Skip to main content Accessibility help
×
Home
Hostname: page-component-564cf476b6-dr4jh Total loading time: 0.293 Render date: 2021-06-20T11:22:25.186Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true }

The Rescripting of Pain Images

Published online by Cambridge University Press:  06 September 2012

Clare Philips
Affiliation:
Back in Motion Rehabilitation Centre, Richmond, BC, Canada
Debbie Samson
Affiliation:
Back in Motion Rehabilitation Centre, Richmond, BC, Canada
Corresponding
E-mail address:

Abstract

Background: The majority of pain sufferers experience images when in pain. The most distressing of these images (the Index image) provokes intense emotional reactions, appraisal shifts, and increases in pain. The ability of pain sufferers to rescript their Index images, and the consequences of doing so, remain to be determined. Aims: To assess the effects upon emotions, appraisals and pain experience of rescripting Index images in pain sufferers. Method: The Index images of a group of 55 pain sufferers were assessed using a voluntary image induction procedure (VIE) to obtain basal levels of pain, appraisal and emotion. Participants were than randomly allocated to one of two groups: Rescripted Image repetition or Index Image repetition. The two groups were compared on their responses to their Index and Rescripted images respectively. Results: The participants found it easy to rescript their distressing Index images. During rescripting, they reported dramatic reductions in emotion, negative appraisals, and pain. The clinically and statistically significant decrements in pain were found independent of reductions in emotion. The pain levels during rescripting were significantly below their basal levels, with 49% reporting no pain at all while viewing a rescripted image. These changes were not a function of image repetition. Conclusion: Index images of pain sufferers can be easily elicited and rescripted. Rescripting leads to remarkable reductions in emotion, cognitions and pain levels that are not attributable to image repetition. The significant reductions in pain were independent of reductions in emotion. The implications of these results for CBT approaches to pain management are considered.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

Access options

Get access to the full version of this content by using one of the access options below.

