Visualization for Chronic Pain

I have begun reading The Brain’s Way of Healing by Dr. Norman Doidge. It details case histories in the new medical field of neuroplasticity (the ability of the brain to change itself), and was recommended by my GP at Helios Medical Centre. It appears to be well researched, and is endorsed by neurologists, psychiatrists and physicians from institutions like the University of California, Boston School of Medicine, Harvard Medical School…

Bless Doidge for putting chronic pain as the subject of chapter one.

In that chapter, Doidge reports a way of retraining the pain circuitry in our brains that was discovered by a pain specialist in the United States named Michael Moskowitz. Not wanting to necessarily wait on a copy of Moskowitz’s “Neuroplastic Transformation Workbook” to arrive from Amazon, I will be undertaking that mental rewiring programme at home here in Christchurch, kiwi-style. I will be using as motivation and further study all the blogs and websites I can find of people doing the same. I’ll also be using that single chapter by Doidge, while continuing to inhale the rest of his book. And I’ll write a brief post each day about my findings, and changes or setbacks I notice.

There are likely to be plenty of the latter over the next six to eight weeks, which is the timeframe Dr. Moskowitz suggests before results are truly signs of neuroplastic change, and not just placebo and the result of temporary distractions from the pain. Hopefully I already have some useful experience from my seven-years-since, daily meditations.

Eventually, the visualizations and constant relentless effort of retraining the circuitry should be pretty much unnecessary, and my pain circuitry will have returned more or less to what it was before the chronic feedback cycle set in.

So, the preliminaries.

May all beings be happy. May all beings be free. May all beings share my good fortune.

Days One — 3

I’m currently on Day 5 — here are my brief catchup notes for the previous four days.

Day 1: elated. Probably mostly due to the placebo effect and the simple fact that, when in pain, anything that takes your mind off it is going to have a relaxing effect. Went to the park with my partner and her toddlers. Because of the elation, I probably overdid things. Lots of monkeying around — shoulders and neck!

Day 2: confused about the technique. Setback in terms of pain — possibly caused by trying to keep up with toddlers yesterday! Lots of questions — do I have to interrupt what I’m doing at any time of the day when I feel pain, and visualize? I am in almost constant pain sometimes for hours. Should I continue visualizing all that time? Feeling as though I can’t guarantee I’ll be on time for things if I need to keep stopping all the time. Even visiting friends was tricky today. Don’t seem to be getting any relief from the technique at all today.

Day 3: Moskowitz uses the MIRROR acronym to describe how to apply the technique. The first ‘R’ is for ‘Relentless’. So, in answer to yesterday’s questions — yes. All of that. “Anytime pain intrudes on consciousness”, writes Moskowitz, “it is greeted with visualization.”

Which seems intimidating — and yes, it’s hard to be that consistently motivated. But, reading about the experiences of others helps. Learning about the science behind the technique is motivating for me. And I’m also learning to do the visuals “on the fly” — closing my eyes at red lights to imagine the brain maps. Sometimes the visualization is bringing relief from the pain. Other times, I’m working on accepting that sometimes the visualization will be feeble or feel ineffective.

Day 4: elation returned. Feel emboldened to continue with the technique. Visualizations more vivid. Relaxation more pronounced than last two days. Quite significant relief from the pain if I stay focussed, fades as soon as I stop visualizing though. And still nothing like as much relief as Day One.

There! All caught up. From now on I will post each day separately.

Further Reading

This blog post has a reasonable summary (if you squint past the typos):

Here is Dr. Moskowitz’s book on Amazon:

And The Brain’s Way of Healing on Norman Doidge’s website:

What Are Nano Practices?

Nano practices are quick momentary habits that can change your life. I like to experiment with these lean brain-hacking techniques because they punch above their weight for how much time investment is required. Although I do not think they replace a daily formal meditation practice, they do assist us when integrating “on the cushion” insights into daily life, or making use of neuroplasticity to overcome unhelpful patterns of wiring in the central nervous system (brain and spinal cord). Or both.

But taking advantage of nano practices requires persistence at first, while we craft the habit.

How to craft a habit
(this is an aside — you can skip it)

One way to build a good habit is to craft a three-step cycle: trigger -> action -> reward. You choose a trigger (or sometimes our own habit-forming consciousness will choose one for us) and use it as a reminder to perform a certain action, that you then reward yourself for doing. Ideally the action will provide its own reward, but it doesn’t have to.

It takes persistence to start that cycle rolling, and you’ll have to deliberately notice the triggers and decide each time to follow through with the action part. But as we all know, habits build their own momentum — a good thing, in the case of nano practices. Eventually it will establish a virtuous cycle of habit: the more you do it the better it feels and the better it feels the more you do it. But unlike some habits, there’s no Breaking Bad-style drug addiction looming in your life if you take one of these practices on.

Once that cycle is established through persistence, it will form a virtuous spiral that has the potential to rewire the reward circuitry in your brain through neuroplasticity.

Depending on the results you are trying to achieve you may need to graduate from persistence into something more like relentlessness. For example, in February of 2016 I was suddenly and unwillingly cut out of three parallel careers by chronic whiplash pain 1. In July 2016 I cobbled together a home-based neuroplastics intervention based on my own reading and research (I kept a diary of it for 30 days). Although still not capable of full-time work, I’m a lot better off thanks to the habitual nano practice of visualising during pain spikes (which is ongoing and probably will be for the rest of my life). I can work to a “one hour on, one hour off” schedule for most afternoons, which is a huge win compared to where I was at.

But in order to shift the pain to that extent, I had to be more relentless than the pain for about three months before it started to become baked in 2.

Just remember, no matter how much effort it takes to begin with, soon you will not need to work at it. You will automatically ignite a flicker of intention with every little trigger and then engage the practice without question. Like letting out the clutch. What an investment those early efforts are!

Further Reading

One man who wrote a book on habits (literally) is Charles Duhigg, and The New York Times has kindly reviewed his work. He suffers from the usual “motivational talker” oversimplifications, but there is some useful stuff in there.

Although much of James Clear’s content on habits is taken from Charles Duhigg’s book, habits are His Thing and he does a good job of illustrating the repercussions of habit theory. Similar to Charles Duhigg, there is a lot more to habits than what he highlights, but it is very clearly explained for what it does cover (which for both authors is a great deal more than I am, tbf).

  1. I am coping fine thanks, and not looking for sympathy 🙂 Empathy is OK, but do not pity the man who has more time to write than ever before!

  2. {Look, another little clicky balloon}
    Until I get around to writing an Introduction to Neuroplastics for Persistent Pain, the following diary update provides a basic starting point on the technique with some further reading links at the bottom: neuroplastic brain hacking technique for persistent pain.