What Moskowitz has added to our understanding of this ability of the mind to eliminate a particular pain is that constant mental practice is necessary to strengthen this ability and change the firing of the brain in a way that is sustained. Unlike medication or placebo, the neuroplastic technique allows patients to reduce its use over time, once their networks have rewired.
The effects last. Moskowitz has patients who have kept their gains for five years. Many of his relatively pain-free patients still have damage in their bodies, which can, on occasion, trigger acute pain. He thinks that once they have learnt and practised the technique over hundreds of hours, their unconscious mind takes over the task of blocking pain by using competitive plasticity. When it doesn’t, they can still use the spike of pain as the signal to consciously use competitive plasticity to do more rewiring. “I don’t believe in pain management anymore,” says Moskowitz. “I believe in trying to cure persistent pain.”
 Doidge, Norman. The Brain’s Way of Healing. Penguin Press 2015.