Recovering from Chronic Fatigue Syndrome:
A Guide to Self-Empowerment 

By William Collinge, Ph.D. 

Table of Contents 

Chapter 9. Imagery and CFS
      "I visualize every day. I picture good things, seeing myself do things I'd love to do, like swimming in Hawaii, soaking in my hot tub, dancing... I visualize fulfilling goals, even tiny ones. Like planting flower seeds tomorrow morning."  --Debbie
     Can you picture yourself healthy? Can you actually imagine life after CFS? Can you imagine what a life of balance, harmony, and health will look like for you when you are well? In Chapter 7 we reviewed some of the research showing that imagery can affect immunity and healing. Now I would like to show you how you can use this approach with CFS. 
     We all practice imagery, constantly. When you drive home, you have a map in your mind which you follow. When you walk around your house, you are following a map. What you "know," you know in images. This is the language of the brain. When you see someone you know, it is their image you recognize. Your images are also constantly affecting your body. If you were abused as a child, you may carry a subconscious image of yourself as a vulnerable child about to be hit at any moment. You may hold your shoulders in a tight, protective posture as your defense against this possibility. 
     The power of imagery can be harnessed as a self-help tool. It has proven to be useful for many illnesses ranging from cancer to AIDS to heart disease. In my practice, I have seen people with CFS benefit from imagery in several ways. 

     One way is through using drawings or images to help you clarify issues in your life. Often in my self-help programs we use drawings to reveal the person's inner attitudes and beliefs about what is happening. This can lead to useful insights about needed changes. 
     For example, during a group imagery session, Mary Ann drew a picture of herself being subdued by CFS, which was represented by a monster. Seeing this drawing, she realized how victimized she felt, and she immediately became in touch with her anger at this situation. Her anger fueled a renewed determination to break her old habit of volunteering to do all the legwork for her support group, which had been draining her energy. 
     This was the beginning of a much needed shift in her life, to stop doing favors for others that she really did not want to do. That shift has endured beyond her illness. 

     Imagery can help you strengthen your belief in recovery. Clinical experience has taught me that belief in recovery is a prerequisite in healing from CFS. Very often, however, I meet people who are seeking help, but cannot actually imagine themselves recovered. Whenever I begin working with someone, whether it is individually or in group programs, I address this issue. 
     We touched upon reasons for this problem in Chapter 1. A major source of the difficulty are the images portrayed by the media. The images of endless debilitation are indeed very powerful. Unfortunately, the media's concentration on these negative images is not balanced by a presentation of images of healing, or the quiet triumphs of people who have recovered. These would provide a counterpoint to the negative images, but since good news does not seem to attract media interest as much as bad news, many people are left with only one kind of imagery to associate with CFS. 
     We are faced with a similar problem in media coverage of the AIDS crisis. Although people have recovered from AIDS and even converted from HIV positive back to HIV negative, this kind of news is not consistent with the popular imagery or beliefs about AIDS, so it simply goes unacknowledged. One rare exception to this is the story of my colleague and friend Niro Asistent, who made the cover of New Age Magazine in October, 1991. 
     The ability to imagine yourself well affects you in many ways. On the physical level, the bio-chemistry of hope is very different from that of despair, and your immune responsiveness is affected by both. On the psychological level, a great deal of change in behavior is necessary to promote healing. Without belief in recovery, there is no incentive to sincerely follow through with such changes. And also, in those moments when you are in the pits, feeling your absolute worst, imagery can be a resource to get you through. 
     One of the best ways to strengthen your belief in recovery is to create images of yourself well, and view them each day. Now that you understand the nature of CFS and the major principles in promoting recovery, you can create images which should be both realistic and inspiring to you. 
     Try the following exercises. Depending on your state at the moment, different exercises may serve you better than others. The object is to create images which you can call upon repeatedly. The first time you do these exercises, allow more time to develop the images. Once you have developed them, then you will be able to call upon them any time you want a shot of inspiration. 
     For each of the imagery processes described, note that there are three parts of the process. First, always begin with a period of calming relaxation. Close your eyes and take several breaths to clear your mind of the clutter of the day so you can be fully present for the process at hand. It is essential to take this time to relax so that all your attention is available to the imagery. 
     The second stage is the healing imagery itself. Feel free to let your images change. As your healing work progresses, and as you get to know yourself better, your images will naturally evolve and change. Be open to this and whatever messages you can glean from these changes. 
     Finally, it is always good to end with imagery of yourself healed, doing something you love to do. This reinforces the sense of momentum and direction for your healing process. This is where you are headed, and this is the incentive for the earlier healing imagery. Be sure to include this each time. 

