Living With Chronic Pain

Guided Imagery

For those of us in pain, nothing is worse than hearing our provider say the dreaded words, “There’s nothing more we can do for you.” But as I’ve shared, there are significant ways pain can be managed that aren’t medically oriented- exercise, meditation, massage, and hypnosis. Guided imagery is another option. The theory is it acts centrally to change our perception of the pain as well as acting as an analgesic. Guided imagery allows us to visualize and experience our pain in a controlled setting so that we can alter our perception of pain and the power it has over us. Through this technique we can learn to increase pain tolerance levels, improve sleep and decrease pain. It doesn’t require any equipment and can be done on your own in a calm, quiet and comfortable room. Once mastered it can be done anytime, anywhere, allowing us to control and alter how we respond to pain. 

How does it work?

Pain keeps us in a fight or flight mode, constantly on high alert and stressed. This kicks in a cascade of hormones such as cortisol that stimulates the sympathetic nervous system and perpetuates the cycle. Inflammatory markers are also increased, adding to the pain. Guided imagery has been shown to effectively calm the mind and shut down the heightened nervous system response. It encompasses all the senses- sight, sound, taste, smell, and touch to what we’re feeling and thinking. By being immersed in a peaceful scenario, we control our heart rate, breathing so that our anxiety and cortisol levels decrease and we feel less pain. 

Using our imagination also forces us to think in abstract terms which engages the right side of our brain. This side is associated with positive emotions and thoughts such as happiness, empathy, laughter, holistic thinking, creativity, feelings, intuition. The more we strengthen pathways that produce these thoughts the easier it will be to express them when we feel anxious and in pain.

Is it effective?

Multiple studies have shown statistically significant reductions in pain and improved function. They even showed it reduced participants need for anti-inflammatory and pain medications. It’s easy, requires no equipment and can be done anywhere, but a quiet, peaceful area with soothing music in the background is a great way to start.

Impacts pain tolerance

Pain tolerance is defined as the amount of pain we can take before breaking down physically and/or emotionally. Not to be confused with pain threshold- the minimum stimulus required to produce the sensation of pain. Studies have shown just the presence of another individual, even a stranger, helps us to tolerate a higher level of pain than when we’re alone. This may be because we want to put on a brave face as well as the love and affection they provide. Supervised sessions not only offers this additional benefit but can show individuals just how effective guided imagery can be. On your own or in a medical setting this option has been proven to increase pain tolerance by imaging different scenarios that allow us to face off with our pain and walk away the winner. The pain control unit at UCLA, after doing everything to correct any underlying causes, describes it as a way to:

  • Reduce or block the pain signal from reaching our consciousness 
  • Decrease it’s ability to interfere with our lives
  • Give back control to manage our pain
  • No longer treats people in pain but instead treats the pain in people

Stops our negative imagery

Those of us suffering with chronic pain have little faith it will ever improve. Worry and anxiety overwhelm our focus, making it impossible to think about anything else. We can’t stop anticipating and running through our heads all the potential problems and scenarios that can happen at any time, as I did at Disneyland. This persistent negative imagery becomes a bad habit, acting as our default mode. The only way to stop is to learn a new method that we reinforce over and over and over and over and over… again until it becomes our new default.

When should it be used?

It can be a valuable tool for:

  • Aiding the healing process. Just after surgery, imaging nourishment, oxygen, and nutrients are flowing to the area repairing the organ, bone, ligament, tendon or muscles involved has been shown to dramatically improve function.
  • Helps us to overcome or prepare for situations we fear will exacerbate pain. In a safe setting we can imagine ways to shut down our fears or speak our minds when needed.
  • Decreases stress levels that come with worrying and anticipating the worst will always happen. Now we can envision those horrible settings and learn ways to deal with them calmly.
  • Can give us insight into why we feel and respond as we do. Is it out of anger, shame, or fear?
  • Form long term, appropriate habits that become our routine, not the exception. It allows us the freedom to look forward to an activity, confident we will overcome any adversity and have fun.
  • Gives us the skills to cope with not just our pain, but anything else life may throw at us.

Just like meditation, hypnosis, acupuncture, biofeedack, this is another great tool to add to your toolbox. Whatever we focus our attention on, grows in importance. And if filled with negativity it tends to be a self fulfilling prophesy. Breaking that cycle a few minutes a day will at the very least will bring a much needed break and at the best, help to decompress and drop pain levels. Once comfortable with the technique it can be done anywhere, anytime. Next week I’ll show you how.


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