What’s so special about visualisation? There are many things that we can focus our minds on instead of pain. Listen to music. Daydream. Do exercise. Develop software. Play. Go for a walk. Have coffee dates. Go to parties. Travel. Trust me, I’ve tried all of the above and more. The list of things is as long as our society’s bewilderingly long list of entertainments. It even goes beyond entertainment: meditation (focus on breathing), yoga, psychotherapy. Then there’s painkillers, ice-packs, massage… Why choose to visualise, out of all these possibilities? How is it any different?
On some level, it’s not different at all. All these things — visualisation included — remove the pain from our consciousness. The difference is, that most items from the above list don’t stop the pain programme from running subconsciously. They push the pain out of our awareness, but that just means the pain signals are received and processed in our brains on autopilot, while our backs are turned if you like. They run unopposed. It is in this exact environment that the pain maps are enlarged through “neuroplasticity gone bad”, until they are running at up to five times the level of sensitivity than is usual for non-persistent “acute” pain.
Visualisation is different because in order to visualise at all, we must engage the very brain regions that are hyper-involved — fivefold — in persistent pain processing. We are not distracting ourselves or ignoring the pain. We are challenging it directly.
Say you have an over-eager puppy at the park. Your puppy is running up to kids and jumping at their face, eating their sandwiches, crapping in front of their mums (bear with me here). She’s generally just acting as she pleases.
You have several choices on how to improve things. You could scold her and tell her how bad she is, give her a smack every time she nears another person. That will get her behaving, but she’ll be scared of you, scared of other people, and eventually the relationship you have with this puppy won’t contain the love and companionship you’re both aiming for. You could take her home and never to the park again, but that would have a similar effect.
You could also take her running around and around the park, to all the trees and the river and back to the playground and around the park again, distracting her until she’s so exhausted that the idea of eating a kid’s sandwich never even enters her mind. Good luck with that. Most puppies have more energy and can run much longer than you can. And as this puppy matures, all you’re going to get is one very fit and healthy animal that can outrun you all day and still jumps up at children, still eats their sandwiches and craps on their picnic blankets (sometimes it might even mix those actions up a little!)
Another option is to put your puppy on a leash, and train it up with little doggy-snacks to come when it’s called, so that eventually you can drop the leash.
In our analogy, the pain is the puppy. Maybe you’ve tried scolding yourself to get rid of the pain, or maybe you haven’t. Chances are though, if you’re in persistent pain, then you’ve tried the distraction tactic — giving your mind so much to focus on that it “can’t” process the pain. Now you’ve got a very strong, fit and healthy network of neurons that you’ve unwittingly trained to outrun and outpace every distraction you throw at it.
Time to get serious and take those neurons to puppy school! Continuing our analogy, the visualisation is the leash. By visualising, we give those neurons something else to do instead of pain processing, just like with the leash we can guide the puppy to stay on the path. When the puppy is on a leash, she can’t run quite so riot. We are not distracting her temporarily, nor punishing. We are training her to do a different job.
Training means being relentless. We train our neural architecture just like the puppy. We even have temporary pain relief that functions like a little snack as an incentive.
Of course, at times puppy will still get ideas about eating duck poo or chasing cats. But because you have not just indulged her with temporary distractions, because you have invested time in teaching her a different job, you can call on that training. Call her back to neutral. And she will stray less and less. Eventually you won’t even need a leash or the snacks.
Your puppy will be trained.