References

Aldrich, S., Eccelston, C. and Crombez, G. (2000). Worrying about chronic pain: vigilance to threat and misdirected problem solving. Behaviour Research and Therapy, 38, 457470.CrossRefGoogle ScholarPubMed
Andrykowski, M. A., Cordova, M. J., Studts, J. L. and Miller, T. W. (1998). Post-traumatic stress disorder after treatment for breast cancer. Prevalence of diagnosis and use of the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-Chronic) as a screening instrument. Journal of Consulting and Clinical Psychology, 66, 586590.CrossRefGoogle Scholar
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York: New American Library.Google Scholar
Berna, C., Vincent, K., Moore, J., Tracey, I., Goodwin, G. M. and Holmes, E. A. (2011). Presence of mental imagery associated with chronic pelvic pain: a pilot study. Pain Medicine, 12, 10861093.CrossRefGoogle ScholarPubMed
Bjelland, I., Dahl, A. A., Haug, T. T. and Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic. Research, 52, 6977.CrossRefGoogle Scholar
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C. and Forneris, C. (1996). Psychometric properties of the Post-Traumatic Stress Disorder Checklist (PCL). Behaviour Research and Therapy, 34, 669673.CrossRefGoogle Scholar
Brewin, C. R., Wheatley, J., Patel, T., Fearon, P., Hackmann, A., Wells, A., et al. (2009). Imagery Rescripting as a brief stand-alone treatment for depression patients with intrusive memories. Behaviour Research and Therapy, 47, 569576.CrossRefGoogle ScholarPubMed
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 34, 461470.CrossRefGoogle Scholar
Clark, D. M. and Wells, A. (1995). A cognitive model of social phobia. In Heimberg, R. G., Liebowitz, M., Hope, D. and Schneier, F. R. (Eds.), Social Phobia: diagnosis, assessment and treatment (pp. 6973). New York: Guilford.Google Scholar
Day, S. J., Holmes, E. A. and Hackmann, A. (2004). Occurrence of imagery and its link with early memories in agoraphobia. Memory, 12, 416427.CrossRefGoogle ScholarPubMed
Eccleston, C., Crombez, G., Aldrich, S. and Stannard, C. (1997). Attention and somatic awareness in Chronic Pain. Pain, 72, 209215.CrossRefGoogle ScholarPubMed
Eccleston, C. (2001). Role of psychology in pain management. British Journal of Anaesthesia, 87, 144152.CrossRefGoogle ScholarPubMed
Ehlers, A. and Clark, D. M. (2000). A cognitive model of post-traumatic stress disorder. Behaviour Research and Therapy, 38, 319345.CrossRefGoogle Scholar
Ehlers, A., Maercker, A. and Boos, A. (2000). PTSD following political imprisonment: the role of mental defeat, alienation, and perceived permanent change. Journal of Abnormal Psychology, 109, 4555.CrossRefGoogle ScholarPubMed
Gillanders, D., Potter, L. and Morris, P. G. (in press). Pain-related visual is associated with distress in chronic pain sufferers. Behaviour and Cognitive Psychology.Google Scholar
Hackmann, A., Bennett-Levy, J. and Holmes, E. A. (2011). Imagery in Cognitive Therapy. Oxford: Oxford University Press.CrossRefGoogle Scholar
Hackmann, A., Ehlers, A., Speckens, A. E. M. and Clark, D. M. (2004). Characteristics and content of intrusive memories in PTSD and their changes with treatment. Journal of Traumatic Stress, 17, 231240.CrossRefGoogle ScholarPubMed
Hackmann, A. and Holmes, E. A. (2004). Reflecting on imagery: a clinical perspective and overview of the special issue of memory on mental imagery in psychopathology. Memory, 12, 289402.CrossRefGoogle ScholarPubMed
Holmes, E. A., Arntz, A. and Smucker, M. R. (2007). Imagery Rescripting in cognitive behaviour therapy: images, treatment techniques and outcomes. Journal of Behavior Therapy and Experimental Psychiatry, 38, 297305.CrossRefGoogle ScholarPubMed
Holmes, E. A. and Mathews, A. (2005). Mental imagery and emotion: a special relationship? Emotion, 5, 489497.CrossRefGoogle ScholarPubMed
Holmes, E. A. and Mathews, A. (2010). Mental imagery in emotions and emotional disorders. Clinical Psychology Review, 30, 349362.CrossRefGoogle ScholarPubMed
Jamani, N. and Clyde, Z. (2008). Treatment of pain-related fear in chronic (persistent) pain: the role of safety-seeking behaviour and imagery. The Cognitive Behaviour Therapist, 1, 315.CrossRefGoogle Scholar
Lang, A. J. and Stein, M. B. (2005). An abbreviated Post-Traumatic Stress Disorder checklist for use as a screening instrument in primary care. Behaviour Research and Therapy, 43, 585594.CrossRefGoogle ScholarPubMed
Luria, A. R. and Bruner, J. (1987). The Mind of a Mnemonist: a little book about a vast memory. Cambridge, MA: Harvard University Press.Google Scholar
Melzack, R. and Wall, P. (1965). Pain mechanisms: a new theory. Science, 150, 971979.CrossRefGoogle ScholarPubMed
Morley, S., Eccleston, C. and Williams, A. (1999). Systematic review and meta-analysis of randomized controlled trials of cognitive-behavioural therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain, 80, 113.CrossRefGoogle ScholarPubMed
Philips, H. C. (2011). Imagery and pain: the prevalence, characteristics, and the potency of imagery associated with pain. Behavioural and Cognitive Psychotherapy, 39, 523540.CrossRefGoogle ScholarPubMed
Philips, H. C. and Rachman, S. (1996). The Psychological Management of Chronic Pain: a treatment manual. New York: Springer.Google Scholar
Potter, L. (2007). Pain Related Mental Imagery. Doctoral Thesis, University of Edinburgh.Google Scholar
Pratt, D., Cooper, M. J. and Hackmann, A. (2004). Imagery and its characteristics in people who are anxious about spiders. Behavioural and Cognitive Psychotherapy, 32, 165176.CrossRefGoogle Scholar
Rachman, S. (2007). Unwanted intrusive images in obsessive compulsive disorders. Journal of Behaviour Therapy and Experimental Psychiatry, 38, 402410.CrossRefGoogle ScholarPubMed
Ruggiero, K. J., Del, B. K., Scotti, J. R. and Rabalais, A. E. (2003). Psychometric properties of the Post-Traumatic Stress Disorder Check List -Civilian Version. Journal of Traumatic Stress, 16, 495502.CrossRefGoogle Scholar
Salkovskis, P. (1985). Obsessional-compulsive problems: a cognitive behavioural analysis. Behaviour Therapy and Research, 48, 295303.Google Scholar
Sullivan, M. J. L., Bishop, S. R. and Pavik, J. (1995). The Pain Catastrophizing Scale: development and validation. Psychological Assessment, 7, 524532.CrossRefGoogle Scholar
Tang, N. K. Y., Salkovskis, P. M. and Hanna, M. (2007). Mental defeat in chronic pain: initial exploration of the concept. Clinical Journal of Pain, 23, 222232.CrossRefGoogle Scholar
Turk, D. and Rudy, T. (1992). Cognitive factors and persistent pain: a glimpse into Pandora's Box. Cognitive Therapy and Research, 16, 99122.CrossRefGoogle Scholar
Wild, J., Hackmann, A. and Clark, D. M. (2007). When the present visits the past: updating traumatic memories in social phobia. Journal of Behaviour Therapy and Experimental Psychiatry, 38, 386401.CrossRefGoogle ScholarPubMed
Winterowd, C., Beck, A. T. and Gruener, D. (2003). Eliciting and modifying imagery. In Cognitive Therapy in Chronic Pain Patients (pp. 183207). New York: Springer.Google Scholar
Whittal, M., Woody, S., McLean, P. and Robichaud, M. (2010). Treatment of obsessions: a randomized controlled trial. Behaviour Research and Therapy, 48, 295303.CrossRefGoogle ScholarPubMed
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavia; 67, 361370.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.
13
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

The Rescripting of Pain Images
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

The Rescripting of Pain Images
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

The Rescripting of Pain Images
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *