Today has been a busy day, and I’ve managed to ride it out with little drama by remembering to slow down and visualise at certain times. Transitions between activities are a classic time to forget the technique and just race ahead with the next thing — but pain is functioning beautifully as a messenger to be mindful and do the practices that unwind my brain.
I’m now pretty convinced of the technique’s effectiveness. There will be future setbacks, but I’m excited.
I have another piece I’m writing about this stuff and the crossover between it and mindfulness / vipassana. But it will have to wait as there’s more research required. Watch this space.
So glad to have come across your website! I am dealing with pelvic pain for over a year and started visualizations after reading The Brain That Heals Itself. Since my pain is constant and much much worse when I am sitting, I cannot figure out how much imaging I should be doing. I know you have wondered the same thing. It is not realistic nor sustainable for me to do this ALL DAY long plus it causes me to focus on pain all the time. I have been doing this for 9 weeks and can detect no improvement . I will not give up as I know it works for so many people, including yourself! Your posts are so encouraging and I am so appreciative of your efforts! I was just wondering how many times a day you visualize and how long each one takes. I do mine a lot but I picture the pain maps in chronic pain, then acute pain then no pain which I focus on a little bit longer telling myself “no pain in my brain and shrink the pain maps. Sometimes I will run through this quite a few times, other times just once or twice. But I sometimes feel obsessed with this but I know Dr. Moskowitz said to be relentless. Any advice you have would be welcomed! Thanks so much for your blog!
Thanks so much! I’m pleased to hear that you’ve found my site. It sounds like you have huge levels of motivation, try and hold on to that! I would love to chat about things a bit more .. Unfortunately I’m in bed with a nasty tummy bug. But I’ll be better tomorrow hopefully, and will be be in contact then. In the meantime I’ll be thinking of you, and hoping you find some relief… Bless you.
Elaine, sorry to keep you waiting. I’m mostly recovered from whatever gastro bug I had. Two days in bed!
I’m so sorry to hear about your condition, it sounds devastating to be in that kind of pain constantly, and to have resting positions like sitting taken away from you must be a big struggle.
It’s hard to say how often I visualise. More frequently in the morning for sure. By the end of the day it’d be hundreds of times I suppose, although it’s kinda scary to say that — I never really thought about it — but I think it’s helpful to have an obsessive streak in this scenario! 😉
Do you mind if I ask a few questions? Can you link your pain to an injury and if so, did you have scans or tests to find out what the problem is? I am not a doctor (!) but I do have a bit of geekiness about anatomy (handy for yoga teachers) and so I’m just wondering if there might be an underlying injury that is being aggravated and that’s why the pain isn’t improving.
Is the pain worse or better when you lie down (on your side, or your back, or your front)? Often people with pelvic pain are more comfortable on their back with their knees drawn up and their feet flat on the floor. Or you could stretch your legs out and put some padding beneath your knees, which can be helpful for lower back pain. If you want to try lying on your front, a folded blanket under your tummy / ribs can help.
Do you detect *any* change in your pain over the course of the day? Such as easing off in the middle of the day, or waves where the pain diminishes and then increases? Moments of distraction where the pain is pushed to the background?
I thought I’d put together a few more words about the foundations of my practice in the hopes you find it helpful:
1. Clarity is everything
How clearly I’m able to visualise the maps shrinking is my “gold standard” for how effectively I’m practising. When I’m really busy, I notice that the clarity goes down a lot — usually when I’m trying to think about something else while visualising in the background. Do you notice that?
I let the clarity be a bit vague while I’m doing something critical (like driving or cooking something hot) but I take the next opportunity (pain spike) to close my eyes and go through the practice a few times until the clarity returns.
2. Morning sitting
You could do this lying down or standing — the most comfortable way to be still that’s going to work for you.
Each day, I try to start with fifteen to thirty minutes of visualising. My mind is usually so foggy at this time, that I get through only about three full rounds before my timer goes off (I use “Meditation Support Timer” an Android app on my phone). But if I get through three rounds with time left to go, I start to try and focus on the sensation of breathing at the tip of my nostrils or in my belly. Something that doesn’t hurt. Just the simple, tactile touch sensations of breath moving in and out.
My mind gets distracted easily, just in general really but especially in the mornings. The distractions can be either a) pain or b) something else.
If it’s a) I run through the visualisation again — three times. No more. Back to breathing.
If it’s b), then I just gently remember to come back to my breath, without condemning myself for having wandered. Just grateful for having remembered. Back to breathing.
I repeat that until I get distracted again, and then the same rules apply, until the timer goes off.
