Story Submitted By Denise Allen M Health Sc OT, AccOT, Occupational Therapist, Australia
Visualisation uses our imagination and our senses to create an experience. For example, if I ask you to visualise holding a lemon in your hand you may feel its weight and texture or smell its aroma or even salivate. In visualising that lemon you have engaged your imagination and your senses. Guided visualisation can be a supportive technique that may help children feel calmer, prepare for an upcoming event, and think through what might happen. It enlists the imagination to problem solve. It can offer a brief pause from everyday worries and help create a calmer moment to think. Visualisation can also be called imagery, mental rehearsal and mental time travel.
A case study will be used to illustrate the use of guided visualisations. Tom is a 14-year-old boy, who is anxious about returning to school in 2 weeks' time. He has had almost 3 months off school having treatment for bone cancer. Initially he kept up contact with his friends and did a fair amount of schoolwork but as the side-effects of his treatment worsened the contact with friends dropped off and he fell behind academically. Understandably Tom is feeling anxious about how he will cope with his return to school physically, academically and emotionally.
During a therapy session Tom was asked to remember a good day he had at school before his diagnosis and cancer treatment. He then created a mind map that included having fun with his friends, a positive experience with a favourite teacher, the feeling of doing well in an assessment task, the loudness of the playground and the smells of canteen.
Tom then created a mind map of his anxieties about returning to school. This included not knowing how his friends would react, being out of the loop about current events, dealing with questions about where he has been, people teasing him about his bald head and weight loss and doubting whether he would cope academically, and concern that he may get sick or tired during the day.
Tom and the therapist them brainstormed possible solutions to each of the above anxieties. He decided in the next two weeks that he could Facebook friends- posting a current photo and a brief outline of his current health, invite one or two close friends for a pizza and X-box night and ask his dad to talk to the Principal, Year Advisor or Counsellor at his school about his return. He planned to go for a 30 minute walk each day to improve fitness, and to be driven past, or walk through, the school on the weekend. His mother also agreed to be on call if he did feel unwell.
Tom then participated in a relaxation session which used a guided visualisation created around the items from his 2 mind maps. In the relaxation Tom used breathing and muscle relaxation to relax his body before the visualisation was introduced.
Imagine waking up on your first day back at school, acknowledging that you feel a little anxious, but that these feelings are quite reasonable, and taking a few deep slow breaths to calm down..........
Now imagine walking in the school gate.......remind yourself that you had seen and spoken to some of your friends recently and that they expecting you at school today..... Now imagine seeing a friend who comes up and greets you warmly and takes you over to join the group you used to sit with. Imagine the things they might say to you and how you will respond....perhaps you are pleasantly surprised by how supportive they are....Now the bell rings …....first up is one of your favourite subjects..... imagine one of your friends inviting you to sit with them.......imagine what the teacher might say to you......imagine devising a plan on how you can catch up on missed work........becoming aware of your breathing again and taking some deep slow breaths and every time you breathe out letting yourself relax even more.... You now have one minute to imagine the rest of your first day back at school.......focusing on the good things that could happen and remembering that this is only limited by your own imagination...........
(NB time is dilated in a relaxation/ visualisation and one minute can seem much longer.)
Tom used the relaxation and visualisation approximately every second day in his lead up to returning to school. Tom shared that mentally rehearsing possible situations and using his imagination to plan ahead made him feel more prepared and a little more confident about returning to school.
Tom's return to school went quite well due to his preparation and his family support. He had one incident where he was taunted for his appearance, and his friends came to his aid. In some subjects he felt overwhelmed by the amount of work he had missed, and he found that the simple breathing exercises helped him settle when things felt overwhelming. Tom was exhausted by the Friday of the first week and only attended for a half day, though he reported that he was looking forward to the next week of school.