New Study on Guided Imagery for Healing Kids' Chronic Pain

Eight-year-old Alice suffered from horrible stomach pain. In my office she closed her eyes, breathed slowing into her belly, and asked inside what was the cause. Stress appeared as a large square black block in the middle of her brain. What to do? Her inner voice said calmness was the antidote. Pictured as a swirling lavender ball, she breathed calm feelings into her hands, belly, neck and head. Stress melted and her tummy stopped hurting.

Over the past 25 years I've seen how the pain of chronic stomachaches and headaches can debilitate a child. The worry, anxiety, fear of pain and feeling out of control can send kids over the edge. But kids can also learn imagination techniques to help them heal.

I was therefore extremely pleased to read about the new research just published in the November journal of Pediatrics showing that guided imagery CDs relieved children's chronic stomach pain. Conducted at The University of North Carolina at Chapel Hill and Duke University Medical Center, 30 children ages six to 15 listened to relaxing CDs several times a week over eight weeks. The children enjoyed the CDs so much that there was virtual complete compliance. Their results showed 63.1 percent of the treatment group significantly decreased their pain, compared to 26.7 percent in a control group that just received standard medical care. Once the two-month study was over, the control group was given the same guided imagery treatment so they wouldn't lose out; results were similar (61.5 percent improved). At a six-month follow-up, children continued to do well.

One of their images stood out. The children imagined a special object like butter melting into their hands making them warm and shiny, then placing their hands on ailing tummies, spreading warmth and light inside to create a protective barrier that prevented anything from irritating their bellies. I often use a similar direct hands-on approach to teach children they can heal themselves.

My focus is children and teens learning to create their own imageries through a toolbox of nine core imagination skills to mix and match as needed. Their personal kit includes: the relaxing balloon breath, discovering a safe special place, meeting wise animal friends and wizards as guides, receiving gifts from them to assist, connecting to the wisdom of their heart and belly, dialoging with symptoms and feelings, and using color and energy for healing and pain control.

With these tools, kids make up their own creative scenarios. Below are five suggestions to help you on your way.

1. Teach the Balloon Breath as a Foundation Tool
The Balloon Breath is a simple technique of breathing slowly and deeply into the belly while focusing attention about two inches below the navel. This type of diaphragmatic breathing helps center and calm.

2. Pay Attention to Wisdom of Inner Guides
An imagined Animal Friend (or Wizard) can be a valuable tool to access inner wisdom. These imaginary guides are kind, loving and have a child's best interest at heart. Gifts from them are used to receive power and assistance. One six-year-old boy's pride of lions stood guard around his hospital bed to give him courage during a frightening medical test. Another eleven-year-old girl received the Gift of a spiral-moving rainbow to heal chronic stomach pains, along with rainbow glasses to see the world in a more positive light.

3. Incorporate Color to Relieve Pain
When children are very focused and involved with their personal imageries, they are distracted from their pain. One seven-year-old girl created a "color thermometer" that could raise or lower different emotions and pain. She initially worked with feelings; they seemed easier for her than the pain itself. She increased 'blue' Calmness and decreased 'orange' Fear; then increased 'pink' Love and decreased 'black' Anger. This helped her progress directly to reducing her pain in a similar manner. And a 12-year-old boy found that by first increasing his pain, he realized he had some control over it. He then used this control to lower his pain to an acceptable level.

4. Practice the Three-Question Exercise
It's an easy imagery formula that may relieve or totally eliminate pain. Start with doing the Balloon Breath. Ask your child: "Where in your body do you feel the pain?" Then follow with:

1. What color is it?
2. What shape is it?
3. How heavy is it?

Be accepting and positive of any response. Have your child continue to breath slowly three or four times between rounds. Repeat the three questions and your reactions to them.

Over the course of three to five to ten minutes, there is generally a change from dark, sharp and heavy, to light in color, round and light in weight. I've seen this work with all kinds of pain. The length of this process depends on your child's openness to relaxation and the intensity of pain.

If there are any bits of pain left, suggest a conversation with Pain in order to find out what your child needs to know, understand or do to let go of the rest. Or, he can imagine melting away any leftover hurt through his body (through skin, belly button or whatever he comes up with).

5. Use the Power of Audio
As in the fine UNC/Duke study, a well-chosen relaxation CD can work wonders. A favorite all-purpose guided imagery with the kids I see is imagining planting a magical garden where they visualize growing healthy and strong. While their garden grows, they float in a nearby healing pond, allowing the waters to wash away their pain, or heal inside hurts by drinking from the special liquid. After one group session, three boys were relieved of the pain of their stomachache, headache and canker sore, respectively. You may create your own, try the script on pages 127-128 in "The Power of Your Child's Imagination*" or have your child listen to the Creating a Magical Garden and Healing Pond CD I recorded.**

Remember, it's not necessary to have the perfect script, or years of experience for facility with this work. What is important is your sincerity, your respect for your children and their process, and your allowing them to bring forth their natural inner wise healer. As a young pre-teen discovered: "Your imagination can help you heal."

Van Tilburg, M., et. al. (2009) Audio-Recorded Guided Imagery Treatment Reduces Abdominal Pain in Children: A Pilot Study. Journal of Pediatrics, 124 (5) 890-897.
* C. Reznick. The Power of Your Child's Imagination: How to Transform Stress and Anxiety into Joy and Success (Perigee/Penguin, 2009).
** Go to for info.