Getting The Picture Across: Using the Power of Imagination to Cope with Fibromyalgia

by Katarina Zulak

It's almost funny that the single word pain is supposed to mean all of the different sensations you feel when you live with a chronic pain condition. I find it hard to describe in words how different pains physically feel, especially to someone who does not have chronic pain. Sometimes a metaphorical image captures it best.

Visual Metaphors Can Improve Communication By Evoking Empathy

 Visual metaphors are better able to evoke understanding and empathy in others (G. D. Schott). If I tell you about a large needle being slowly inserted into my eyeball, your reaction is likely to cringe, grimace and/or squint your eyes.

When you hear someone describe an image of something happening to them, your brain will "mirror" that experience – you imagine what it would literally feel like for the same thing to happen to you. In fact, we have neural pathways, called mirror neurons, devoted to empathising with other people this way: "both mirror neuron and alternative neural networks are likely to be enlisted in the empathetic response to images of pain" (G. D. Schott). Using visual metaphors can help you to describe your pain better to your doctors and your family and friends.

Nerve pain brings to mind intensity, heat and electricity. My sciatic pain can feel like a zap of electricity – a sudden, searing, mini-bolt of lightning. Pain is often compared to a burning or searing fire. Describing a sharp stabbing feeling, like a hot knife, can really help to get the picture of how your pain feels across.

Muscle pain might be best described as a tool-kit wielded by a sadistic handyman. The drilling in my head referred from spasmed neck muscles, the throbbing ache in my SI joint like a hammer pounding down on the spot. It's also common to describe pain as a tormenting animal, clawing, tugging or squeezing the painful area of the body.

Deep, internal pain can feel like the pressure of a bowling ball, or worse, an anvil, suddenly teleported pressing down on the painful area. Some tools from the sadist's toolkit might join the party, like pliers pinching or an ache that feels like a vice grip being tightened.

Take a deep breath after reading those descriptions. They can be stressful to contemplate, because it may bring to mind all the different pains you feel at once, and/or activate your mirror neurons so that you're imagining many types of pain at once. Luckily, the power of visualisation can be used not just to describe pain, but to reduce it as well. 

Use The Power Of Your Imagination To Manage Your Pain Better

If you have chronic pain, just reading or hearing descriptions of pain metaphors might start to make you feel tense and stressed. Images can elicit a very physical response, bypassing the analytical parts of our your brain. If I describe the sensation of a dentist drill, whirring away, drilling a hole deep into my hip joint, how do you feel? In contrast, imagine I describe being in a forest, with sunshine streaming through the trees and dappling the forest floor – do you feel more relaxed? That's the power of our imagination to affect thoughts and feelings.

In fact, visualising can be a potent way to ease pain and shift attention. Imagining a soothing, or more positive mental picture can significantly lower levels of the stress hormone cortisol. When you enter a relaxed state, your brain releases endorphins, which are natural pain-relieving biochemicals. Using your imagination is a helpful way to distract from focusing on pain, which is likely another reason that visualisation can help to manage pain. Numerous studies have demonstrated that guided imagery reduces pain and improve physical function.

Guided imagery often involves visualising tranquil natural settings, like walking on the beach or in a garden. The visualisation should incorporate all of your sense. For example, a beach visualisation would include the mental image of a beach, but also the sound of the surf and the cry of seagulls, the smell of salt air, the feeling of sand under your feet – you get the idea. There are many websites, CDs and apps that provide sessions you can listen to if you're interested in using this technique.

Another technique involves reframing your original visual pain metaphor or replacing it with a pain reduction visual metaphor. For example, if you feel like your pain sensation is like being pricked by hot needle, then you reframe visual to be a cold needle. After concentrating on that, you can imagine the needle itself becoming soft, like a string of spaghetti.

Guided visualisation to soothe pain involves minimising, distancing or numbing the pain sensation. You can imagine the warm oil being poured over tight muscles, for example, or ice freezing out burning sensations. The secret to success with any visualisation technique is practice and repetition – it becomes more effective the more you do it.

A Picture Is Worth 1000 Words: Express Yourself Using Art Therapy

Envisioning pain can also go past physical sensations into describing how the pain impacts your life. If I was going to draw a picture of my fibromyalgia, it would be like a cage. I often feel trapped within limitations of what I'm able to do for the pain flares and I have to stop. Chronic pain can feel like an alarm that is always blaring – like trying to work through a fire drill. I would probably use colours like bread and orange or grey and black to describe The 'feel' of pain.

Not surprisingly, exercises that get you to draw your pain/health condition are also helpful to relieve stress. "Expressing oneself through [art] makes our thoughts, feelings and ideas tangible and communicates what we sometimes cannot see through words alone" (Psychology Today). Creative expression is quite healing, even if it's limited to abstract doodles or colourings. Drawings and collages can also picture positive images that evoke well-being.

What is a visual metaphor for your pain? If you had to draw an image of your chronic pain condition, what would it look like?

Resources

Psychology Today (Picture Of Health: An Art Therapy Guide) https://www.psychologytoday.com/ca/blog/arts-and-health/201703/drawing-picture-health-art-therapy-guide

Arthritis (Guided Imagery For Arthritis) https://www.arthritis.org/health-wellness/treatment/complementary-therapies/natural-therapies/guided-imagery-for-arthritis-pain

Calgary Neuropathy Association (Visualization And Pain Management For Neuropathy) https://calgaryneuropathy.com/visualization-pain-management/

Brain (G. D. Schott: Pictures Of Pain And Their Contribution To The Neuroscience Of Empathy) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408436/