EXERCISE 1. After CFS: Living a Life of Balance  
     The first time you do this exercise, take about twenty to thirty minutes to develop the imagery. Close your eyes, and take several long, slow, deep calming breaths. 
 Now create an inner movie of how you imagine your life will look after you have recovered from CFS. Include the following details. 
 How do you look? 
 How is your body different? 
 How are your eating habits different? 
 How do you moderate your energy now? 
 How is your pattern of exercise? 
 How is your pattern of working hours? 
 What kind of work are you doing? 
 With whom do you relate? 
 How is your communication with them? 
 How is the quality of your relationships different? 
 What kinds of people do you spend more time with? Less time? 
 How is your honesty and self-expression? 
 What are your goals? 
 How do you maintain your environment? 
 What do you appreciate about your life? 

     Now draw a picture of yourself that can represent you living this life of balance. This can be a picture you can hang on your refrigerator or a wall in your home. 

EXERCISE 2. What Makes Your Heart Sing? 
     Close your eyes, and take several long, slow, deep calming breaths. Now imagine yourself totally healthy, doing something you love to do, something that makes your heart sing. Whether it is swimming in the ocean, playing a musical instrument and singing, walking in nature, making love, dancing, fishing, or playing with children, find some activity that truly arouses joyful feelings within you. 
     In this inner movie, let yourself enjoy it to the hilt, more than you ever have before. Immerse yourself in the pleasant feelings and sensations. Let your images be vivid enough that these feelings well up within you. Remind yourself that you are worthy of happiness and fulfillment. 
     End by drawing a picture with as much detail as possible. This can be a picture you can hang on your refrigerator or a wall in your home. 

EXERCISE 3. Looking Back on CFS. 
     Close your eyes, and take several long, slow, deep calming breaths. Now picture yourself in the future, five years after recovery from CFS. During those five years since you recovered, you have been able to contemplate what you learned and how you grew from that adversity. 
     Now imagine you are sitting on the ground in a meadow, with a circle of people. It is a beautiful day, and the nature that surrounds you seems most approving of your presence. The circle of people includes your closest friends, family members, teachers, and all the significant people of your lifetime. Be sure to include everyone with whom you have ever had an important relationship. The circle may even be two or three persons deep, so everyone can be included. Take a few minutes to fill out this circle. 
     Now give an informal talk entitled "My Healing Journey." It is about your past experience with CFS. Begin the talk with the following: "I'd like to tell you a story. I'd like to share with you what I learned and how I grew from having CFS..." 
     After finishing the talk, imagine that the circle of people offers you with a gift. This gift symbolizes their appreciation for you being in their lives and sharing your story with them. Express your gratitude. Accept the gift graciously, and hold it close to your heart. 
     Now draw a picture of this gathering in the meadow. Attach names to the figures who represent all the important people of your life. Place this drawing on your refrigerator or a wall in your home. 

     Using imagery to promote healing is one of the more sensationalized, mysterious, and misunderstood methods of self help. Yet, many people believe it is the most powerful mind/body approach, and in Chapter 7 we saw evidence that it can cause changes in the physical body, including in immune functioning. Before going into how to use imagery with CFS, I would like to give you some background about how it works. Try the following exercise. 

