Living With Chronic Pain

Guided Imagery Can Help Decrease Pain

How we see ourselves shapes who we are, what we believe and what we see is our place in the world. Mental images fuel these perceptions every minute of the day. That’s why making sure they remain hopeful, positive, and uplifting is so critical to feeling well mentally and physically. What we tell ourselves throughout the day will impact our interactions, attitudes, and motivation. Being convinced someone has it out for us, we’re more prone to look for that type of behavior in every action. It becomes a self fulfilling prophesy. Expect it often enough and it will happen. 

The same holds true for pain. Expect, anticipate, believe it will never change and we have no control over it, life becomes overwhelming and hopeless. Changing that perception by learning new ways to cope can make a huge difference in how we live with chronic pain.

Guided imagery gives us the opportunity to imagine scenarios and ways to alter the outcome on our own.  It uses all our senses e.g. taste, sight, smell, touch, and hearing to create images that feel real. 

Physiological responses

Imagine standing in your kitchen. Feel the floor beneath your feet, the counter in front of you, the smells and feel of the room. Breath it in. Then take a lemon. Feel its texture. Is it smooth, cobbled? Cold? Round, oval? Pick up a knife. Is it in a holder on the table? Do you have to open a drawer and pull it out? Cut the lemon in half. Smell the tangy, citrus odor. Now take a bite. Feel your teeth puncture the pulp and the immediate sour taste explode in your mouth as it hits and saturated every cell and every taste bud. It’s so powerful you can’t help but curl your lips in a pucker and shudder. 

It’s hard not to react just reading that section. Reliving the time you actually did cut and then eat a lemon. For me it was so sour I couldn’t imagine biting into one again. I still remember my daughter biting into one when she was a baby and the incredible face she made when her eyes bugged out, her mouth puckered up and her entire body shook after, just to do it all over again!

Negative imagery

In the absence of competing cues, all systems in the body respond to imagery just as they would to a genuine external experience. Our bodies remember, so much so that just the memory alone may have caused your autonomic nervous system to kick in while reading the paragraph about the lemon, causing you to physically respond by salivating. Now imagine how your body is responding if you’re living in constant pain, feeling hopeless, helpless and sure it will never change? This affects both our emotional and physical well-being, shutting down or minimizing the amazing healing capabilities at our disposal.

Many are thinking they can’t possibly imagine a scenario so real it would be of any value. But we do it all the time, when we worry, anticipate and envision the worst possible outcome in the future. It is a complete fantasy since it hasn’t happened yet. And often reality is nothing like we imagine it will be. Patients often define their pain in specific images:

“It’s like a swarm of bees attacking me all at once.”

“Like an elephant sitting on my chest.”

“A hot poker stabbed into my back.”

“A knife ripping down my leg.”

“Like walking on hot coals.”

None of us actually experience any of these things, but we imagine that’s what it would feel like if we did. These familiar and powerful images focus our attention on the pain. The more we worry the more attention it gets, growing and overwhelming every other experience, until it’s all we see and feel.

These negative beliefs feed on themselves until they become self fulfilling prophesies. Just as the thought of a lemon has the ability to make us smell and taste its juices these images can have profound physiological impacts as well, interfering with our ability to cope. 

Too often we aren’t even aware this is what we are doing. We all know the power of positive thinking, Guided imagery includes a wide array of mind and body techniques that allow these unconscious thoughts and feelings to be brought into the foreground. There they can communicate with our conscious mind, be evaluated for what they are and let go. It encompasses simple visualization and imagination to imagery, game playing, story telling, or artwork.

Guided imagery

Once considered a crazy alternative to medical intervention we now know it sends a message to the emotional centers in the brain which then transmits it to our endocrine, immune and autonomic nervous systems. There, a whole slew of bodily functions are affected- heart rate, breathing patterns, blood pressure, (i.e. all the fight or flight responses). Multiple studies have shown the incredible power positive expectations have in our healing and pain management. Guided imagery has helped:

  • Manage pain after orthopedic surgeries. After just a couple of sessions patients required less medication and were discharged sooner than those who didn’t learn guided imagery techniques.
  • Improved muscle relaxation and reduced the fears, anxieties and stress related to pain.
  • Reduced the side effects to chemotherapy.
  • Decreased the frequency of migraine headaches and the need for prophylactic medications. 
  • Form new, positive, long lasting habits.
  • Deal with and let go of underlying fears
  • Improve coping skills  

If we can derive both physiological and symptomatic relief from learning treatments that work at the core of our beliefs, perceptions and attitudes, why wouldn’t we add it to our arsenal? Next week I’ll discuss exactly how to begin your guided imagery journey.


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