Using Metaphoric Associative OH Cards With Chronic Pain

Posted on February 20th, 2015

The client name is fictitious for privacy purposes.

Sandy was involved in a motor vehicle accident about four years ago and has been experiencing persistent pain symptoms in various parts of her body. About seven months ago she visited a rheumatologist who diagnosed her with fibromyalgia. Working with people who experience chronic pain is challenging and therapeutic methods like cognitive behavioural therapy may not always be effective in helping people cope with their pain.

Relaxation strategies, principles of pacing, cognitive restructuring, and physiotherapy were only somewhat helpful for Sandy. However, she continued to experience constant pain, depressed mood, anxiety, social isolation and other problems. Despite these adversities, she remained hopeful and was willing to continue working on her psychological and physical challenges. I decided to use associative OH cards to help Sandy express her “inner world” through images.

I first used the Persona deck and asked her to choose three cards: a card that would best described how she was before the motor vehicle accident, a card that would best describe how she feels now, and a card that would describe they way she would want to be. I asked her to describe each card as well as how each card feels. I then gave her the Habitat deck and asked her to choose some cards that would best describe her present state and her desired state.

Some of the keywords that she used to described her current state of being were: sad, lonely, miserable, exhausted, confused owl, and angry. She also noted that “I know that the pains I have are for life.” This statement gave me a good idea of what kind of belief she has about her pain and how this belief can be standing in the way of her recovery. She described her desired state of being as: peace of mind, freedom, happiness, contentment, serenity, and vacation.

Once Sandy described her current state and her desired state we then focused on figuring out what steps she needs to take to get to her desired state. However, she immediately objected to this process due to her disbelief in her recovery. To overcome this objection, I asked her to pretend for a moment that it was possible to attain recovery by asking her a question - if it was possible, what could you do to improve your life? After a several attempts, she agreed to put her disbelief aside and generate some ideas about what steps she could take to improve her well-being.

Some of the ideas that Sandy was able to come up with were: attending aqua-fit classes, spending more time in nature, vacation and travel, and spending more time with family and friends. Although, these ideas may appear to be common sense, people who experience chronic are often not aware of what they can do to manage their pain because they are focused on their pain (problem state) most of their time. Metaphoric associative OH cards can be used as an excellent tool to help people become more aware of their present state, gain a vision of their desired state, and generate practical steps that can be taken to get to the desired state.

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