The next time you get a shot or have a migraine, don't try and see yourself lying on a warm beach. Instead, picture a luscious chocolate bar or digging into a bowl of creamy, buttery mashed potatoes.
Building on established ideas that shifting the mind's attention away from pain can reduce sensitivity to pain, researchers now say that fantasizing about food may be an effective coping strategy for both chronic and acute pain.
"Imagery tactics are the most potent cognitive behavior interventions for pain," said Dr. Hamid Hekmat, professor of psychology at the University of Wisconsin at Stevens Point and lead author of the study. "We found that food fantasies such as imagining eating your favorite ice cream, chocolate cake or meal had a strong pain-attenuating effect. It enhanced mood, reduced anxiety, and helped coping with ice water pain."
And, in the midst of a crisis, when the mind is flailing for anything to latch on to for distraction, it can help to know what to focus on that will alleviate pain.
For his study, Hekmat twice asked 60 healthy subjects to submerge their hand in icy water to determine their pain threshold and tolerance. During the second round, participants were instructed to imagine a favorite meal in detail, a neutral scene, such as people walking, or they were not instructed to fantasize about anything.
With food fantasy intervention, subjects were able to withstand pain twice as well and had a higher pain threshold than when they didn't fantasize. Subjects who did not fantasize about anything showed almost no improvement in pain tolerance and threshold while subjects who pictured a neutral scene showed minor or no improvement.
Hekmat said chocolate was the most common food fantasy, reported by 32 percent of the participants. Roast dinners were next (31 percent) followed by pasta (14 percent), pizza (8 percent) and fruit (4 percent.)
The research was presented at the annual meeting of the American Pain Society in May 2008 in Tampa, Fla.
But the source of pain can go beyond the body.
"Pain is an emotional response and, as such, can be modified by emotions," said Dr. Peter Staats, an adjunct professor at the Johns Hopkins University School of Medicine and another author on the study. "A positive emotional thought of any type will function as a dampening effect on pain."
In addition to emotion, painful sensations cause anxiety and stress, which in turn increase sensitivity to pain, causing more stress -- a vicious cycle.
"There is no effective [pharmacological or surgical] therapy for stress," said Dr. Herbert Benson, director emeritus of the Benson-Henry Institute for Mind-Body Medicine at Massachusetts General Hospital. "Fortunately, we have within us an opposite response to the stress response."
Relaxation is a natural way to soothe the body's stress response to pain. Repetitive practices such as meditation, prayer, movement techniques like yoga, and visualization can help draw the mind's focus away from pain. As a result, the body's stress level is lowered and the pain does not feel as acute.
"When other thoughts come, you disregard them and return to repetition," Benson said. "It breaks the train of everyday thought."
Hekmat and his colleagues based the current study of food fantasies on similar studies they did in the past showing that sexual fantasies can reduce anxiety and improve a person's tolerance for pain.
Although there is no data on which type of fantasy is more effective for coping with pain, including less visceral techniques such as meditation, Hekmat suspects that those results would vary highly according to the individual and would be one area to further his research.
And compared to soothing imagery, the titillating effects of food and sex may be an effect some people prefer when they are in pain.
"Pleasurable response derived from excitement may facilitate the involvement of internal opioid mechanisms to counteract pain," Hekmat said. "Excitement absorbs attention and pleasant imagery can induce hypnotic-like states that detracts from pain, improves positive mood and reinforces personal belief in the manageability of pain."