Self-Induced Visual Imagery, Affect Arousal,and Autonomic Correlates

LoUIS A. GOTTSCHALK, M.D.

Systematic studies have not been carried out onpossible relationships involving self-induced visualimagery or emotional states and the autonomic ac­companiments of these products of unverbalized in­trospection. There is a definite need for such studies,even preliminary studies, not only to demonstratecause-and-effect relationships between internalizedmental processes and visceral responses, but also to in­dicate the explanatory limitations of behavior andconditioning theory with respect to relationships be­tween the mind and body. Moreover, such studiespoint to gaps in our information concerning possibleintervening variables in the physiological and somaticdisorders, not only of everyday life, but also thosedysfunctions observed in chronic medical diseases.

METHOD

While in the process of a personal psychoanalysis,the author had a dream which on later reflection andinvestigation was found to contain some vivid for­gotten early memories. The dream was a very clearone and depicted a one to two year old baby boycrawling up some huge stairs. As the baby crawledup these stairs there were a number of details thatwere quite distinct, including the fact that the stairswere covered with a carpet having a floral design. Asthe baby climbed on upward, he reached a landingwhich had a large stained glass window above it. Asthe baby continued climbing up the stairs, he reachedthe second floor of the home and came into a roomthat looked like a kitchen. There was a woman inthis kitchen, and he tried to attract her attention bycalling to her, but she was talking to a man that wasin a black suit. Much to the baby's frustration he couldnot break through the preoccupation of this womanand man in each other.

Although the author could not recall ever havingbeen at or seen such a place himself, a check withhis mother verified that all of the dream's details(carpeted staircase, stained glass window, kitchen-likeroom on second floor) were accurate representationsof his first home from which the family moved whenhe was about the age of three.

The dream was recognized in the psychoanalyticprocess as representing a frustrated search by thedreamer for one-to-one, uninterrupted attention and

Dr. Gottschalk is from the University of California at Irvine,Department of Psychiatry and Human Behavior, Irvine, Cali­fornia 92664.

166

support from his mother. There were mild affectivecomponents recognized and experienced in reportingthis dream during the analytic session, but there wasno notable autonomic arousal.

About a hundred psychoanalytic sessions later,while again reflecting on this dream during an analyticsession, the author experienced an acute sense ofseparation anxiety, tachycardia, and an uncontrollableurge to cry. The sensation was disturbingly unpleasant,and he discovered that by not thinking of the dreamsequence he could escape the unpleasant sensations.Much to his surprise, he discovered that if he re­evoked the dream scene of the baby climbing thestairs and searching for his mother, a strong feelingof anxiety and tachycardia recurred again, with astrong urge to cry. The urge to cry could be inhibited.Whether or not it was inhibited, within a few minutesof this state of anxiety and tachycardia, itchingurticaria began to develop with definite wheal forma­tion. The development of acute and rapidly reversibleurticaria was unusual in that he had rarely hadurticaria previously and was not subject whatsoeverto any allergic disorders. By not thinking of the visualimagery of this dream, all symptoms and signs againrapidly disappeared. But these phenomena could allbe re-evoked, at will, by again conjuring up the visualimagery of the dream.

About five years after the termination of the psycho­analysis, the author decided to pursue an objectivepsychophysiological study of this interesting introspec­tive phenomenon. First, he tried re-evoking thespecific visual imagery of the dream sequence which,during his psychoanalysis five years before, was capableof provoking a state of separation anxiety, tachycardia,and acute urticaria. He found that, without anyoneelse detecting what was going on and while seatedquietly in the chair, he could bring on the transientpsychological state of tearful anxiety and tachycardia.The urticarial response, however, no longer occurredat this time under these circumstances.

To substantiate further this psychophysiologicalsequence of events, the following experiment wascarried out: (The collaboration of a cardiologist· wasarranged).

