Mental Imagery in Pain: Mechanisms and Treatments

Session Title: Mental Imagery in Pain: Mechanisms and Treatments

Topic: CLINICAL SCIENCE

Description of Workshop: Pain-related mental imagery has the potential to exacerbate pain when it is negative, but also has the capacity to be harnessed and reshaped to help individuals manage pain more effectively. Yet, its mechanisms and clinical applications remain underexplored. This workshop brings together leading international experts to present cutting-edge research and clinical insights into how mental imagery can be harnessed to understand and treat pain. The session will span mechanistic research, cognitive neuroscience, and clinical applications, to provide a comprehensive and multidisciplinary perspective on mental imagery in pain.
Dr. Jemma Todd will present recent empirical work from a psychological perspective, positioning mental imagery as a key factor that can impact pain. Drawing on experimental studies, ecological momentary assessment, and clinical data, she will show that negative pain-related mental imagery (especially when vivid and intrusive) is a reliable predictor of pain severity and interference. Her qualitative and empirical work in health conditions (e.g., endometriosis) also demonstrates how imagery can interact with other social-psychological constructs such as pain interpretation, fear of progression, and systemic factors. These findings highlight the importance of mental imagery as a transdiagnostic mechanism of pain experience across populations.
Prof. Chantal Berna will present clinical and mechanistic research. She has demonstrated that individuals with different chronic pain conditions frequently experience vivid and intrusive mental images related to their pain. Moreover, her work has shown that these images are not mere metaphors, but emotionally charged cognitions that can intensify pain, distress, and avoidance behaviours in different populations, including endometriosis, post-surgical/posttraumatic pain, as well as in hypermobile Ehlers Danlos syndrome. Finally, using a double-blind naloxone challenge, she has revealed that mental imagery-based pain modulation operates independently of the endogenous opioid system, suggesting a distinct neurocognitive mechanism. These findings support the potential of clinical approaches that use mental imagery for pain regulation, especially in populations with disrupted opioid signalling.
Prof. Tor Wager will cover neuroimaging research on how mental models and beliefs, shaped through imagery, can modulate pain perception. His lab uses fMRI and computational modelling to decode the neural signatures underlying the experience of pain, memory, and emotion, showing how cognitive interventions that use imagery and placebo can alter brain networks involved in pain processing. His work bridges neuroscience and clinical applications, offering critical insights into how mental imagery could be optimized for therapeutic use in pain management.
Prof. Mark P. Jensen will conclude the session by presenting and discussing a specific strategy that uses imagery for pain management; hypnotic age progression. This imagery-based technique involves guiding patients to visualize a future self who has successfully achieved a pain management goal, then experiencing the goal attainment and internalizing the positive results. He will present research findings on the effects of this technique on pain intensity in a sample of individuals with chronic pain, and then model how the technique can be applied in real world settings.

Speakers