title: The rescripting of pain images.
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.
  
  
  OBJECTIVE
  To assess the effects upon emotions, appraisals and pain experience of rescripting Index images in pain sufferers.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Back in Motion Rehabilitation Centre, Richmond, BC, Canada. clarephilips@yahoo.com
authors.forename: Clare
authors.initials: C
authors.lastname: Philips
authors.forename: Debbie
authors.initials: D
authors.lastname: Samson
mesh_terms: D059787:Acute Pain / Q000523:psychology* / Q000534:rehabilitation; D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D058443:Catastrophization / Q000523:psychology / Q000628:therapy; D059350:Chronic Pain / Q000523:psychology* / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003469:Culture; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D004644:Emotions; D005260:Female; D006801:Humans; D007092:Imagination; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012050:Rehabilitation, Vocational; D012649:Self Concept