Calm Through Guided Imagery
by Jeri Glatter
As end of life doulas when we prepare to serve the dying and their loved ones, we carry a virtual tool box. Many of our tools of the trade are derived from our INELDA training, while some of them originate from deep within our intuition. Doulas employ an array of tools, and whether they have been taught to us, or they are ones that we hold personally, these tools continue to improve and grow as we gain experience, knowledge, and a deeper understanding that accompanies each death.
One of my favorite tools is guided imagery. Guided imagery can be used for both the dying person and the family. It has the remarkable ability to reduce anxiety, fear, and pain. It moves us more deeply into an internal experience with the benefit of harnessing the mind. It can be used by anyone, at any time, and therefore gives the dying person and their loved one a sense of control, when many things at this time are out of their control.
One of the opportunities I had to fully realize the impact of this technique was demonstrated while I was supporting a patient who was diagnosed with ALS. When I met him, he no longer had the use of his body. The only muscle control that remained was his ability to open and close his eyes. Knowing the trajectory of this disease and that his ability to speak would be gone, he had taught himself Morse Code, blinking the dots and dashes of the alphabet. This would be his final way of communicating. Through a slow, but inspirational exchange, along with a short interview with his wife, he told me about a beloved canoe trip that he used to take on the Delaware River. We agreed that on this fall day, in his hospital room, it would be fitting to once again embark upon one of his beloved canoe trips through the use of guided imagery.
We were the only two people in the hospital room when we began our journey, the sound of air whooshing mechanically through the BiPAP machine which helped him breathe. The machine served as a metronome for the pace of our imagined expedition. I closed my eyes to enable the realism, and the magic if you will, to accompany me on the experience. And so, I too traveled with him on our trip. In our imagination, the journey started at his home as he was busy readying his canoe. His wife worked diligently in the house preparing a feast for a picnic lunch to be enjoyed later in the day. We envisioned him fastidiously attaching the canoe to the top of their car, securing each rope for safe passage. I knew it was important for him to ensure the safety of his cherished wife.
We continued our outing, driving along the highway, up the steep and winding roads as we approached the Delaware Water Gap. The sky was a brilliant blue and I described the contrast of colors with the full bloom of autumn foliage. The fall temperature had not yet begun to dip. The car windows were open, and the scents of fall danced on the breeze. I described each color of the leaves, the sky and the occasional white puff of a cloud. Employing all of the senses, we listened to the music on the radio, and imagined his voice singing along, belting out the tunes as we drove towards our destination.
Along this route, for many miles you can see where you are headed. The row of evergreens on the mountain top has a characteristic break, or gap, as you pass over the highest point, and we felt the descent as we made our way down into the valley on our approach to the river.
We arrived at the water’s edge. With the canoe placed in the water, he steadied the vessel, reaching his hand out to assist his bride onboard. Within moments they had set sail, freely floating with the current of the river. The day became warmer as the sun shone overhead, and sweatshirts were removed as they felt the last kisses of summer warmth on their skin. They held hands and smiled at one another.
It was at this point that I chose to open my eyes, to see if somehow, I could measure the success or failure of my efforts. As I peeked up at him, I saw tears rolling down his face. I gently asked if I should continue, and he responded with, “Yes, please.” Closing my eyes, we returned to the river. Seeking as much imagination as I could, described the feelings of him placing the oar into the water, and pulling the two of them forward. My hope was that somehow I could redeliver the sensation of being back in his body. A body that moved at his command, carried him to a place of peace, and was not paralyzed from an illness.
The perfect location was spotted for their picnic lunch on the shore, a simple clearing that was absent of mud and was covered in soft grass. As the canoe was docked, his wife hopped out and began the task of creating their dining space. A blanket was unfurled and seamlessly a feast appeared. I described the colors and texture of the blanket they sat upon, the smell of the river, the scent of the air and the taste of morsels of delectable cheeses—which were his favorite treat. They completed their lunch with a spontaneous nap, his wife gently resting her head on his chest.
After I had concluded our session, I asked him if this visualization had been helpful to him. He was both emotional and grateful. He had not been able to move any of his limbs in years, yet through our visualization together, he felt every sensation in his body. It was then that I explained that at any moment, he could return to this special and calming place. All he would need to do is to close his eyes and feel himself rowing in the canoe along the river with his beloved. We agreed that on each one of my future visits we would take another imaginary canoe trip. I saw firsthand how this simple tool brought so much joy to my patient, and gave him the ability to journey outside of a body he could no longer use.
Next month, we at INELDA will be teaching two new classes. On April 5th, we will offer a one-day Business Development Class and on April 6th, we will have a one-day Guided Imagery Class. Both classes will be held in Morristown, New Jersey (please visit our website, www.inelda.org for more details). Whether you have completed our end of life doula training or not, you are invited to join us. You too can learn how to employ the skills, tips, and practices of effective guided imagery and various types of visualizations. We hope to see you there—as you add to your own virtual tool box!