intervention [6] to explore
or create any other options. In fact, she showed a lack of energy and an
inability to fight by using a depressed tone of voice. Kathleen seemed to
have a strong sense of the inevitability of having her body attacked and
invaded by the cells [6]. Because her fight was apparently notcompletely
effective-she was unable to match the size of the intruder and she
lacked a defense from behind-it would seem that the diagnostic im­
plications inherent in this imagery sequence showed some openness to
the return of cancer in her body, although her partial defenses suggested
that a debilitating episode of the disease might not occur for some time.
In the ensuing discussion Kathleen expressed many of her fears about
cancer and ended by spontaneously stating that the medical statistical
risk for the return of her cancer was 50% over 5 years. This coincided in
essence with the GIM therapist’s assessment, that some defenses were
present but that they did not seem to be complete. In subsequent GIM
 TheRoleof Guided Imagery and Music in Diagnosis 41

sessions Kathleen did not produce any further imagery related to her
battle with cancer. She terminated GIM sessions some months later,
keeping in occasional contact with the GIM therapist. It remains to be
seen over time how Kathleen’s health will continue; she was still healthy

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

3 years after this GIM session.

Discussion
These three examples have been presented to highlight the several
interesting and beneficial aspects of the study of GIM-related imagery
asa preliminary diagnostictool with physical illness or trauma. All three
case examples support the hypothesis that links between the mind and
body do exist and are operative on many levels. As mentioned in the
introduction, Western philosophy has tended all too hastily to perceive
the mind and body as being separate.Although convenient, and in many
casesadequate, for diagnosis and treatment, this model may not always
be suitable. Certainly, when the body is physically ill or has undergone
trauma and the person is concurrently depressed or highly stressed, a
more appropriate approach may be to consider the interrelatedness of
the mind and body, and to listen for messages that the body and mind
bring to consciousness. One of the many pathways through which we
can accessthese messages is via imagery. Imagery is a very promising
and physically non-invasive method for interacting in a dynamic way
with the mind-body process.
In the casespresented, using the Bonny Method of Guided Imagery
and Music, material arose demonstrating that imagery is not merely a
mental activity, that imagery has the potential to be interpreted as
relating to the body. For each case presented, there is evidence in the
imagery to suggest that a link to the body exists and can be expressed
verbally within the GIM session. Within the three casespresented, the
type and level of the imagery relating mind to body is significantly
different. The images in each case were increasingly more and more
specific about the manner in which the client viewed her body. In Case
One, the client used abstract color, later related to the body and loosely
related to a recalled event. In CaseTwo, the client used images of abstract
color and light and related them directly to how her body was feeling.
In Case Three, the client used specific images of cancer cells and her
body’s fight against them, with direct and immediate feelings also being
present. Not only were the images increasingly specific, but there also
appeared to be a concomitant progression in the level of insight into the
meaning of the imagery for the body, from Case One to Case Three.
42 Short

Another feature of the casespresented was the degree to which severe

physical trauma may surface through the imagery process, with direct
implications regarding the body. This was particularly shown by
memories of physical/ sexual abuse in CaseOne, typified by the interac­

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

tion of selected color images. In Case Three, trauma surfaced as fear of
the return of cancer and appeared as very specific images of the body’s
fight with cancer-like cells. In contrast, Case Two showed a lack of
physical trauma and, instead, revealed imagery characteristic of a
rehabilitative process.
In all three cases, the response by the clients to interventions by the
GIM therapist yielded further information regarding their physical
status. In Case One, this was exemplified by the therapist’s encourage­
ment of the red to interact with the yellow; in Case Two, by the
therapist’s suggestion to double-check parts of the body; and in Case
Three, by the encouragement of the capacity to explore defense options.
It is this dynamic nature of the GIM technique that enables possibilities
for change and interaction with other images, yielding even further
information about the current physical status of the client. The client’s
ability to fight off the cancer cells in CaseThree and the client’s capacity
to take the blue light inside of her body in CaseTwo are good examples
of this.
The diagnostic implications of this imagery-based assessmenttechni­
que include these features: (a) recognizing the mind-body links via
appropriate imagery, whether images of past or present situations,
traumatic or rehabilitative processes; (b) applying interventions to pin­
point processes in the imagery and screen out unnecessary data; and (c)
following through with discussion and validation of the imagery proces­
ses with the client in the latter part of the GIM session.
Using this method the GIM therapist may be able to formulate a
preliminary diagnosis. For the three casespresented, the diagnoses were
indeed verifiable: in Case One, via self-disclosure and in Case Two, via
medical examination. Case Three was somewhat indeterminate at the
time of writing. Indeed, many cases may lead to such indeterminate
conclusions because of the fluctuating nature of disease and imagery.
This underscores the premise that the technique, as currently perceived,
is considered an adjunct and not a definitive alternative to thorough
medical assessment.
The cases also indicate certain requirements and precautions in ap­
plying this technique. Before commencing GIM, the client in Case One
had had no previous experience with imagery, whereas the client in Case
Two had used imagery regularly in a cancer support group, and the
client in CaseThree had actively and frequently used imagery by herself
 The Role of Guided Imagery and Music in Diagnosis 43

