Visualizing "Pain-Free": The Clinical Use of Vision Boards

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Vision boards are sometimes used by both clinical and nonclinical populations to bridge the gap between an individual's hopes, goals, dreams, and reality. The use of vision boards is especially promising for individuals with chronic pain because vision boards help redefine and illuminate goals and health specific goals, help recreate an abundance mindset, and promote a restored sense of agency in bridging the gap between future goals and actuality. Plus, vision boards can be combined clinically with Solution Focused Behavioral Therapy (SBFT) to help individuals with chronic pain set and achieve wellness related goals under the guidance of their mental healthcare provider.

Bridging the Gap Between Future Health Goals and Reality

Witmer and Young (1985) performed the foundational vision board psychology study and found that the benefits of creating vision boards include increasing awareness of self and others; future planning and career and lifestyle development; improving learning, skill development, and performance; reducing stress and enhancing health; and enhancing creativity and problem solving in everyday living.

Expanding upon this framework, vision boards can be used clinically by a counselor or therapist to help a patient transform their internal mental maps of their hopes goals and dreams into a singular ‘vision’ by using images to direct the transformation of an abstract hope into a discrete image, and finally into an actuality. Through this emerging method, an individual with chronic pain may combine several seemingly disparate goals into one singular, complete image comprised of smaller visual representations. This is especially key in the therapeutic process for individuals with a newly diagnosed chronic pain condition, because it organically prompts the individual to reassess what is really important to them.

For example, a young woman with chronic pelvic pain was devastated by the rupture of a large ovarian cyst. Post-operatively, her goal was to be well enough to return to her college, Barnard. Her psychologist challenged her to create a "back to school" vision board and the patient, a proud Barnard woman, quickly realized that any vision board about Barnard would be incomplete without a signature swivel chair found in the Milstein Center. The swivel chairs held a special importance in both the emotional and physical health interests of the patient, as the chairs are low to the ground, and so they would be challenging to sit in given the current state of the patient, and she would have to really focus on her recovery in order to be able to sit in them again. But, she created a digital vision board with a Milstein Center chair in the center of it, looked at it every day over the summer, and was motivated to recover well and return to school in the fall if for nothing else but to sit in the Milstein chair again. Through this example, we see that creating a vision board helped gap the bridge between the young woman’s abstract hope (returning to school) and her reality, because of the power held in the ability of a vision board to inspire mental transformation from an abstract hope into a concrete goal into a reality.

What Does "Pain-Free" Look Like?

The goals of many individuals with chronic pain tend to be quite abstract — patients will say their goal is to “feel pain-free” or “feel like themselves again” but these goals are not concrete. Many therapists will then ask their patient “what does pain-free look like” or “what does feeling like yourself again look like?” Rather quickly, most patients will list activities they would pursue or places they would visit, which they could then include in their vision board. The idea behind vision boards lies in the fact that they empower individuals with chronic pain to visualize these abstract hopes into discrete goals they can actually work to achieve.

Witmer and Young also postulate that “experiencing something in imagery is essentially the same psychologically as experiencing it in actuality” which can motivate individuals with chronic pain to take actionable steps towards achieving the goals on their vision board. Expanding on the earlier example of the young woman from Barnard College and her desire to recover well and return to school, we can see how this postulate by Whitmer and Young relates to the therapeutic power of making a vision board. In order for the young woman to return to school and sit in her beloved swivel Milstein chair, she would have to obviously regain all the abdominal and pelvic strength she lost during surgery for her ruptured ovarian cyst. The discrete image of a Milstein chair served as a conduit between the abstract hopes and discrete goals of the woman, because the Milstein chair was a symbol representing a full abdominal and pelvic strength recovery.

Vision Boards and Solution Focused Behavioral Therapy (SFBT)

A 2016 study by Burton and Lent presents a compelling argument for the clinical use of vision boards, noting that combining vision boards with SFBT could be especially efficacious for individuals with chronic pain. SFBT begins with developing a clear description of a goal. The development of useful goals normally includes the following criteria: goals that (a) have a personal meaning to the client, (b) are positive, (c) are attainable, (d) are future-oriented, and (e) are able to be practiced regularly. For example, the aforementioned goal of returning to school after a chronic illness diagnosis would fit the aforementioned criteria.

Next, Burton and Lent recommend that the therapist assign their client homework, in that the client had to come to the next session prepared with a completed vision board, which the therapist and client would analyze together. Lastly, the therapist should inform the client of the clinical relevance of their vision board, and help them choose a highly visual place to put it, so that every time the patient looks at the vision board they are reminded of their goals and will unconsciously make choices that are consistent with the goals the vision board represents.

Burton and Lent support that including a therapist in the vision board process promotes accountability for the client, and moreover through combining vision board with SFBT counselors can engage the client in the counseling process and draw on internal client resources. Furthermore, through a brief review of a client's vision board a psychologist can appreciate aspects of a chronic pain patient's life that may help them better help their patient. Thus, vision boards also pose benefits to the patient-provider interaction and can make for a richer patient experience.

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When I Like to Make a New Vision Board

As a chronic pain patient myself, I typically create a vision board before any major planned surgical procedure or after an emergency procedure, as I find that vision boards help me refocus my energy from pain and trauma toward healing. I would also advise fellow chronic pain patients to consider making a vision board after receiving a new diagnosis or any significant medical news, or after completing a health goal outlined by a previous vision board. From the pain therapist’s office to a cozy recovery suite, a vision board is an efficacious way for chronic pain patients to recreate an abundance mindset, set and achieve health goals, and even visualize “pain-free” days to come ahead.