• The collaborative assistance of John Braunstein, M.D.,Associate Professor of Medicine, and Director of Ballistocardi­ography Laboratory, College of Medicine, University of Cin­cinnati, is acknowledged with appreciation.

Volume XV

SELF-INDUCED VISUAL IMAGERY-GOlTSCHALK

Physiological measures were obtained on four dif­ferent experimental sessions while the subject evokeddifferent kinds of visual imagery from his past mem­ories according to a prearranged schedule which pro­vided some adjustment for possible effects of order ofvisual stimuli and for the return of physiological vari­ables to a baseline. The subject made a consciouseffort to maintain a regular and constant respiratoryrate, unless otherwise noted, so that any cardiovascularchanges observed would not occur secondarily torespiratory changes. The schedule of self-evokedvisual imagery and voluntary physiological activitiesfollowed on the first experimental session (7 f1 /55)was:

1. Baseline period, during which the subject relaxedand thought of no visual imagery (l minute),followed by counting silently and visualizingnumbers (2 minutes).

2. Baseline period (I minute) followed by visualizinganxious-baby dream sequence (2 minutes).

3. Baseline period (I minute) followed by hyper­ventilation (2 minutes).

4. Baseline period (1 minute) followed by visualizingmemories of angry events.

5. Baseline period (1 minute) followed by visualizingmemories of fearful events (2 minutes).

6. Baseline period (1 minute), followed by conscious­ly increasing total body muscular tension (2minutes).

For the next three experimental sessions, the sub­ject evoked five different types of visual imagerybefore each experimental condition after allowing time(at least one minute) for cardiovascular activity toreach a resting baseline. The first of these three ses­sions (7/8/55) had the following schedule:

1. Visualize memories of "abused or hurt pride"(2 minutes).

2. Visualize memories of "fishing" (2 minutes).3. Visualize anxious-baby dream sequence (2

minutes).4. Visualize "sleeping" (2 minutes).5: Visualize memories of "potential physical injury

to the self'.

For the second experimental session of the aboveseries, four weeks later (8/3/55), the same visual im­agery was evoked, except that the stimulus order waschanged to the following sequence: 2,4,1,5,3.

For the third experimental session, 2 days later(8/5/55), a different sequence of stimulus evocationwas followed: 3,4,5,2,1.

The physiological measures obtained during thefirst experimental session were a respirogram, electro­cardiogram (3 leads), and skin conductivity. Duringthe subsequent three experimental sessions only anelectrocardiogram and respirogram were obtained.

October/November/December, 1974

RESULTS

Under the conditions of experimental session # 1,the average pulse rate showed no notable increasefrom the baseline level before and after visualizingnumbers while counting and visualizing memories ofangry events. But marked increases in pulse rate oc­cured over resting levels when the subject visualizedthe anxious-baby dream sequence and memories ofother fearful events, and also when he inducedphysiological changes by hyperventilating and by in­creasing generalized muscular tension without evok­ing any visual imagery. All of these changes in heartrate occurred in the context of no significant changein respiratory rate (14-17/min) except during hyper­ventilation (26jmin). (See Figure I).

Increases in skin conductivity occurred during thevisualization of the anxious-baby dream and memoriesof other fearful events or with hyperventilation butnot with the visualization of numbers and memoriesof angry events or with increased generalized musculartension. (See Figure 2).

The changes in heart rate during experimental ses­sions 2,3, and 4 were looked at separately for eachsession and under each of five experimental conditions,and average heart rate changes for each experimentalcondition were obtained across the three experimentalsessions. Figure 3 clearly shows that heart rate in­creases occurred consistently and most markedly whenthe subject evoked visual imagery relating to theanxious-baby sequence (experimental condition #3)or to "abused or hurt pride" (experimental condition# 1) and not to any of the other self-evoked visualimagery. Average respiratory rate during all of these

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167

PSYCHOSOMATICS

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Karacan et al, (1966) have demonstrated loss ofpenile erection with anxious content in dreams.