EXERCISE 4. In the Kitchen 
     Do this process slowly. Close your eyes, and take several long, slow, deep calming breaths. Imagine for a moment that you are standing in the center of your kitchen. Slowly turn in a circle, and see the familiar items in the room. You may notice dishes in the sink, the toaster on the counter, the cupboards, the dishwasher... you may hear water dripping in the sink, you may see food on the counter. Notice the stove, the oven, the dials, and any pots or pans in view. Close you eyes now and get a clear image of your kitchen surroundings before you continue reading. 
     Now imagine you are turning toward the refrigerator. Look at the hardware on the door, the handle, and the color. Now slowly reach for the door and take the handle. Feel the texture of the handle. Is it cool, or warm? Smooth or rough? Now very slowly apply pressure to pull the handle toward you, and feel the door beginning to open. You may hear the breaking of the suction of the gasket around the door as it separates from the frame of the refrigerator. You may feel a rush of cool air around your ankles, and you may see the light come on inside. 
     Looking into the refrigerator now, notice the different kinds of food on the shelves. And notice if there are drawers containing other food. Take a moment to do a brief inventory of what you see. Now imagine you see a lemon sitting in the back, behind some other items. Reach over and back, grasp the lemon and bring it out. 
     Close the door and turn to step back toward the center of the kitchen. Now feeling this lemon in your hand, notice the nub on the end, and notice the rough texture of the skin. Squeeze the lemon lightly, and feel how it gives under your fingers. 
     Next, turn toward the counter and find a cutting board and a long sharp knife there. Placing the lemon on the cutting board, and poise the knife over the center of the lemon. Now run the knife through the lemon, slicing the lemon in half. Feel how easily the knife glides through.  
     Setting the knife down now with half the lemon, take the other hand and hold it up at eye level. As you look across the smooth cut surface, notice how there are tiny beads of juice resting on the sheen of the flat surface. 
     Next, squeeze the lemon slightly and watch as a tiny mist escapes up from the surface into the air. Now bring the surface toward you mouth, stick out your tongue, and run your tongue over the surface... 
      Notice now what is going on in your mouth. If you notice any increase in saliva, your imagination is working. But how does this occur? How did the images of the lemon cause your salivary glands to respond? 
     Obviously, there must be some pathway of influence between your brain and your salivary glands. That pathway is your nervous system. And what has happened is that the images you created in your mind triggered certain nerve impulses which were sent from your brain to your salivary glands and told them to prepare for lemon juice. The glands responded, not to the presence of real lemon juice, but to the image in your mind. 
     Just as you have nerve endings reaching into your salivary glands, you also have nerve endings reaching into your bone marrow, thymus, spleen, lymph nodes, muscles, and all other tissues of your body. It is through this system of "wiring" that imagery is able to affect the tissues and organs of the body. This is the same wiring that allows sexual arousal to take place with no physical stimulation. 
     Yet this is not the only means by which images can affect the body. Another is through chemical substances produced by the brain tissue. In addition to being the seat of the nervous system, the brain is also a gland. It manufactures many more kinds of drugs than could ever be found in any pharmacy. Your brain routinely transforms thoughts into chemical by-products, releasing them into the bloodstream. 
     If you are dwelling on images of debilitation and hopelessness, this is your imagery practice, and, as all images do, it has its own unique chemical by-products. If you practice the imagery of hope, you send a different chemistry into your body. 
     We spoke in an earlier chapter about communication between your brain and immune system, and how the white cells have receptors on their surfaces to receive chemical messengers from the brain. Hence, because of its complexity, the immune system gets both types of stimulation from imagery. 

Specific Healing Imagery 
     "I can actually physically feel changes in my body when I do the visualization and imagery. That physical change takes away the anxiety I feel with this illness." --Ginger 

     The essence of using specific imagery to heal the body is to invent a way to symbolize what you want to have happen. The symbols need not necessarily be visual, like a photograph. They may use the other senses as well, such as feelings, sounds, tastes, or smells. The point is to create a symbolic experience in which the actions you want to take place are taking place now, and you can sense evidence of it happening. 
     For instance, in cancer and AIDS there is an adversarial process between white cells and cancer cells or viruses. The white cells are predators, and cancer cells or viruses are their prey. At the cellular level, what is needed is determination, aggressiveness, and discernment in the immune system to root out and remove the pathogens. 
     It is fairly easy to come up with symbols to represent this process. Imagine a pack of wolves chasing down rats in a field and gobbling them up. As you watch the wolves at work, you see how they cooperate with each other to circle around the rats and close in for the kill. The wolves use their very keen senses, their intelligence, and team work to clear the field of the rats. What is left behind is a clean, healthy field. One cancer patient would practice this imagery while driving on the freeway. In the privacy of her own car, she would growl, gnash her teeth, and even salivate as she devoured the little critters. 
     The healing process in CFS is not quite as simple as the adversarial approach. At this writing, we are not sure what the disease process looks like, though we know the symptoms are the effects of chronic immune activation. If on-going activity of a virus is what causes this process, then the aggressive kind of imagery used in cancer and AIDS would be appropriate. 
     However, it may be also be a "hit-and-run" virus, one that did its damage and then left the immune system in a state of disarray, unable to recover long after the virus was gone or became inactive. If this is the case, then the symbolic themes for healing may be different. 

