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by Martha Stark, MD / Faculty, Harvard Medical School


Surprisingly, research studies have demonstrated that simply setting the intention to experience something positive that disconfirms the learned expectation of something negative can sometimes be almost as powerful as having the actual experience of something positive that disconfirms the learned expectation of something negative (Ranganathan et al. 2004; Miller 2018). In other words, whether real or only imagined, whether actual or only envisioned, the therapeutic impact of the mismatch will be similar – if indeed the prediction error is demonstrated persistently enough and convincingly enough within the four- to six-hour reconsolidation window.


More specifically, a growing body of evidence supports the finding that simply visualizing something, even though it occurs entirely in the mind, is almost as effective as actually doing it. According to a study done at the Cleveland Clinic (Ranganathan et al. 2004), participants were able to strengthen muscles just by visualizing physical movement. This impact simply required concentrated mental practice, namely, “the cognitive rehearsal of a physical activity <without movement>” (Saimpont et al. 2013, p. 1). In fact, a recent study demonstrated that subjects wanting to master a particular skill were able to decrease by 50% the number of actual practice hours required if they were able to visualize mastery of it (Miller 2018).


Indeed, there is mounting support for the idea that mental practice, in combination with physical practice, can improve performance remarkably (Arora et al. 2011). Just watch Olympians doing their visualization exercises (with their eyes closed) as they prepare to compete in such sports as figure skating, swimming, diving, dressage, downhill skiing, gymnastics, skateboarding, and pole vaulting, to name a few, and you will realize that top-ranked athletes figured out long ago that focused mental practice could definitely improve performance.


From this it follows that, with respect to the second part of the quantum disentanglement statement, an old, outdated, disempowering narrative can be updated whenever, again and again and in rapid succession, a learned expectation is placed side by side with either an experience that is real in the present or an experience that is envisioned for the future. In other words, a jolting prediction error will occur whenever either something new is already being experienced (although perhaps has not yet explicitly been named as a challenge to the learned expectation) or something new is simply being envisioned (and is therefore being explicitly named as something intended to challenge the learned expectation).


So whether the something being named is real (actual) or simply envisioned (imagined), the critical piece will be the creation for the patient of a destabilizing juxtaposition experience that disconfirms the learned expectation, prompts a dramatic reorganization and updating of mental constructs, and results in a recontextualizing, or reframing, of the emotionally distressing experience.


Finally, although the concept of intentionality is used by some to suggest setting the intention to impact something outside the self (McTaggart 2008), I am more comfortable limiting use of the concept to the somewhat less woo-woo idea of setting the intention to impact one’s own experience, one’s own state of mind, one’s own mental constructs, one’s own narratives.


Arora S, Aggarwal R, Sirimanna P, Moran A, Grantcharov T, Kneebone R, Sevdalis N, Darzi A. 2011. Mental practice enhances surgical technical skills: A randomized controlled study. Obstet Gynecol Surv 66(6):336-338.

McTaggart L. 2008. The Field: The Quest for the Secret Force of the Universe. New York, NY: Harper Perennial.

Miller M. 2018. Envisioning your way to success: The power of mental practice. Blog. doi:

Ranganathan VK, Siemionow V, Liu JZ, Sahgal V, Yue GH. 2004. From mental power to muscle power – gaining strength by using the mind. Neuropsychologia 42(7):944-956.

Saimpont A, Lafleur MF, Malouin F, Richards CL, Doyon J, Jackson PL. 2013. The comparison between motor imagery and verbal rehearsal on the learning of sequential movements. Front Hum Neurosci 7:773.

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