How I Visualise — Pursuing a Cure for Persistent Pain

Nearly two weeks ago I began practising a form of “neuroplastic brain training” designed for people suffering persistent pain. This was in an attempt to resolve neck, head and at times whole-body pain that I’ve been experiencing since being hit from behind by a bus while driving in 2012 (there were two subsequent cases of whiplash and a concussion after that, which have likely contributed to the pain getting worse and not better).

Today I’ll try and explain how I practice the technique every day. Hopefully you’ll see that, despite the seemingly complex theory behind it all, the visualisation is actually quite simple, and even rather beautiful if you use the suggestions in here. There is also plenty of freedom to engage your own creativity when coming up with your own visualisation — in fact, that’s encouraged!

When I first started this technique thirteen days ago I didn’t have a lot of material about it. I had read of the benefits and some pretty useful discussions about attitude in Doidge’s book [2]. But there were no actual images of what to be picturing in my mind. Instead, for visual specifics, all I really had to go on was a single paragraph:

“[Moskowitz] visualised the very brain maps he had drawn, to remind himself that the brain can really change, so he’d stay motivated. First he would vbisualise his picture of the brain in chronic pain — and observed how much the map in chronic pain had expanded neuroplastically. Then he would imagine the areas shrinking, so that they looked like the brain when there was no pain.” [4]

Not willingly idle while awaiting Moskowitz’s book from Amazon USA, I went ahead anyway and did it kiwi style, as the first ever entry in this Chronic Pain diary explains. [1]

I figured, “well, I’ve seen pictures of fMRI scans online. I’ll just Google some of those and play around with them visually.”

I knew from Norman Doidge’s book [2] that it doesn’t matter at all what you visualise. The whole point is, that by visualising anything — anything at all — we engage brain regions that are involved in both pain processing and visual imagination. By bigging up the visual imagery, we dampen down the pain, goes the logic. Eventually, through thought stimulation, we rebuild the anatomy in those regions (hello, neuroplasticity) to focus less on pain. Eventually, we can leave out the visualising altogether and go on about our lives, only occasionally making recourse to the technique whenever pain spikes recur (but that apparently becomes a rare event — bring that shit on).

So far, nearly two weeks in, I’ve found all the information I could have needed in Doidge’s book, by reading the relevant chapter a few times and relying on my own imagination when coming up with the visual images. Moskowitz’s book is definitely worth having too, and although pricey, you can’t fault the shipping which had it to my door from the US within a week!

Moskowitz, the creator of the technique, suggests to visualise brain maps shrinking, because it probably helps with motivation to relate it directly to the intended goal, but if I was feeling facetious I’d suggest it’s also because he’s spent a lot of time looking at such things in his professional life. From what I understand you could just as well be visualising Tibetan deities (an interesting thought, considering how important that practice is within the Tibetan tradition). There could well be advantages to coming up with your own imagery, as this will engage more regions of your brainware than just memorising the images that Moskowitz uses.

Having said that, I went with the “brain maps” idea, and I’ve found it solid.

Whenever a pain spike intrudes on consciousness, I gotta say my first instinct is to ignore it, and hope it’ll go away. Next tactic is, to rearrange my body — to “twitch” it into a shape where the pain is lessened. I’m a slow learner.

Eventually, I remember that I’m doing that other thing now, that visualisation stuff. I don’t have to live with this persistent pain shit any longer. For real! OK, wake up from distraction.

Feel the pain. Recognise it. And then I do my best to get motivated by remembering that the pain isn’t actually in my neck — not really. Pain is only experienced when neural signals are interpreted at “the thinking parts of [my] brain” [5]. I remember that once acute pain develops into persistent pain, the number of neurons dedicated to processing it increase five-fold [6].

Set the Intention: to return the brain to its original pain processing configuration, freeing up those neurons to do other jobs, and freeing my mind from the constant bracing against discomfort.

After all that talk, the visualisation is actually a simple three-step process:

1. Establish mentally that the location of pain is actually inside my head, not in my body.
2. Visualise the pain as glowing “starburst” regions — it doesn’t, in fact, matter at all where one puts them or how they’re shaped. I find that there are certain locations in my imaginary skull cavity that my mind naturally puts them, so I just go with it.
3. Shrink them, using whatever imagery comes to mind — but I make it quite a long animation. Not just two frames, I shrink them progressively. I think about colour, and I change the colour of the regions as they shrink, cycling through all the rainbow (remember Roy G. Biv?).

Using Moskowitz’s “pain maps” suggestion a) helps remind me that the pain only exists if I allow my brain to reinforce those neural pain pathways. But b) it’s also my understanding that associating the visualisation with a particular location in my body engages the “posterior parietal lobe”, which, as well as being a pain-processing region, can be targeted neuroplastically by generating an “internal location of stimuli” [5].

I continually remind myself to visualise the shapes inside my actual skull where it is sitting now, not in some imaginary simulation of my skull out in front of or beside my actual body.

And that’s it! I repeat three times for strong pain, or until the pain diminishes, whatever is sooner. Whenever I feel pain.

It takes patience to interrupt what I’m doing and visualise, especially when I’m pressed for time. That’s probably the most challenging (and crucially important) aspect of the whole technique. R for Relentlessness.

But other than that, the visualisation itself is rather simple and even quite pretty, if you go for the colourful approach.

[1] Here in NZ, there is a bit of mythology around “making do” without necessarily having access to all the latest tools or materials. Number 8 wire and some tape will repair most things. That kind of thing. http://zigzagyogi.com/2016/07/visualization-for-chronic-pain/
[2] Doidge, Norman. The Brain’s Way of Healing, Penguin Books. www.normandoidge.com/?page_id=1042
[3] ibid. pp19
[4] ibid. pp15
[5] ibid. pp14
[6] Moskowitz, Michael, MD. Neuroplastic Transformation Workbook pp4, https://www.amazon.com/Neuroplastic-Transformation-Workbook-Michael-Moskowitz/dp/0615814654
[7] ibid. pp10