Coming Back Into Balance 
     There is a simple solution to this ambiguity. An immune system out of balance is not as effective against viruses as one which is in balance. You can deal with both issues -- the possibility of an active virus, and the chronic immune  overactivation -- by restoring overall integrity and harmony in the immune system. 
     Rather than getting too absorbed in scientific details, it is best to settle on general themes. A focus on harmony, rhythm, and balance is suggested. Following are some imagery processes to deal with these themes. 

EXERCISE 5. You, the Maestro 
     Spend fifteen or twenty minutes with this process. Close your eyes, and take several long, slow, deep calming breaths. Now imagine you are an orchestra conductor. Perhaps you are the eminent director of an internationally-known philharmonic in your name. You have a vast, talented, well-equipped orchestra, with all the essential players. They are loyal to you and have devoted their entire careers, indeed their lives, to making beautiful music for you. 
     In this orchestra you have the full range of instruments, who can make a tremendous variation in sounds. When they are playing in harmony and rhythm with each other, the music is truly beautiful. Imagine, however, that the orchestra has fallen into disarray. The tuba section is playing full blast, while the flute section is being drowned out. 
     What will you say to your orchestra? How will you get them back into harmony? 
     Playing classical music is a good way to develop this imagery. You might experiment with a beautiful, perhaps methodical piece such as Ravel's Bolero for this. With the music playing softly in the background, close your eyes and practice directing your orchestra. Enjoy the feeling of harmony that arises in you when you immerse yourself in the music. And imagine that the orchestra represents your immune system, with all its players, having restored a state of harmony and balance. Listen very closely, more closely than ever before in your life, to discover what true harmony is. Feel the vibrations of the sound penetrating all the way into your marrow, the birthplace of your white cells. Become intimately familiar with the concept of harmony. 
     Now end by picturing yourself healthy, doing something you love to do. 

EXERCISE 6. Healing Your White Cells 
     In the chapter on the relaxation response I made the point that relaxation is a state in which all the body's healing mechanisms function at their maximum. The chemistry of stress disturbs healing, and the chemistry of relaxation supports it. 
     We observed that every cell in your body has a genetic code which defines its role in your health. This genetic code can be thought of as image which is carried in the heart of every white cell. In CFS certain white cells have fallen out of alignment with their own internal image, and are malfunctioning. Some are hyper-aroused, and some are depressed or inhibited. 
     In this process, you use the relaxation response to benefit the white cells themselves. Close your eyes, and take several long, slow, deep calming breaths. For a few minutes, use your favorite method of creating the relaxation response in your body as a whole. 
     Now picture your white cells (or a symbol for them) going through a relaxation experience. Imagine your white cells taking long, slow, calming, deep breaths. Imagine them exhaling any tension or negativity they might have accumulated. Imagine them releasing the forces of disease with each out-breath. Assist them in this with your own breathing. 
     Feel how this relaxation has a calming effect on the white cells. Feel how their tension melts away. Feel how their exaggerated state of arousal slowly drifts back down toward balance, as they rest more deeply. For those which are depleted and exhausted, feel how the deep breathing and profound rest help them restore themselves. Feel their energy building, like a marathon runner resting on a tropical island after several long weeks of intense training. 
     Stay focused on the deep, calm breathing. Imagine every cell is breathing with you, and that as deeply as you go into a state of healing relaxation, your white cells go just as deep. Spend a while in this healing s    tate, letting your white cells soak up the benefits of deep relaxation. 
 Now end by picturing yourself healthy, doing something you love to do. 

