Abstract
Background: Although clinical observations suggest people with chronic pain have pain-related imagery (PRI) there is little research exploring its impact. Objectives: To explore PRI in people with chronic pain, assess the impact of evoking and drawing PRI on pain experience, and explore relationships between PRI and psychological variables found to play a role in the pain experience. Sample: Adults (N = 90) with chronic pain were recruited from three pain services. Design: Between-group experimental questionnaire design. Methods: Participants were randomly allocated to the intervention (drawing a pain image; n = 40) or control (n = 50) condition. All completed measures of PRI and pain experience. Measures: Quantitative measures of pain experience (intensity, fear, catastrophising, acceptance) and PRI, and qualitative pain drawings. Findings: Drawing an image had no impact on pain experience. Over half the sample (n = 49) reported PRI, largely experienced as negative. Having PRI was linked with greater catastrophising. Those who described images as interfering and eliciting negative emotions were more likely to report pain fear, catastrophising and lower acceptance. The drawings painted a vivid picture of pain as a threatening experience and reflected catastrophic perceptions. Conclusions: Many people in chronic pain services have PRI. These images appear to be a non-verbal reflection of unhelpful cognitions, encapsulating emotions and underlying beliefs. Images may provide direct access to the emotional “heart” of pain. Image interventions may have potential to drive change by reducing negative pain cognitions and enhancing acceptance. Drawings provide a helpful tool in accessing pain images.