I find that having this as a way to start the day helps tune up the visual centres in my brain. That’s how I think of it anyway. And then the visualisations come a bit more easily throughout the day.
3. Have options!
I find it’s helpful to have a lite version of the visualisation that I can run through with my eyes open when I’m driving or in a busy supermarket.
With regards eyes open visualisation, I try to use it strictly when necessary — eyes closed is always better if you can.
I try and do the visualisation three times through whenever possible — once through is just what I fall back on if I’m short of time.
So, you have: eyes open vs eyes closed, lite version vs full cream, once through or three times through. That’s a lot of variables to juggle!
I think that ideally eyes closed, full cream, three times through is what we’d be doing every time if we could. But we have lives to lead, so you can change things up. Do it lite version, eyes open, three times through if you like. Or whatever.
4. Prioritise the technique over all else
For now, while we’re doing the rewiring, I think we do need to let it take over our lives as much as humanly possible. I know it seems unreasonable to be visualising all day, and we’ve both struggled with this, but remember that it is a time-limited thing. If we are still doing this practice all day every day in a year or two’s time then it will have failed. Even if it gives us pain relief (which I know it has not for you, yet), it’ll just be another crutch, like stretching or pain killers. Useful, but not the cure that Moskowitz is talking about.
This requires letting the pain set the pace of your life. Letting it slow down your expectations of yourself to the point where you can at least do something (even if it’s “lite version, eyes open, once through” for four hours in the middle of the day because you have a flurry of work).
Learning to slow down and turn off the pain by occupying the neural networks with other activity is what will disconnect the maps. Our brains don’t easily unlearn things — we’re too clever for our own good! So the first thing we have to try and find, is room in our lives for the pain to set the pace. It might only be for another couple of months, and then your life will change forever. It might be tempting to say you cannot afford it, but the classic response is, can you afford not to? Are you currently working, Elaine?
Personally, I’m unable to work because of my pain, so I’m in the dubiously fortunate position of being able to prioritise this over all else. Not knowing your situation, this may be more or less possible for you — but again, remember it’s a time-limited thing and afterwards we should be *more* available and *more* present for our loved-ones, careers, society.
If we can possibly get it to happen, the investment of time now will more than pay for itself not just for ourselves but for all those around us.
4. Did you go looking for the pain or did the pain find you?
This is the big one for me and the subject of an upcoming post. We are aiming to challenge our pain spikes, not the whole syndrome at once. What I realised quite recently was that I would “check in” with myself to see how the pain was going throughout the day. Nothing wrong there, it’s just normal. But this checking in for the pain *is not the same as being interrupted*. It’s not a pain spike — it’s self-awareness.
Every time I notice pain now, I ask myself “did I go looking for this pain or did the pain find me?”
If the former, then I can just carry on with my life as best I can. It wasn’t a pain spike.
If the latter, then I drop everything and visualise — eyes open if I’m busy and the clarity is high enough. But eyes closed whenever possible.
If there’s any doubt (sometimes it’s hard to know) then I assume it was a pain spike and I visualise.
5. Keep a diary
Almost forgot this one! Clearly, I’m keeping a diary every day. You could try the same if not already? It needn’t be online — you could even use a spoken diary into your phone or a voice recorder if it’s too painful to sit at a desk. A visual diary perhaps if you’re more visually inclined. The benefits are many! I find mostly because it gives me pause to reflect on what’s working and what’s not.
6. Talk to a doctor
Are you getting looked after as someone’s patient? It sounds to me as though you could do with a bit of support close by to help you through the tough time you must be having. What’s your environment like, are you living in a rural area or in a big city? A naturopath or herbalist with a medical degree is hard to find but well worth the effort. They can function as a physician or general practitioner but will also look at complementary medicine like acupuncture and herbal remedies. Also valuable is a good massage therapist and even a compassionate counsellor or faith leader if you are open to any of those healing modalities. I’ve experienced feelings of loss, resentment and shame associated with being unable to work or do my usual activities and would have definitely reached out to a counsellor were it not for the financial impossibilities!
I really hope that some of this helps you — but I’m just remembering that you’ve been doing this for longer than me! So if you’ve tried some of the above already in the previous nine weeks and it hasn’t helped, then please forgive my rambling; whereas if you do find something new and want to share, or if some of this doesn’t sound right or won’t work for you, I’m always happy to continue our conversation! Feel free to ask me anything, and I’ll see what I can come up with.
In the meantime, are you on Facebook? Head over to Facebook and send me a friend request! I’m “Julian Luckee South”. There’s a small group I’m a member of for people with chronic illnesses of all kinds. A friend of mine started it — you might like to be part of. Plus it means we can have the conversion in private should you prefer it. Just a thought.