EXERCISE 7. The Golden Healing Light 
     Allow about fifteen to twenty minutes for this exercise. Close your eyes, and take several long, slow, deep calming breaths. Now imagine that hovering just a few inches above your head is a golden ball of healing light. You may even feel a sensation of warmth or tingling on your scalp below this ball of healing light. As you continue with your long, slow, deep breathing, allow this golden ball of healing light to slowly descend toward the top of your head. 
     Feeling the sensations grow slightly stronger, let the golden ball of healing light now begin to penetrate the top of your head. Feel it entering the top of your skull and filling your head with its golden healing warmth. Let its golden healing light reach into all the tissues and cells inside your head, filling them all with golden healing warmth. 
     Feel the golden ball of healing light now slowly descending further down into your neck and throat areas, filling them with warmth and golden light. Now, like a thick lazy liquid, let it spread further down into your chest and out toward your shoulders. Feel the golden healing warmth now spreading down through your upper arms, slowly pouring its way down into your forearms, through your wrists, into your hands. Everywhere this golden healing light goes, it penetrates into the deepest levels, all the way into your marrow. Let it fill your marrow with golden healing light. 
     Imagine the golden ball of healing light now moving down through your rib cage, expanding outward in all directions, and slowly descending down into your abdomen, filling all your internal organs with golden healing light. With each breath, you can reinforce the healing power of this golden light penetrating every cell. 
     Moving down now into your lower abdomen, through your pelvis, out to your hips... fill all these areas with this magnificent golden healing warmth. and now letting this golden healing warmth begin to pour down into your thighs, through the marrow of your long thigh bones, down through your knees, into your calves... finding its way through your ankles, into your feet, and filling your feet, all the way to the tips of your toes. 
     Now let this golden healing light become centered in the middle of your chest, so that with each breath you take you reinforce its glow, just as an ember glows brighter when you breathe into it. 
 Realize that no virus can withstand the intensity of this golden healing light. Viruses simply dissolve and vaporize under this light. You might even hear a hissing or fizzing sound as your entire body is cleared of viruses through the powerful action of this light. Even those viruses which were hiding out inside cells are vaporized. There is no escape. 
     Know that you can send this golden healing light throughout your body, your marrow, your immune system, and each white cell, simply by closing your eyes and breathing into it... Know that every white cell drinks in this golden healing light with every full breath you take. 
     Now end by picturing yourself healthy, doing something you love to do. 

EXERCISE 8. Fighting Spirit 
     Use this kind of process if you feel drawn to the imagery of an adversarial confrontation between you and the forces of illness. If you believe that you are fighting a virus, or if you feel anger, disgust, or rage toward the illness, this kind of imagery can help you channel your fighting spirit. Of course I am only outlining the process below. After you learn the steps of this outline, you will be able to adapt it to your own imagery in the future. 
     Now take a few minutes to choose two symbols: one to represent the forces of illness and one to represent the forces of healing. It is recommended that you use living creatures, since they can more easily arouse powerful, primal feelings in the subconscious. If you use more abstract images like lights, stars, machines or inanimate objects, these usually do not carry as much emotional charge. A strong emotional charge is empowering. 
     If you use people, even a kind of people you consider bad, there may still be some ambivalence about doing what you need to do to get rid of them. Use symbols in which the contrast between the forces of darkness and light is very strong and easy to grasp. 
     For example, to represent the forces of illness, you might use creatures such as maggots, worms, insects, or rats. They are trying to invade and dominate your life. They have absolutely no regard for your well-being. They have no respect for you, nor any interest in negotiation, discussion, or compromise. Their behavior toward you is disgusting and destructive. If they had their way, they would destroy your health, and ultimately even take your life from you. 
     To represent the forces of healing, choose a symbol that has the qualities of intelligence, sharp senses, swift movement, cleverness, aggressiveness, and lethal, undeniable power. You want your defenders to be overwhelming, decisive, and thorough in their protection of you. Examples might include a pack of wolves, sharks, polar bears, eagles, piranha, or other powerful creatures. All your defenders are totally and completely loyal and devoted to your well-being. You are their master. Remember, the white cells function by killing invaders, according to nature's laws of predators, prey, and the survival of the fittest. 
     Once you have selected your symbols, close your eyes, and take several long, slow, deep calming breaths. Now picture a scene in which the disease process is taking place. See the symbols of darkness, doing whatever you imagine they do in your body. Take your time to work out a scenario that represents this. You might even draw a picture that shows what the disease activity looks like. 
     After you have developed your imagery of the illness, begin to introduce your healing forces. Bring them into the picture and see how they confront and destroy the forces of illness. See that your healing forces are intelligent, overwhelmingly powerful, and thorough in wiping out their prey. See how they are well-organized and cooperate with each other, as they root out and destroy the vermin. Now take your time to be sure all the invaders have been vanquished. Once you are certain of this, see your protectors strutting around, triumphantly celebrating. 
     Now take a few moments to give a speech of gratitude to your protectors. Let them know how much you appreciate their efforts. After all, they are willing to give their lives for you, if that is what it takes to protect you from the forces of illness. Thank them and praise them profusely. 
     Now shift to another scene. This time, picture yourself healthy, happy, fully recovered, doing something you love to do--whatever makes your heart sing. This, after all, is the goal, the incentive for which all your protectors have been working. Take your time to truly feel the feelings of pleasure and fulfillment that come from being healthy and doing what you truly love to do. 

