Figure 1.

Cognitive behavioral therapy (CBT) formulation of the potential role of mental imagery in chronic pain. Triggers, such as pain or a reminder of the pain, evoke the image, which is linked to strong emotions, a negative interpretation (meaning), and avoidance. All this leads to a stronger/more negative experience of pain, and an increased likelihood of new occurrences of the image. The descriptions of patients' most relevant mental images in Table 1 are organized along this vicious cycle's structure.