In the history of psychosomatic research, it hasbeen quite common for investigators to note that theevocation of various manifest emotional states, suchas anger, fear, depression, can lead to specific kindsof changes in autonomic innervation, for example,changes in gastric function (Wolff and Wolf, 1947;Mittlemann and Wolff, 1942; Margolin, S.G., 1951),urticaria and Raynauds disease (Stem et ai, 1961,Graham et ai, 1962; Graham and Kunish, 1965;Gottlieb et al, 1967), cardiovascular function (Reiseret aI, 1951), and many others.

A recent thorough review of the literature on physi­ological correlates of visual imagery (Zikmund, 1972)describes the variety of physiological changes that mayappear during visual imagery. One study (Zikmund,1965) is cited exploring the relationship of autonomicreactions (heart rate, respiration rate, and blood flow)to visual imagery; marked intersubject differences andno consistent autonomic changes were found whichcould obviously be related to visual imagery. Un­fortunately, the subject matter of the visual imagerywas apparently ignored in this study, which readilyaccounts for the intersubject differences and incon­sistent relationships between the evocation of visualimagery and autonomic reactions.

Although the Method school of acting recommendsthat an actor evoke a realistic emotional state bythinking of an actual experience that he wants toportray, not much use has been made of this dramaticphenomenon in a scientific way. No one, for in­stance, has reported asking an actor to evoke oneemotional state or another, recorded the autonomic

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DISCUSSION

The findings of this study would remain completelyprivate if it were not possible to have an external ob­server observe and count the pulse rate, record theskin conductivity, and record the respiratory rateunder the various experimental conditions. Only themanifest physiological findings indicate to an externalobserver that the state of the subject is undergoinga change, even though he was apparently in a restingstate, lying down in a supine position, motionless, andwithout any changes in facial expression or detectibledifferences in respiratory rate or pattern. Only thesubject was able to report how this apparent feat wasaccomplished, by sharing the visual imagery whichhe evoked to stimulate the observed tachycardia orskin conductivity changes. Examination of only thesephysiological changes provides no inkling, however, ofthe nature of the subject's ideation, visual imagery,and effects.

Experimental human vascular conditioning, usingclassical conditioning techniques, has been accomplish­ed (Gottschalk, 1946) in the form of conditioned peri­pheral vasoconstriction in the fingers of ten humansubjects (measured by photo-electric plethysmography)using a low voltage faradic shock to the opposite handas an unconditioned stimulus and a light as a con­ditioned stimulus. Other authors (Pavlov, 1927;Marinesco and Kreindler, 1934; Menzies, 1937;Finesinger et aI, 1942) have reported autonomic nerv­ous system conditioning, including changes in saliva­tion, pupillary size, skin temperature, heart rate,or blood flow; in these experiments classical or operantconditioning techniques were used. The use of thesubject's own private, stressful visual imagery as astimulus to evoke autonomic nervous system responseshas, apparently, not been previously reported. It is myconviction, however, that such psychophysiological se­quences, rather than being quite rare, are quite fre­quent. This observation is based on transient symptomformation observed with many patients during psycho­therapy or psychoanalysis, the symptoms being invol­untary manifestations mediated through the autonomicnervous system and accompanying certain verbalizedemotional contents. That such transient symptomformation is commonplace during psychotherapy wasattested to by Ferenczi (1912), who was probably thefirst psychoanalyst to write about these phenomena.These studies alone, however, do not clarify whethervisual imagery without verbalization can arouse;1utonomic reactions. Gottschalk et al (1966) havedemonstrated that the anxious visual imagery in dreamscan arouse evidence of adrenergic stimulation (in theform of elevated plasma free fatty acid levels) and

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SELF-INDUCED VISUAL IMAGERY-GOTISCHALK

On the basis of the findings noted in the short studyreported here, there should be more studies carried outon the effects of self-induced visual imagery, emotion­ally laden and neutral, on autonomic nervous systemfunction as it is represented both in physiological andbiochemical changes.