How do I know whether it's working? 
     How you feel afterward will tell you to what degree your imagery is serving you. In fact, this is more important than the details of the images you use. If you feel triumphant, uplifted, empowered, more energy, more relaxed, more confident, these are all beneficial states. Remember, the purpose of imagery is to have impact on your chemistry. All these shifts in your subjective feelings reflect shifts in your chemistry, and they are the evidence that you are on the right track. 

Is there a right way to do imagery? 
     As stated above, the most important criterion is how you feel afterwards. You can be following all steps properly, but if you don't have a subjective experience of feeling better or uplifted afterward, then you need to change something. The only right way is the way that brings you these subjective results. 

How often should I do imagery? 
     The more often you practice, the more familiar the images will become to you and the more deeply they will be embedded in your subconscious. When the subconscious fully embraces these images and the attitudes they represent, it will work around the clock to bring your life more into alignment with what these images represent. 
     For this reason, it is good to have a routine for yourself of at least once a day, at a given time and place, for your practice. If you can do it three times per day, that is even better. Also, rather than the formal three step process, you can "check in" with your images several times during your day, for just a few moments. Sitting on the toilet, driving in your car (with eyes open!), anytime you feel to, check in and reinforce your imagery. 

What about tapes? 
     If you find a tape whose voice and images you feel drawn to, then go ahead and use it. However, your own images may be preferable to someone else's, because they originate in your own subconscious and will have the greatest meaning for you. (See Appendix C for information on tapes for CFS by the author.) 
     One suggestion is to make your own tape. Write out a script that includes everything you want in your imagery. Then record it, taking care to leave plenty of pauses to develop the images as you go along. Also be sure to include all three stages in the tape, with the introductory relaxation and the triumphant ending. 

I can't draw. Is drawing really necessary? 
     No, it is not necessary. However, it can be helpful. Realize that your drawings are not going to be entered into any art contest and do not judge them, for this might dissuade you from using them. Also, understand that the drawings are just a rough approximation of your images. They simply serve the purpose of suggesting or reminding you of certain themes and attitudes. Have fun with them, and don't take them too seriously. 

My attention wanders. What to do? 
     It is natural for your attention to wander during meditation, relaxation, and imagery. This is not a problem. When you discover this has happened, simply bring your awareness back to the imagery and resume where you left off. There is no need to judge yourself about this, for there is nothing wrong with it. It is only a problem if you are nonaccepting of this. 

My images change a lot. Should I be consistent? 
     It is comforting to have consistency, and you will probably settle on favorite images that will stay with you for some time. However, your images will naturally change as you change, as your health situation changes, and as you gain more insight about your own healing process. 

I don't see pictures in my mind. Can I still use imagery? 
     Imagery is a broad concept that embraces all the senses. Some people's images are more pictorial, while others image more in terms of feelings, sounds, or other sensations. All of these are equally valid. The sound of a pack of wolves howling at the moon, or the feeling of the golden healing light melting away and vaporizing any remain viruses can also be effective images. 

Audio CD Program Available  Recovering from CFS:  The Home Self-Empowerment Program

For information about Dr. Collinge's four-CD audio program of inspirational talks and guided self-healing exercises that accompany this book, click here