Visualization is a technique that is used by professional athletes, fighter pilots and award-winning actors to achieve success at their craft. It is also used by many people as a stress management technique in the form of guided imagery, whereby people are taught to imagine a relaxing place or situation and pull this up whenever they are overwhelmed or experiencing stress.
If you have multiple sclerosis (MS) and are on one of the disease-modifying therapies, visualization can be used very effectively to help you give yourself stress-free injections. It uses the natural learning processes of the brain to rehearse situations before they happen in order to perform them better in the future.
I used visualization to get through the first several weeks of injections that I gave to myself (after I relieved my husband of this duty), which helped immensely. I’ll lead you through a visualization exercise that you can adapt for yourself.
In order for a visualization to be effective, it must be detailed and vivid. As much as possible, you’re trying to trick the brain into believing what you are visualizing actually happened. When actual events happen, they are rich with information from the senses like sounds, smells, touch sensations and, of course, images. An effective visualization needs to include all of the above in great detail, as well as emotions surrounding the event. The following example should help you, especially if you adapt it for your situation. Read through it slowly, imagining each step vividly. Then, close your eyes and go through the exercise again, but adding your own details.
An Injection Visualization:
It’s early evening and it’s time for your injection. You have had a lovely meal and feel very good right now. You are not at all nervous about your injection. In fact, you think about your last MRI and how your neurologist said that it looked very stable, with no new lesions. That makes you happy and you are determined to stick to your treatment.
You get your syringe and an alcohol wipe out of a drawer in your bedroom, where you keep one week’s supply. You light a candle and put on some nice spa-like music. You have decided that this is part of your “injection ritual,” because these things make you feel good. You go into the bathroom and wash your hands with a nice-smelling soap and put on your softest robe. You come back into the bedroom and sit in your chair. The lights are soft and low and the candle is filling the room with the scent of lavender. The window is open and a gentle breeze is coming in.
You check your injection log and see that today you should inject your right thigh. You find just the spot on your thigh that you will be injecting. You open your alcohol wipe and rub it over the area. It is cool and smells like alcohol briefly. But it dries quickly and you once again smell the lavender of the candle. You open your syringe. You gently pinch the skin to give you a significant amount of fat to inject in. You insert the needle quickly, knowing that any pain you feel will be over as soon as the needle has broken the skin. Sure enough, you quickly get past the brief pain and the needle is in place. You depress the plunger. You withdraw the needle and drop the syringe into the sharps container concealed under your chair. Only 30 seconds has passed since you took your syringe out of the package.
You smile. You are proud of yourself. You close your eyes and enjoy the breeze coming in the window, the smell of lavender and the soft music playing. After a couple of minutes, you decide that you will get up from the chair and go join your family for a little while before going to bed. You blow out the candle and turn off the music before leaving the room, tossing your syringe wrapper and used alcohol wipe in the little trashcan next to your chair.
Make It Your Own: Clearly, visualizations are very personal. Mine is probably way too “girly” for you men to use, for example. As mentioned, it is very important that you visualize the process exactly as you would like it to go, including the procedure that you will follow (time of day? autoject or not?) Include sounds (heavy metal or opera playing?) and smells (coffee or chamomile tea?). It is also important to include feelings in your visualization –- will you be proud, determined, happy that it is over, brave, calm? Remember, these are the feelings that you want to have, so you will not include nervousness or fear in your visualization. In the world of visualization, everything goes great. Consider it a rehearsal of perfection.
Make It Nice: It can also be very helpful to add in details that might not happen every time (or ever) when you inject, but that make it nice to think about. For instance, I don't really light a candle before I inject. If you want, you can picture yourself in your favorite vacation spot going through the injection routine. While it is important to include the essential parts of the injection (i.e. inserting the needle and depressing the plunger, or using the autoject successfully), the rest of your visualization can be designed to make you feel happy. The trick is to associate nice feelings with the injection process.
Worry Is Your Enemy: The opposite of a successful visualization is worry. When you worry, you vividly picture in your mind all of the things that could go wrong, decide in advance that it is going to really hurt to stick yourself, and allow yourself to feel scared and unsure that you are able to do this. This is a destructive process that makes things harder and not go as well. When you catch yourself worrying about your injection (or anything else), remind yourself that worrying is like practicing to fail. Try visualizing everything going well instead.
When To Practice: Practice your visualization right before you give yourself your injection. Soon, you may find that you don’t need to picture all of the steps. For instance, my visualization now consists of thinking about how happy I will be when I have finished my injection for the day and how proud I am that I was able to do it. That is enough to bring up the feelings of calm confidence that my earlier more detailed visualization evoked.