Mindfulness, breathing, imagery and visualisation are potent activities that can be effective for stress, anxiety, depression and pain. We teach you these techniques as part of a comprehensive treatment programme.
The practice of mindfulness develops our ability to control our attention and regulate our emotions. Being aware of the present moment is a powerful method of directing our focus on what is truly existing around us as opposed to thinking about the past or future. In its simplest form, softly focusing upon the breath anchors us to the present. Typically our mind wanders like a small child straying from the path and needing gently encouragement to return. This maybe a thought, a noise or a sensation from the body. All of these are normal and we are not seeking to stop these stimuli but rather to develop control over what happens next, i.e. where our attention goes and consequently how we respond emotionally. Look at the examples below.
Situation -> emotion -> automatic thought(s) -> physical response -> behaviour
1. At work -> feel anxious -> think about a forthcoming presentation -> tension in the muscles -> spend time learning the material
2. Back pain on bending -> feel anxious, frustrated, fearful of movement -> think about how long the pain has been there, will it ever go? It means that I cannot… -> tension, pain, altered movement -> avoid bending
Using mindfulness to change the outcome means that you become aware of the process and that it is a thought that is driving the physical responses and behaviours. As human beings we have the unique ability to think about our own thinking and to be able to imagine and play out scenarios in our head. The problem is that the brain cannot differentiate between a thought and actually being in a situation meaning that the body responses are the same.
Imagine a bright yellow lemon on a plate. Imagine taking a sharp knife and slicing the lemon into two halves. See how the lemon segments fall apart as a small cloud of zest burst from the fruit, filling the air with the citrus aroma. Then imagine slicing each the half segments, again noting the lemon falling to the side, letting off a fine cloud of fresh juice. Now imagine taking one piece and gently place it on your lips and tongue, noticing the flavour, the texture and how your body responds.
As you have probably noticed, the body does respond to this visualisation and you salivate as if a lemon is truly tempting your palate. The same happens when we play out scenarios in our head that are negative. In pain we often err towards negative thinking about what the pain means and what will happen. The power of this thinking is immense and has very real physiological effects including the increasing development of powerful neural circuits in the brain: ‘nerves that fire together wire together’. This means that we tend towards hypervigilance to sensations in our body and to our own thinking that can be catastrophic, re-igniting the neural pathways and triggering protective responses as well as feelings of anxiety. The protective responses include pain and tension thereby enhancing the very feelings that one is trying to diminish.
Sensitivity to our sensitivities is common in persisting pain. Hypervigilance to pain in the body (noticing many sensations in the body, some of which are normal) followed by catastrophising (interpreting body signals as being dangerous) is a problem as the individual is creating further threat by thinking and playing out scenarios of ‘danger’ that the brain responds to, as previously explained.
A simple mindful task – see here
We use imagery on a daily basis when thinking as images and stories are played out in our mind’s eye. The brain and body respond to these images as if we are there which is why we can create the same feelings. Employing imagery in a positive sense means that we can trigger pleasant feelings of positivity at our own will.
A simple experiment: sitting or lying comfortably, close your eyes and start to create an image of a favourite place or person. The more you can ‘feel’ and ‘sense’ the place or person the more you will note that your body changes. The sense of joy, warmth, ease and pleasure pervade the body as the image becomes alive in your mind’s eye. Maintaining focus will keep this feeling going. Be aware and present in the moment to fully experience the feelings.
Motor imagery is a way of training the motor centres of the brain that are involved with the planning of movement. Imagining moving our body is a normal activity that we should all be able to perform. When we have pain or injury, this can be difficult as a result of the adaptations in the brain. These changes need targeting in order to normalise the control of movement (planning and execution stages).
Visualisation is a very effective way of changing our chemistry so that we can change our pain and body tension. Here are several examples that I use commonly. Sitting or lying comfortably in a quiet room is best to start these techniques, although as you become more skilled, you will be able to practice at other times (e.g./ work, travelling)
1. Imagine a channel that runs from your nose to the painful area though which you can breathe down into the affected area and then let go. Practice for 2-5 minutes, noticing how the area changes as you breathe in and out.
2. Take your attention to the affected area. What colour comes to mind? Be aware of that colour. Think about another colour that would be soothing, the antidote. In your mind’s eye, change the affected area into the calming colour, noting how the body feels. Keep attending to the area with this colour for 3-5 minutes.
3. Picture a large screen like a big cinema. Place an image of your painful area or whole body onto the screen. Gradually reduce the size of your body down to a dot. See the shrinking body and note how you feel. Once you have reached the size of a dot, make it disappear.
There are many visualisations and imagery techniques that can be used to change the activity in the brain. On the basis that pain is emergent from the body but underpinned by activity in the brain, being able to directly influence the chemistry and hence neuron function in the latter is a potent way of changing your pain experience.
There are some excellent resources to help you to learn more and develop your skills in this territory including a collection of CDs from Breathworks and books such as Mindfulness, The Miracle of Mindfulness, Full Catastrophe Living and The Power of Now.