Visualization, Chronic Pain, and Neuroplastic Transformation: An Introduction to Dr. Moskowitz’s Neuroplastic Pain Management Strategies


Last week I posted my book review of Normon Dodge’s The Brain’s Way of Healing. As I stated in that review, one of the greatest perks of this book was how it pointed me to resources I felt I could trust and that would be worth my time.

The most interesting resource Dodge’s book pointed me to was, a fascinating website that contains graphics, educational resources, and up-to-date research on how neuroplasticity relates to chronic pain. I highly recommend you check it out. This website, in turn, pointed me to Dr. Moskowitz’s workbook entitled Neuroplastic Transformation.

In the introduction to Neuroplastic Transformation, Dr. Moskowitz describes the necessary process of acute pain alerting us to danger by sending signals to the 16 parts of the brain that process pain and then create a perception of pain. In acute pain, when the danger is over, the brain then creates a “counter signal” that dampens the pain as the tissue heals.

Moskowitz states, “This process [of acute pain] is much different than persistent pain experience, in which the signal sets up an endless loop between body and brain, inflammatory processes become chronic, anti-inflammatory processes are overwhelmed and the nerve cells dedicated to pain increase up to five-fold.”

The question becomes, how do we stop this endless loop of chronic pain? Moskowitz explains that we don’t experience the sensation of pain until it passes through the “automatic survival brain” (the brainstem) and reaches the “thinking part of the brain” (the cerebrum). This means that we want to intercept the loop before it reaches this thinking part of the brain.

How do we do this?

The answer is that we access the brain through visualization and other non-painful stimuli, activating the same parts of the thinking brain that would typically be processing the persistent pain, and forcing them to be used for a different purpose.

Each of the 16 parts of the brain that process chronic pain also has other jobs that they are in charge of. In the process of chronic pain, the percentage of brain cells assigned to processing pain drastically increases. By activating these 16 parts of the brain with other jobs, we can begin to “flood the pain map” and force the cells to process non-painful stimuli instead of the pain.

As Dr. Moskowitz states, “By activating the thinking part of the brain to stimulate other networks, nerve cells are reassigned to those networks and are taken from the extended pain map.”

We activate the thinking part of the brain o stimulate other networks by using non-painful stimuli such as thoughts, images, sensations, memories, soothing emotions, movements and beliefs. Furthermore, we do this persistently so that “Every episode [emphasis mine] of pain that intrudes upon consciousness is…challenged with non-painful stimuli.”

Challenging every single episode of pain that intrudes on consciousness with non-painful stimuli becomes quite a task when the pain is constant and never goes away. It literally means evoking these images, thoughts, sensations, etc…. constantly throughout the day for weeks and months at a time.

The strategies that Dr. Moskowitz suggests [the same strategies that cured his persistent, severe pain] are not an easy task. They take a great deal of motivation, persistence, and the willingness to continue for long periods of time with no sign of progress. Dr. Moskowitz suggests that his techniques need to be continued for six weeks without a break for change to be noticed.

Using the acronym MIRROR, Moskowitz describes the qualities that an individual must possess to succeed at neuroplastic transformation:

Motivation: “Stay motivated to change the brain even without immediate success.”

Intention: “Focus on changing the brain to stop persistent pain.”

Relentlessness: “Counter-stimulate every pain intrusion using thoughts, images, sensations, memories, soothing emotions, movement, beliefs.”

Reliability: “Count on the brain to make positive change.”

Opportunity: “Use pain intrusions as an opportunity to practice neuroplastic treatment approaches to stop pain.”

Restoration: “Disconnect expanded pain circuits, shrink the brain pain map and restore pain to its important role of sounding and alarm about danger.”

These qualities are where it all starts. Seeking out neuroplastic transformation requires a great deal of tenacity and the willingness to continue for long periods of time without yet feeling any relief.

To be successful, Moskowitz recommends taking one section of his workbook at a time. At the end of each section are instructions for specific visualizations and non-painful stimuli that can be incorporated into your day to flood the pain map and bring about neuroplastic change. He recommends practicing each strategy until it becomes a natural and ingrained part of your day before adding in additional strategies.

So, why am I going into all of this detail before sharing some of the specific visualizations he recommends? I think it is important to understand the mechanism behind these techniques if we are going to believe they can actually help. Without that belief, I think that the motivation required to persevere won’t be present. First we understand how it works, then we start moving forward with the belief that these strategies will bring about some form of change and relief.

Stay tuned for future posts, in which I will share some of the specific strategies suggested in Neuroplastic TransformationI highly recommend this workbook to help you develop coping skills to manage your chronic pain.



Moskowitz, M. H. & Golden, M. D. (2013) Neuroplastic Transformation: Transforming the Brain in Pain. Neuroplastic Partners, LLC.  

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  1. Thanks for the info. I’ll look up more on that website. I’m interested in knowing if I can apply it later on to other alarm bells that are overreacting (I.e. chemical sensitivity and sound sensitivity from the nervous system).

    Also some might find it easier to start with a video TED talk about chronic pain from last year where a doctor explained that feedback loop, especially if they are not used to all the science of neurology yet. It’s on YouTube. It would be a good confidence booster in neuroplasticity to watch since TED talks are very picky about who they invite to present. It’s not a pseudo science.

    It might not cure extreme cases or all cases but neuroplasticity has been proven to significantly help. I’d been waiting to get more on hands news about it so I’m really glad it’s getting there.

    1. In the book The Brains Way of Healing, he talks about various sensitivities in one of the later chapters. Some of the techniques used to help that required working with specific devices that would be used in an office setting and probably couldn’t be done at home. But I am sure there is some sort of application that could be used at home as well. I’ll have to check out that TED talk video – sounds really interesting.

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