In the last in our series of blog posts on palliative care and complementary therapies, psychologist Marilyn Day tells us how visualization techniques can be a powerful way to relieve pain and anxiety.

Often, towards the end of life, a person with a life-limiting illness may feel anxious or depressed about their condition, and worried about how their loved ones will carry on without them.  The person may also be in emotional, physical, or spiritual pain.  One technique that can have a calming effect, in this situation, is guided imagery and/or visualization.

Guided imagery and/or visualization is used by health practitioners to help patients focus on positive, peaceful, relaxing images instead of the pain, worry, or distress.

As a psychologist, with a nursing background, visualization has been my favourite tool with many patients.  I remain amazed at the diversity of what people see and how fitting the images are for their personal situation.  Anyone that works with “energy” modalities may include that modality during the visualization, with the permission of the patient.

What kinds of imagery work best?
Imagery can be drawn from the experiences of both the guide and/or the patient.  A brief interview with the patient can identify areas of life experience that evoke pleasant emotional responses, such as walking in nature, encounters with pets/animals, feeling warm/positive energy flowing through the patient’s body, etc.

Different types of visualization
Visualizations can be “totally guided” or “interactive”.

  • totally guided visualizations – the guide does all the talking, with the patient creating their own images (with eyes closed);
  • interactive visualizations – the guide starts the process with an initial image and then, periodically, asks the patient, who has their eyes closed, what they are seeing, experiencing, and/or feeling.  After the initial image is given, subsequent images are created by the patient.

The major objective of both forms of visualization, for the patient, is relaxation and feeling more in control over their minds and bodies.  Ultimately, the patient may use their own imagery, as desired.  Guided visualizations can also include the patient’s family.

Guided visualization and pain relief
Visualization – guided or otherwise – is known to relieve/lessen pain.  It is more effective when the patient is not in extreme pain – so after pain medication has taken effect.

Example visualization scenes that can help control pain include:

  • a pool of warm, healing, relaxing water;
  • applying a “patch” of medication on affected area(s);
  • a beam of laser light shining on affected area(s);
  • a vision of a religious/spiritual entity touching affected area(s);
  • incorporating colours into scenes – either suggested by the guide or created by the patient (e.g., a blanket or cocoon of colour enveloping the patient) enhances effectiveness of relaxation and pain control.

There is no formal process defined for guided visualizations.  The guide’s intuition is most useful in this process.  After an initial experience, the patient may be able to continue using their own images to alleviate pain, whether it be emotional, physical, or spiritual.  The guide may leave the patient, with their image(s) to perhaps fall asleep in peace.

Many books on complementary therapy include information on the use of guided imagery/visualization. Or, if you’d like to find out more, you may like to try these resources:

  1. The Forest Awakens – Guided Imagery for Stress Relief (verbal, music & nature sounds)
  1. A ‘Time-out’ Visualisation Meditation to Heal and Refresh
  1. Visualization techniques

Marilyn Day, BScN, MEd, Registered Psychologist

Marilyn is a registered psychologist with a nursing background. She helped set up the first palliative care program at the Foothills Hospital and has worked in both Employee and Family Assistance Programs and in private practice. Marilyn now facilitates visualization and relaxation sessions for Wellspring, a non-profit organization for those with cancer.

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