Imagery for Pain Relief

The term "imagery" refers to holding an image or thought in the mind. Imagery is a very powerful technique for pain relief, because you can use it to affect your body's biochemistry, its muscular and vascular responses, and your emotions, among other things. One reason imagery is so effective is that the body reacts to imagination much like it reacts to the real thing. For example, imagine making love with someone who is extremely exciting to you, and observe how your body reacts. Or, vividly imagine a situation in the past when you have been very angry. Notice your body's reaction as you relive the event. You can choose to hold various thoughts and images in your mind and thereby control your body.

We can use imagery to relieve pain in several ways. One way is to directly control various physiological processes that contribute to pain, for example, hormones, muscle tension, or blood flow. In most cases these physiological processes are related to one of the main components of the experience of pain itself, the fight or flight emotional reaction. Recall our discussion about the SEAT of pain - that pain is composed of a Sensation, an Emotion, it rivets our Attention, and it is also composed of a Thought.  We can use imagery to affect the Attention and Thought components, particularly thoughts of frustration, helplessness, depression, and impending doom. Because of its diverse effects on the experience of pain, imagery is a very helpful adjunct to other forms of pain treatment, such as relaxation, meditation, or hypnosis.

Let's start by seeing how we can use imagery to counteract the fight or flight defensive reaction to pain, one of most important negative factors in our experience of pain. The fight or flight reaction includes physiological reactions such as muscle tension, and hormonal and vascular changes. We already know that attempting to fight with pain or to escape from it greatly increases our suffering.  Our goal is to stop struggling and trying to escape. How do we do this?  Let's begin with a little progressive muscle relaxation as described in previous newsletters. Start with a few deep "belly breaths", letting go of all your tension on the out breath. Start by relaxing your lower body.  Flex your feet, feel the tension, and then let it go.  Then move up to your legs, tightening your thighs, feeling the tension, and letting it go. Continue up your body through all the major muscle groups. Spend a little extra time relaxing the muscles around your problem areas, particularly if you have backache or headache. If you have backache, pay more attention to your stomach, back, and buttocks. If you have headache, pay more attention to the muscles in your head, face, neck, and jaw. After you have relaxed all your major muscle groups, use imagery by bringing to mind a very relaxing, carefree situation, for example being on vacation. Relive that experience in your mind's eye, and try to get in touch with the feeling you had then. Be as specific as possible. Imagine what it felt like, how it smelled, how it looked. Remember some of the pleasant, relaxing things you did. Spend some time enjoying the experience.

Any image that will help you stop fighting, struggling, or escaping will decrease your suffering. For example, if you have a headache, imagine the pain being bathed in soothing, healing light. Focus on the light, and imagine it calming and comforting the pain. This technique will work very well if you can simply bring your attention to the pain, investigate it, and relax at the same time.  Some people like to use other images such as focusing on the pain, imagining a window opening in their head, and then visualizing the pain flying out the window, then the window closing.  Alternatively, you could focus directly on the pain, and ask yourself what kind of pain it is - sharp, tingly, dull, throbbing, itchy, etc.  Try to describe the pain in specific detail. If it were a light, what color would it be?  Can you change the color? If it were a person, what would it tell you?  Ask the pain what it wants.  Let the pain be there without fighting it. Make peace with the pain. Make friends with it if you can - do not try to force the pain out. The key is to stop trying to fight with or escape from the pain.  Use any image you like to bring your attention TO the pain, relax, and stop fighting or trying to escape.

Another useful image is to let a loving, healing force come in and heal the pain.  Once again, the important thing is not to fight the pain - that is the thing you most want to avoid.  Let the loving, healing force cure the pain by loving it, soothing it, caressing it. You may want to experiment here, trying a number of different images until you find one that works for you.

Now let's work on changing some of the specific physiological responses to pain. Remember that the fight or flight reaction is characterized by a hot head, cold hands and feet, and increased muscle tension, particularly in the neck, shoulders, back, stomach, and buttocks. Let's try an image that will counteract the hot head and cold extremities. One of our favorites is to imagine being at the beach on a beautiful day with warm sun and cool breeze.  Imagine lying down with your head in the shade of an umbrella. Feel yourself digging your hands and feet into the hot sand, while a cool breeze blows across your forehead. Try to recreate the feeling - really feel the hot sand on your hands and feet. Feel the breeze cooling your head.  If you don't like the beach, imagine sitting in a hot bath or spa, with a cooling fan blowing across your face, or with an icepack on your head. Use any image you like, as long as it is relaxing and involves warm extremities and a cool head. You can use autogenic phrases in conjunction with these images - repeating to yourself suggestions such as "My body feels quiet, heavy, warm and relaxed", "I can feel the warmth flowing down my arms into my hands", "My hands are warm, relaxed and calm", "I am relaxed", etc. It is very helpful if you vividly imagine what it feels like as you repeat these phrases over and over. You can repeat them to yourself or out loud - see which one works best for you.

Here is some specific imagery to counteract muscle tension. With backache, you can imagine lying in the sun with your body warm and relaxed. Imagine your muscles melting in the sun like butter, or turning into loose, limp rubber bands that hang down further and further.  Focus on the muscles in your stomach, back, and buttocks. Let your stomach hang out and melt into the ground, let it feel heavy and relaxed.  Let go of the muscles in your back -- let them melt away.  Relax, surrender, and let go. If you are in pain this may increase the pain at first, but give into it, and keep up with your imagery.  Do not defend yourself or tighten up anything.  A very effective image for some people is to imagine the molecules in your body expanding more and more, and dissolving into nothingness. This is a good image to use with headache, because we want to avoid any heat imagery with the head. With headache, try visualizing all the muscles in your head, face, jaw and neck as very loose, limp, and relaxed.  Feel them melting away.  Or, imagine your head immersed in cool water, and all the molecules of your head dissolving like a sugar cube.

When you are in pain, your thoughts of impending doom, depression, or frustration contribute to your suffering. Let's see how to use imagery to affect the thought component.  Imagine that everything is going to be all right. See yourself being healed. Imagine a divine figure coming to help you and heal you. Make it vivid as possible. Use an image that is most real for you. If you have a religious orientation, ask your favorite angel or deity to come be with you and help you. Christians might ask Jesus, Buddhists might ask Avalokiteshvara, Hindus the Lord Krishna, and so on. See the deity coming to you, caressing you, loving you, healing you, soothing you, and telling you everything will be all right, no matter what happens. Imagine the deity telling you that you will be taken care of, and that your suffering will end. Accept the deity, relax, and give in to the will of God, the divine spirit, the universal mind, or however you think of it.

© 2020 by Dr. Ken Pfeiffer