BIBLIOGRAPHY

1. Ferenczi, S.: On transitory symptom-construction duringthe analysis. Zentralblatt fur Psychoanalyse 2: 588-596,1912.

2. Finesinger, J.E., Sutherland, G.F., and McGuire, F.F.:The positive conditional salivary reflex in psychoneuroticsubjects. Alii. J. Psychiat. 99:61, 1942.

3. Gottlieb, A.A., Gieser, G.c.. and Gottschalk, L.A.: Verbaland physiological responses to hypnotic suggestion of at­titudes. Psychosom. Med. 29: 172-183, 1967.

4. Gottschalk, L.A., Stone, W.N., Gieser, G.C., and Iacono,J.M.: Anxiety levels in dreams. Relations to changes inplasma free fatty acids. Science. 153:654·657, 1966.

5. Gottschalk, L.A.: A study of conditioned vasomotor re­sponses in ten human subjects. Psychosom. Med. 8: 16-27.1946.

6. Graham, F.K. and Kunish, N.D.: Physiological responseof unhypnotized subjects to attitude suggestions. Psy­chosom. Med. 27:317-329,1965.

7. Graham, D.T., Kabler, J.D., and Graham, F.K.: Physi­ological response to the suggestion of attitudes specificfor hives and hypertension. Psychosom. Med. 24: 159-169.1962.

8. Karacan, I., Goodenough, D.R., Shapiro. A. and Starker,S.: Erection cycle during sleep in relation to dream anxi­ety. Arch. Gen. Psychiat. 15:183-189, 1966.

9. Margolin, S.G.: The behavior of the stomach during psy­choanalysis. Psychoanal. Quart. 20:349-373, 1951.

10. Marinesco, G. and Kreindler, A.: Des reflexes condi­tionnels: Application de reflexes conditionnels a certainsp:'oblem~s cliniques. J. Psychol. Normale et PatllOlol?ique.31:722,1934.

11. Menzies, R.: Conditioned vasomotor responses in humansubjects. J. Psychol. 4:75, 1937.

12. Mittelmann, B. and Wolff, H.G.:Emotions and gastroduo­denal function. Experimental studies on patients withgastritis, duodenitis and peptic ulcer. Psychosom. Med.4:5-61, 1942.

13. Pavlov, I.P.: Conditioned Reflexes (Trans. by G.V. Anrep)London:Oxford University Press, 1927.

14. Reiser, M.F., Rosenbaum, M., and Ferris, E.B.: Psy­chologic mechanisms in malignant hypertension. Psycho­som. Med. 13:147-159, 1951.

15. Stern, J.A., Winokur, G., Graham, D.T., and Graham,F.K.: Alterations in physiological measures during ex­perimentally induced attitudes. J. Psychosom Res. 5:73­82, 1961.

16. Wolf, S. and Wolff, H.G.: Hllman Gastric Function. NewYork:Oxford University Press, 1947.

17. Zikmund, V.: Physiological correlates of visual imagenry.In The Function and Nalllre of Imagery. P.W. Sheehan(Ed.) New York and London: Academic Press, 1972.

18. Zikmund, V.: Relation between physiological and psy­chological indices of the visual imagery of a motionstimulus pattern. Activities Nen'osa Superior. 7: 179,1965.

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reactions that have been influenced by such affectivearousals, and asked the actor to specify what memoriesor visual imagery were used to bring about such re­sponses. Whether an actor could do so while lyingperfectly motionless, rather than walking around andtalking dramatically, has yet to be ascertained. It islikely that certain actors would be able to influencecertain visceral activities by this means. In any event,studies of this sort would provide much needed in­formation concerning the psychophysiological relation­ships that occur when there are no visible externalstimuli.

October/November/December, 1974 169