during cancer treatment. All the clients described developed a substan­

tial amount of experience in imaging during the GIM series (five to seven
GIM sessions prior to the quoted examples), yet the levels of imagery
were different for each client. Increasingly specific images related to the

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

body may be related to these differing levels of practice and experience
in imagery, although this conclusion needs a great deal of further
investigation.
It would seem that GIM is ideal for clients who are seeking to find
additional ways of relating to theirbodies while severely ill, but it should
be recognized that the energy level of each client must be taken into
account, given the typical Z-hour length of a GIM session. GIM also
seems to be an excellent method of accessing past physical trauma and
related memories, especially material in the area of abuse.
Trends showing particular types of imagery categories directly con­
nected to specific physical trauma and illness have not yet emerged. It
is possible that broad similarities will emerge, yet the style of imagery
is, by its very nature, highly individualized according to the clients and
their life experiences. Further research is needed in this area.
In reference to the hypotheses stated earlier regarding preliminary
diagnostic implications, examination of client material in this article
suggests various interpretations. It should be remembered that these
examples show only one manner of interpreting the images, and that the
interpretations described pertain specifically to these cases. Broader
implications may not be considered amatter of fact until further research
and case material has built up a scholarly body of clinical knowledge.
Nevertheless, the GIM therapist found support for the hypotheses
within the clinical material presented in this article.
The focus of this article is on preliminary diagnostic possibilities.
However, since GIM is a therapeutic method, it also has the potential to
promote ongoing change and transformation in the individual, leading
to significant treatment. Diagnosis in itself is inadequate without a
concomitant treatmentmodality, just as treatment is insufficient without
a baseline diagnosis.
Since, at the point of GIM-related preliminary diagnosis, the client
already has had some experience in using GIM (at minimum, part of one
session), foundations of using the GIM method and relationship to the
therapist have been laid, forming a precursor to ongoing therapy and
treatment on various levels. Diagnostically relevant physical imagery
sequences found in the GIM session may give information about fun­
damental roots of the condition (psychological underlays, stress factors,
abuses), and by working with these problems, physical recovery may be
enhanced. Alternatively, a preliminary GIM diagnosis may point out
44 Short

critical areas of concern to the clinician that may enable a prioritization

of treatment, which in the long term will have enhanced effectiveness.
The ethics of attempting a GIM-related diagnosis without having
treatment directly available (or by appropriate referral) warrants serious

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

consideration. Also, conveying an unsubstantiated or unprofessional
diagnosis to a client may damage the client and should not be taken
lightly. It is wise to remain cautious in regard to GIM-based diagnosis
unless fully trained, accredited, and experienced as a GIM professional.
In the literature little attention has been paid to relating GIM to
physical diagnosis. This article addresses this matter, suggesting direc­
tions for further study and research implications for the future. Finally,
the reader should note that the ideas put forward in this paper do not
exclude or contraindicatestandard medical procedures. They are not put
forward as a challenge to the practice of medicine, but rather to explore
new possibilities and promote further options and perspectives. As a
preliminary diagnostic tool, GIM offers a new and unique opportunity
to make full use of the power of mind-body interactions. We are only
beginning to glimpse this opening doorway of potential benefits which
the Bonny Method of Guided Imagery and Music has to offer.

