ISSN 2043-8087
Journal of Experimental Psychopathology
 Volume 3, Issue 2, 258-273, 2012
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Free Article How a Better Understanding of Spontaneous Mental Imagery Linked to Pain Could Enhance Imagery-Based Therapy in Chronic Pain

Chantal Berna (a)(b), Irene Tracey (a)(b), Emily A. Holmes (a)
(a) Department of Psychiatry, University of Oxford
(b) Oxford Centre for FMRI of Brain Nuffield Department of Clinical Neurosciences, University of Oxford

Volume 3, Issue 2, 2012, Pages 258-273

Therapy with mental images is prevalent in the field of chronic pain, and this has been the case for centuries. Yet few of the recent advances in the cognitive behavioural understanding of spontaneous (i.e. intrusive) mental imagery have been translated to this field. Such advances include imagery as a component of a psychopathological process, as an emotional amplifier and as a cognitive therapeutic target in its own right. Hence very little is known about the contents, prevalence and emotional impact of spontaneous mental imagery in the context of chronic pain. This article discusses the evidence in favour of spontaneous imagery being a potentially important part of patients' pain experience, and makes a case, based on neurophysiological findings, for imagery having an impact on pain perception. Furthermore, it presents how mental imagery has been used in the treatment of chronic pain. A case report illustrates further how spontaneous negative imagery linked to pain can be distressing, and how this might be addressed in therapy. Additionally, the case report demonstrates the spontaneous use of coping imagery, and raises a discussion of how this might be enhanced.

Table of Contents
Spontaneous Imagery Linked To Pain: Images That Are Cognitions about Pain
 Intrusive Negative Pain-Related Cognitions
 Are Images Linked To Pain Merely Metaphors That Describe Painful Sensations?
 Coping Cognitions in the Form of Imagery
Physiological Impact of Mental Imagery
Mental Imagery as a Treatment for Chronic Pain
 Mental Imagery Techniques in the Context of Pain Relief
 Factors Affecting the Response to Imagery in Therapy
 Are Some Images More Useful Than Others?
A Single Case Example of Spontaneous Negative and Coping Imagery in Chronic Pain
 Case Discussion
Future Directions

Correspondence to
Chantal Berna, EPACT Group, University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK.

Mental imagery, chronic pain, guided imagery, coping imagery, suggestions, Cognitive Behavioural Therapy

Received 14 Apr 2011; Revised 26 Oct 2011; Accepted 4 Apr 2012; In Press 23 Apr 2012

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