Whenever Edward started up the stairs to his pediatrician’s office, he would panic. He’d fall down and refuse to move. Even though his doctor was the kindest, caring doc around, Edward was terrified of “the shot.” He had to be carried in and held down for any immunization. Now that it’s flu season, another “shot” is coming up and his parents are distraught over their son’s suffering.

Shots, medical procedures, and surgery can be terrorizing to a child. Parents report all sorts of reactions – from hysterical crying to aggressive and acting-out behavior, to hiding and crawling up in a fetal position. What’s a parent, nurse, or MD to do?

Last week we wrote about how the power of a child’s imagination can reduce stomach pain and headaches. Today I’d like to share two simple imagery techniques to help children create pictures from their mind's eye to prepare for painful shots and medical procedures. When reading the scripts use your most soothing, slow voice with soft music in the background if possible. Depending on the child’s age, adjust the vocabulary and specifics.

1. Face Fear by Developing Bravery and Courage:

Help your child develop strength and courage. When they learn, it will be far easier to get them out of the house and into the medical office without turmoil.  Here’s one way to build confidence.

Sample Script:

“Close your eyes gently and focus on your Balloon Breath (slow breathing 2-3 inches below navel). Imagine where your worry (or fear) is in your body? What color is it? What shape or image does it have?

“Now, imagine where your brave part is in your body? Look all around inside. What color is it? What shape is it? Focus on your brave area. Breathe in the color of your brave part (e.g. blue or ??) through your body. You can start from (wherever the brave part is) and breathe out from there. Notice how your brave part expands just by breathing. Take all the time you need and see how much of your body you can fill up with bravery and courage. Let me know when brave has spread as far as it can.

“Continue to take some slow Balloon Breaths. See if bravery and courage can fill up your whole body. Now notice what happens to worry when you breathe your brave feelings right into it.” (Might cover it up, change its color, or disappear). Take your time.”

As far as your child gets is good. With practice, bravery will likely grow. When she can breathe brave feelings throughout the body, suggest:

“Keep breathing your brave color past your physical body… six inches… one foot… two feet… up to three feet. Imagine a bubble of bravery all around you. This bubble of bravery and courage will protect you when you visit the doctor (hospital). Feeling your brave confidence helps you stay calm no matter whatever or whomever we meet.”

2.  Reduce Pain with Ice-Cream Imagery as Anesthetic:

Preparing for shots or painful tests should include lots of positive images and mental rehearsal of everything going well. Depending on your child’s age, include more or less details about the specific procedure. Here’s one pain numbing imagery that kids really enjoy.

Sample Script:

“Imagine your favorite flavored ice-cream or frozen dessert in a cup. Remember its color, and texture, and smell and taste. With every slow deep breath you take, the cup grows larger and larger, filling up with more and more yummy ice-cream. Visualize tasting your delicious ice-cream,  so cool and refreshing. Now picture putting some of this very cold ice-cream right on the exact spot(s) where you’re going to have your shot (or needle, IV, biopsy, etc.). Wow is that cold! But it’s refreshing and very numbing. You can really feel your arm (leg, back…) cooling and numbing from your favorite ice-cream.

“As you continue your Balloon Breath slowly, the numbing cream works even more. Take your time… (Wait a minute or two). You can hardly feel anything in that spot now. And if that spot, that spot that you might feel any pain at all, is really, really large, you can even lay down in what has now become a bathtub of numbing ice-cream that is cool, refreshing, creamy and icy. There is as much as you need to totally numb any painful spots leaving you comfortable and peaceful. …

“So all you need to do is start your slow Balloon Breath, remember your favorite delicious ice-cream flavor, and wherever you have any pain or discomfort, put some on and it will numb any hurtful feelings during and after your medical procedure.”

Practice definitely makes perfect when preparing for medical situations. Even simple deep breathing becomes very challenging when a child is anxious or fearful. One way to explain the importance of repeated rehearsal is using the metaphor of sports. In order to do well at the game, the team needs to practice. The more they practice the better they get. Depending on a child’s age, use developmentally appropriate examples (e.g. learning to tie shoes, ride a bike, and drive a car). Practicing as much as possible before any procedure will increase the likelihood of being able to actually use imagery techniques when needed. But, if you don’t have that much time, do the best you can, and perhaps bring along a CD* at the time of the procedure for general relaxation or with specific instructions.

And of course, let me know how it goes.

* Go to http://www.imageryforkids.com/shop.asp for info on therapeutic relaxation CDs including Creating a Magical Garden and Healing Pond.

Charlotte Reznick, PhD is a child educational psychologist, an associate clinical professor of psychology at UCLA, and author of a new book, The Power of Your Child's Imagination: How to Transform Stress and Anxiety into Joy and Success (Perigee/Penguin 2009,www.ImageryForKids.com/book).

About the Author

Charlotte Reznick

Charlotte Reznick, Ph.D., the author of The Power of Your Child's Imagination, is a professor emeritus at UCLA.

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