Health: You'd better believe in the bogeyman: Children often use fantastic imagery to describe physical or emotional pain, and such visualisations can help to heal them, says Deborah Jackson

Tony, aged 10, had been suffering from tummy ache for a month. He had a headache, too, and was irritable. The family doctor prescribed tablets for the abdominal pain, but it did not go away.

Eventually Tony was taken to a psychotherapist for a session of 'creative visualisation'. He was asked to 'look inside' his body and describe what he saw. He talked about a 'blue ball' in the back of his head; he said it contained items such as 'rest', 'ill' and 'school', which were all bothering him.

This was hardly surprising: Tony was a bright boy with a demanding agenda. His school encouraged competition and the pursuit of excellence. He was captain of the swimming team, sang in the choir, practised martial arts and was learning a language after school. Something had to give.

Creative visualisation is already used by many psychologists to help adult patients with a range of medical and emotional problems. Learning to use internal imagery, fantasy and symbols can, it is claimed, help people to achieve pain relief, relaxation, changes in behaviour and even to accelerate healing. But the technique has rarely been used with children.

Dr Brian Roet, a private psychotherapist and GP based in London, says creative visualisation is particularly suitable for young people. While adults must relearn how to tap into the imagination and harness the results, children can still do this spontaneously.

Children often describe their physical pain or emotional problems in terms of fantastic imagery - but are often ridiculed or criticised for doing so, he points out. Monsters in the dark and alligators under the bed are often dismissed as nonsense by adults. 'Either adults tell the child not to be so silly, or reassure him that the 'monster' has gone away, in the hope that his irrational fears will also disappear,' Dr Roet says. By dismissing childish fantasies, 'adults are missing the chance to help children to heal themselves'.

He began using creative visualisation at Charing Cross Hospital, London, when he worked there as psychotherapist. He discovered that 'guided imagery' could help patients suffering from cardiac problems, irritable bowel syndrome or chronic pain. He encouraged them to visualise the condition in concrete ways, so helping them to come to terms with it.

It was not until he was asked to treat a child with a mystery stomach ache five years ago that he realised how much the technique could help young people.

'As youngsters we have an ability that many of us lose on the way to adulthood,' he says. 'It is the ability to know the world, and our response to the world, by internal pictures. Adults call this inner world a fantasy world; to children it is their reality. The inner world of pictures is already there - it is not created by the technique.'

Dr Roet now uses creative visualisation with children who have a wide range of physical and emotional problems. 'The age most suitable is from five upwards. Younger, it may be difficult to keep the concentration going.'

Initially, a child may find it strange to be listened to without any adult goading him or correcting his way of expressing his feelings. Even more unusual is a doctor who is willing to listen to talk about the monsters, witches and assorted bogeymen without sniggering. By validating the child's means of expression, says Dr Roet, the 'guiding adult' gives him a tool with which to heal himself.

'Whatever the child says, I go along with it. This only works when children know they are accepted.'

Tony had known he needed more rest from the demands of his school, but conflicting messages in his head had made him powerless to do anything about it. His description of his condition in terms of a blue ball was only the start of his creative journey. By visualising his pain as assorted geometric models, he created a positive image out of the same materials.

'Tony explored further and found a part of the right side of his head in the form of a yellow cube. It kept telling him: 'You can win, you can do it'. When he told this yellow cube he was becoming sick, the yellow cube replied, 'I don't care'. Tony decided to replace the yellow cube, which was directing him to worry in case he did not win, with a green triangle.

'The green triangle told him: 'Do your best, be happy, have a good time, it doesn't matter if you do not win.' The internal Tony then took responsibility for making sure the green triangle remained in charge and the yellow cube did not return. Over the next few days his headaches and mood settled and he felt in control again.'

Dr Roet admits that his work seems unexpectedly easy with child patients. But how can he be sure that the technique is working, or that the fantasy genuinely relates to the problem?

'I look for results,' says Dr Roet. 'I once saw a child who painted vivid pictures and went into his fantasy in great depths. But the aim was that he should stop sucking his fingers, and he didn't. This is the only time I have felt a child was fantasising for my benefit rather than his own.'

Exactly how creative visualisation works is not easy to explain. Dr Roet believes in the body's ability to heal itself, given the optimum conditions; by helping a patient to feel at ease with himself, he believes he may be clearing the path for improvement. The process seems to take place more swiftly in children than adults.

'On the superficial, 'conscious' level the child has a symptom or feeling - an attitude.' he says. 'This is mirrored by the internal world of pictures, and if this world is altered there will be parallel changes at the conscious level.'

Until 12, a child will usually indulge in a fair amount of fantasy play with friends, even if he does not share this pretend world with his parents. Spontaneous play has its own therapeutic value, as children rehearse life events and emotional scenarios they are unable to deal with in logical terms.

Parents and teachers, says Dr Roet, can easily learn the basic skills of listening and validating their children's fantasies, thereby helping them through certain crises. When a child brings his fantasy-fears into conversation with an adult, he may be looking for extra guidance or support.

Yet the art of listening to children is not widely practised in our culture, even though parents are encouraged to set 'quality time' aside. The problem is in our reluctance to let children be. Adults want to solve children's problems for them, encourage them to be more realistic. With creative visualisation, the emphasis is on handing the controls to the child.

'What I like about children is that they are so open,' says Dr Roet. 'The healing process is very alive, so you get good results. I should like to see this technique used far more widely. It allows adults to relate to a child on his level. This has a very different feeling and response from trying to educate him to grow up.'

'HOW ARE THOSE MONSTERS TODAY?'

I WAS given an early opportunity to try Dr Brian Roet's method out with my own daughter.

Frances, aged five, usually goes off to sleep willingly and easily, but one night she started crying and said she did not want to go to bed. When I asked her why, she told me it was because of the 'monsters waiting for me'. So instead of reassuring her that there were no monsters, I took a cautious step into her mental picture world, and asked her what they looked like. 'They are a horrible blue and green colour, a bit like your blouse,' she told me.

Trying not to take the reference personally, I asked what the monsters were saying. 'They say, 'I don't want to play with you' and 'I don't like you', she replied.

I suddenly realised that my daughter was trying to tell me something. She had just started school, and I knew that she had had trouble settling in with a rather powerful clique of friends, but we had never discussed the problem in detail. I was amazed at her revelations, at how much information was waiting to be told - and I was chastened to think what would have been lost if I had dismissed the fantasy and told her to go to bed.

We talked for a while about the monsters, and Frances decided she did not have to be frightened of them, even if they did not want to be friends with her. Some of the monsters were a 'nice pink and silver colour', and she wanted to play with them. In minutes, she was closing her eyes with a smile. 'I'm all right now, Mummy,' she said.

I told Dr Roet of this experience, and he reminded me that I could always reintroduce this visualisation, should the monsters rear their heads again. 'You might just ask her how the monsters are one day,' he said. 'You have set in motion a mechanism to cope with future events.'