REFERENCES
Achterberg.J. (1985).Imagery in healing. Boston: Shambala Publications.
American Psychiatric Association (l987).Diagnostic and statistical manual of the mental disorders
(3rd ed.,Revised)Washington, DC:Author.
Association for Music and Imagery (1990).Definition of the Bonny Method of Guided
Imagery and Music. Approved at the Annual Conference of AMI, Blue Mountain Lake,
NY.
Bishop, P., & Darton, M. (1987) The encyclopediaofworld faiths: An illustrated survey of the
world’s living religions. New York: Facts On File Publications.
Bonny, H. (1978). The role of taped music programs in the GIM processBaltimore, MD: ICM
Books.
Bonny, H. (1989, December). Music the in guided imagery and music process: A substantive look.
Workshop presented at Molloy College, Rockville Center, NY.
Chaplin, J.P. (1985).Dictionary of psychology New York: Dell Publishing.
Cirlot, J.E.(1971).A dictionary of symbols..New York: Philosophical Library.
Cooper, J.C.(1979). An illustration encyclopedia
traditional
of symbols. New York: Thames and
Hudson.
Cox, C., & Bush, C. (1990, February). Mari coursein mandalaassessment:Thirty hour course
of instruction. Workshop presented at Molloy College, Rockville Center, NY.
Descartes, R. (1629). Rules for the direction of the mind. Reproduced in R.M. Hutchins
(Ed.), Great books of the western world: Vol.Descartes;
.31. Spinoza
(1952) (pp.l-40). Chicago:
Encyclopedia Britannica.
Dorland’s illustrated, medical dictionary (1968).
24th edition. Philadelphia: W.B.Saunders Co.
Goldenson, R.M.(1972).The encyclopedia of human behavior: Psychology, psychiatry, and mental
health. New York: Doubleday.
Jacobson, E. (1942) Progressiverelaxation. Chicago: University of Chicago Press.
 The Role of Guided Imagery and Music in Diagnosis 45

Johnson, David Read. (1987).The role of the creative arts therapies in the diagnosis and
treatment of psychological trauma. TheArts in Psychotherapy,14, 7-13.
Jung, C.C. (1968).Analytical Psychology:Its theoryand practice.New York: Pantheon.
Leuner, H. (1969). Guidedaffective imagery (GAI). American Journal of Psychotherapy. 23(6),

Downloaded from https://academic.oup.com/musictherapy/article/10/1/22/2757081 by guest on 01 October 2021

Lockhart, R.A. (1983)Word as eggs: Psyche inlanguage and clinic. Dallas: Spring Publications.
Lynch, L. (1987).Music therapy: Its historical relationships and value in programs for the
long-term care setting. Activities, Adaption andAging. 10(1-2),5-15.
Magni, G., Schifano, F., De Dominicis, M., & Eeltoni, G. (1988).Psychological distress in
geriatric and medical in-patients. Archives of Gerontology andGeriatrics. 7’(2),151-161.
Reid, M. (1988).Towards an epistemology of the imagination,Special issue: Metaphor and
human understanding. Saybrook Review, 7(1), 21-33.
Samuels, M., & Samuels, N. (1975).Seeing withthe mind’s eye.New York: Random House.
Short, A. (1989). Physical illness inthe process of Guide Imagery and Music. Unpublished
thesis
for GIM Fellowship. Bonny Foundation, Salina, KS.
Siegel, B. (1986).Low, medicine andmiracles.New York: Harper and Raw.
Simonton, OS., Matthews-Simonton, S., & Creighton, J.L.(1980).Getting well again. New
York: Bantam.
Summer, L. (1988).GIM in the institutional setting.St. Louis, MO: MMB.
Ventre M. (1990). Level two GIM training lectures. Unpublished manuscript. New York
University/Creative Therapies institute, NK.
Webster’s dictionary.(1978).NY: Modem Promotions.
Wilber, K. (1979).No boundary Boston: New Science Library.

Alison E. Short, B.Mus., RMT (Australia), MA, CMT-BC, FAMI, was one of
the first graduates in music therapy at the University of Melbourne, Australia,
and completed her master’s degree in music therapy at New York University in
1987. In addition, she completed full training in GIM to become a Fellow in 1989.
In her 10 years of music therapy experience, she has worked extensively with
adult populations, including psychiatric, hospice, and geriatric care. Alison has
assisted with all levels of GIM training, at New York University and through the
Australian Music Therapy Association. Alison has a particular interest in the
interface of music therapy with physical illness and has been working at Grotta
Center, West Orange, New Jersey, for the past 5 years.

Alison would like to thank Madelaine Ventre for her assistance and encouragement in
the preparation ofthis manuscript.