Yesterday I had my 4th rtfMRI scan in the chronic pain treatment study, and this time I alternated between using the successful strategies for increasing and decreasing my pain found during the previous scans (the affective strategy, using the feelings of anger, discouragement and frustration for increasing, and the sensory strategy of imagining warmth soothing the area for decreasing) with the new discriminatory strategy I developed during my previous appointment. This was to find out which of all of these various strategies worked best for controlling the activation of my brain's pain centers.
While practicing the new discriminatory strategy during the week I had trouble making the pain increase and spread into the non-painful areas merely by imagining grabbing the border of the painful area and pulling on it to spread it out. I wound up falling back onto imagining the painful area as a swirling whirlpool of fiery lava; that was quite easy to imagine increasing and spreading into non-painful areas. And I had similar trouble imagining my hand pushing the border of the painful area back down, so I experimented with imagining the cool green moss that represented healthy, pain-free tissue spreading from the rest of my body onto the painful area and putting down roots, to infiltrate the painful spot with non-painful tissue. I felt I got the greatest increase and decrease of my pain levels so far using the lava vs. moss imagery while practicing at home. The purpose of the discriminatory strategy is to focus between painful and non-painful areas of the body, and fortunately for me, the kind of pain I experience has discrete areas and distinct borders and lends itself easily to such clear delineation.
The result of this latest scan was that the affective strategy was still the most successful at increasing my pain level (the feelings of anger, discouragement and frustration of struggling against chronic pain), but the new discriminatory strategy was the winner for decreasing my pain level (imagining the cool moss of healthy, pain-free tissue infiltrating the painful area and reducing it down to nothing). I am not surprised by this result, because my main coping strategy all along has been to ignore what hurts and focus on what doesn't hurt. It would not surprise me if this discriminatory strategy is the one that winds up being the overall winner for decreasing my pain. But that's getting a bit ahead of myself here. I still have 2 more strategies to practice and 2 more scans to undergo, and who know how things might turn out?
My next strategy to practice is the evaluative strategy. It's pretty abstract, and it's hard for me to see it as much different than the earliest strategies I learned, because to practice increasing the pain I have to think about a day when I had my worst pain ever and what it was like, and then to decrease it I have to think about a day when I had virtually no pain at all and what that was like. It's hard for me to think about those experiences without also feeling some emotions and without remembering some physical sensations of what those days were like, so it's almost like overlapping with the affective and sensory strategies I practiced at the beginning of the study. Perhaps this is an indication that this strategy will not be a useful one for me. But only time will tell.