Imagination helps kids cope with pain


“Children can clearly reduce their abdominal pain a lot on their own with guidance from audio recordings, and they get much better results that way than from medical care alone,” says lead author Miranda van Tilburg.

UNC CHAPEL HILL (US)—Children with functional abdominal pain who combined the use of guided imagery with standard medical treatment were almost three times as likely to improve their pain problem, compared to children who received standard treatment alone.

Those benefits were maintained six months after treatment ended, a new study by University of North Carolina at Chapel Hill and Duke University Medical Center researchers has found. The findings are published in the November 2009 issue of the journal Pediatrics.

“What is especially exciting about our study is that children can clearly reduce their abdominal pain a lot on their own with guidance from audio recordings, and they get much better results that way than from medical care alone,” says lead author Miranda van Tilburg, assistant professor in the Division of Gastroenterology and Hepatology. “Such self-administered treatment is, of course, very inexpensive and can be used in addition to other treatments, which potentially opens the door for easily enhancing treatment outcomes for a lot of children suffering from frequent stomach aches.”

The study focused on functional abdominal pain, defined as persistent pain with no identifiable underlying disease that interferes with activities. It is very common, affecting up to 20 percent of children. Prior studies have found that behavioral therapy and guided imagery (a treatment method similar to self-hypnosis) are effective, when combined with regular medical care, to reduce pain and improve quality of life. But for many children behavioral therapy is not available because it is costly, takes a lot of time, and requires a highly trained therapist.

For this study, 34 children ages 6 to 15 years old who had been diagnosed with functional abdominal pain by a physician received standard medical care and 19 were randomized to receive eight weeks of guided imagery treatment. A total of 29 children finished the study; 15 in the guided imagery plus medical treatment group and 14 in the medical treatment alone group.

The guided imagery sessions, developed jointly by van Tilburg, were recorded on CDs and given to children in the study to use at home.

The treatment consisted of a series of four biweekly, 20-minute sessions and shorter 10-minute daily sessions. In session one, for example, the CD directs children to imagine floating on a cloud and relaxing progressively. The session then gives them therapeutic suggestions and imagery for reducing discomfort, such as letting a special shiny object melt into their hand and then placing their hand on their belly, spreading warmth and light from the hand inside the tummy to make a protective barrier inside that prevents anything from irritating the belly.

In the group that used guided imagery, the children reported that the CDs were easy and enjoyable to use. In that group, 73.3 percent reported that their abdominal pain was reduced by half or more by the end of the treatment course. Only 26.7 percent in the standard medical care only group achieved the same level of improvement. This increased to 58.3 percent when guided imagery treatment was offered later to the standard medical care only group. In both groups combined, these benefits persisted for six months in 62.5 percent of the children.

The study concluded that guided imagery treatment plus medical care was superior to standard medical care alone for the treatment of functional abdominal pain, and that treatment effects were sustained over a long period.

UNC-Chapel Hill news:

chat9 Comments


  1. David Ezell

    More support for what I frequently blog about—there is no division between the mind and the body–a concept I call the mody. The mody is one entity and we can change the physical with the mental, and the reverse is true as well.

  2. Charlotte Reznick PhD

    I am thrilled to read about this study. It’s a wonderful addition to similar research in the field. My own work has been in teaching children to access the power of their imagination to heal themselves and reach their full potential. I’m a Los Angeles based child educational psychologist and Associate Clinical Professor of Psychology at UCLA. In one guided imagery group I conducted a few years ago, kids were complaining of all sorts of symptoms: one had a headache, another a stomachache, and still a third boy had a stinging canker sore. So I created an imagery that helped all of them: they imagined creating a magical garden where they could grow healthy and strong and rested in a healing pond while their garden (a thinly disguised metaphor for their body) grew. Afterwards, both the headache and stomachache was gone and the canker sore didn’t sting. This lead me to record a CD Creating a Magical Garden and Healing Pond that kids and parents tell me helps with all sorts of pain – physical, emotional, and spiritual. I invite you to learn about this at my website and my new book The Power of Your Child’s Imagination: How to Transform Stress and Anxiety into Joy and Success (Perigee/Penguin) at
    Charlotte Reznick Ph.D.

  3. Kevin O'Gorman

    Is there any possibility of this type of approach to health care being used with older people experiencing chronic pain? I would think these guided imagery strategies combined with meditation and other pain relief treatments might be suitable for use with people coping with arthritic conditions etc.

  4. Charlotte Reznick PhD

    Kevin, these types of guided imagery techniques are absolutely being used with people with chronic pain, You can go to the Imagery International at for a list of people who use imagery in their practice.
    best, Dr. Charlotte Reznick

  5. Stephanie Anderson

    Such a helpful discovery for health practitioners and will definitely aid in treating the kids. I second to Kevin’s question, it is possible to use this method in effectively and a more innovative treatment for adults or older people? I also found refuge in dealing with panic attacks with with this helpful site

  6. Miranda van Tilburg, PhD

    I second Dr Reznick’s comments to Kevin and Stephanie’s question. Guided Imagery is often used with adults who suffer from chronic pain or other problems. A helpful website for those who suffer from chronic abdominal pain is It has loads of information and a list of people who use a very successful self-hypnosis program for the treatment of IBS.

    Best, Dr Miranda van Tilburg

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