Finally, let me thank you again for your kind words, it has been very encouraging for me to hear that it’s helped even if it were only in a minor way.
Wishing you so much warmth, light and love.
EDIT: cleared up some typos.
Hi, Julian
First of all I am so glad you’re over your bug and secondly, thank you so much for taking the time to answer me in such an in-depth way! I wish Dr. Moskowitz was near me so I could ask him all these questions and then report back to you what he says but though I live in the United States he practices on the West Coast and I live in the East. I did e-mail him but I was not expecting any answers since I’m sure everyone in the world who has read Norman Doidge’s book wants to contact him. But it was worth a shot!
I did not have any injury. It was after an infection that I guess irritated the nerves but am completely over the infection now and the pain remains – a classic case of neuroplasticity gone wild! It’s been 15 months but from what I’ve read it doesn’t matter how long you’ve had your chronic pain for brain maps to enlarge. My pain has definitely spread to a larger area and now I know why after reading Dr. Doidge’s book. Swimming actually makes it feel better even if just while I am doing it. Walking not so much but I do some yoga stretches a couple of times a week. I know you’d approve of that!
Anyway, I always had trouble getting my mind around being relentless with the visualizations versus having it take over your life. Dr. Moskowitz says to do it when pain intrudes on your consciousness or a pain spike hits. Mine is pretty much constant so I am trying to do a lot more imaging as I am sure I do not do it hundred of times a day like you said. I am not working either so really I have no excuse not to do more – it’s just getting harder to stay motivated the longer I do this without results. But I remember Moskowitz did it for 6 weeks to get improvement in his shoulder area (hope it’s going to be the same for you) but it took him 4 months to get even 15-20 minutes of relief in his neck area. And a year before he got total pain relief. So I have to remind myself he wasn’t really a fast healer either. Unlike Jan, the nurse in Chapter One, who visualized 10 to 12 hours a day (!!!!) for a month which is probably why she got better so quickly. But she was almost bedridden so she had nothing else to do and was on high doses of opioids. I just take Neurontin (also known as Gabapentin) at night in a low dose to help me get some sleep or I really couldn’t visualize at all the next day. What puzzles me is that Moskowitz did all this visualizing while he worked all day seeing patients. I researched everything I could find on the internet about him and I read in the beginning he did the brain maps thing like you and I are doing and then later he switched to naming the 9 areas in the brain that process pain. He said he could do this while talking and driving, etc. I don’t think I could talk and do this at the same time! He must be a superman! I can get through my visualization in about 20 seconds when I only imagine the brain maps shrinking so sometimes I’ve been adding naming and picturing the 9 brain pain processing areas and then having the “lights” go out at each area after I name them. And when I’m sitting I can feel my anxiety rising with the pain and then it’s really hard for me to do this with intention and clarity so I have to work on that.
I’ve started visualizing 30 minutes before I get out of bed in the morning. But maybe I’m going through my images too fast as I can probably do it at least 30 times. It’s hard to not let doubts creep in when I’m in a lot of pain but I read somewhere it’s not a belief-based thing but just suspend disbelief and do it anyway as you will be creating new circuits and deactivating the pain pathways.
I will take your advice and close my eyes more often when I run through the images in my mind.
In the past I have e-mailed 3 mind-body doctors I found on the internet and told them about my pelvic pain and they all reassured me the pain was coming from my brain and while they differ in methods than Moskowitz they all said it was a neuroplastic event. One lady whose blog I found said what helped her was to simply allow the pain to be there and basically ignore it. That most definitely does not work for me and it is at odds with Moskowitz who says it is a fool’s errand to try and distract yourself from the pain as the pain will always win out. I guess there are different methods for neuroplastic issues but I feel what I’m doing now is my best shot. So I will keep at it and I want to thank you for your advice and encouragement.
I have read reviews of the workbook you ordered written by Dr. Moskowitz and some buyers said his website, neuroplastix.com has most of the info you need. As it costs $48 it really isn’t something I can afford right now as I usually borrow books from the library for free. I feel like I almost have the info on his website memorized! I’m much better at reading about this stuff than applying it!!!
Thanks again for your reply and I will keep reading your blog. It doesn’t feel now like I am the only person in the world trying this!! Hope you have great success with the technique. By the way I have heard from people that New Zealand is absolutely beautiful!
Thanks for sharing your experiences! There is a mine of ideas in there. I hope some of my thoughts can help you too, truly all I can offer is what I’m doing and my simple intention to benefit self and others. Let us keep at it and see how we go. Plenty of time on our hands both it seems hah. Don’t forget to friend me on Facebook if you want to keep in touch. I’m always open to new connections 🙂