Dr. David Bresler is a health psychologist and board-certified acupuncturist who formerly served as founder of the UCLA Pain Control Unit. He is the author of over 100 publications, including the book "Free Yourself from Pain." Currently, Dr. Bresler is Co-Director of the Academy for Guided Imagery, Director of Program Development for the L.A. Healing Arts Center and is Co-Director of the Century City Hospital Pain Control Center.
Tell me how you first got involved working with pain control.
I've always been interested in pleasure and pain and the neurochemistry of affect. As a result of doing my doctoral dissertation, which was on the relative contributions of norepinephrine, dopamine and serotonin in modulating affect, there were important implications that I wanted to apply on people.
So I ended up taking a post-doctoral fellowship in psychiatry at the NPI (Neuropsychiatric Institute) at UCLA and was able to continue my work there. I had simultaneously, outside of the university, been studying Chinese medicine and acupuncture...since the late 60's. Acupuncture proved to be very effective in the treatment of chronic pain. And I began to believe that acupuncture had some kind of neurochemical basis. We didn't know about endorphins back then but based on my other work...suddenly two things, acupuncture and the biology of affect came together for me. I was able to continue my work with acupuncture and look at some of the neurochemistry. I began to work with the issue of pain to see how acupuncture might treat it. A lot of things came together for me at about the same time. In the early 70's, I heard of the work of Carl Simonton. We met and hit it off really well.
Were you doing imagery work before you met Carl?
Yes. We had begun to do some human clinical trials of acupuncture in pain patients and one of the patients who was referred to us was a surgeon who had developed a rectal carcinoma. He had had surgery and extensive radiation...and it had left him in pretty bad shape. Because of the high-density of radiation we couldn't use a lot of conventional techniques. We couldn't even do a nerve block because the needle track would ooze for a couple of weeks. Here was a man who was tolerant to very high doses of narcotics and he was beginning to risk respiratory depression. He had few options left.
Before having the neurosurgeon cut a bunch of nerves, his doctors suggested he try acupuncture. He got sent into our pilot program and as I evaluated him, I asked him to describe his pain. He replied that the pain felt like a dog chewing at the base of his spine. "It's a horrible, nasty, awful, vicious dog chewing away on my spine." Without knowing anything at all about imagery, I asked him to close his eyes and describe exactly how the dog was chewing. At that time, I was thinking more in neurophysiologic terms just to see about the distribution of his discomfort and so-forth. The imagery took off from there. "What's the dog's name? I wonder if the dog would be willing to let go of your spine and talk to us for a minute." I was winging it without having any understanding of imagery.
And this was the first time you tried anything with imagery?
Correct. It was hypnosis without the induction. I'd been trained in hypnosis where you take people step-by-step into deeper and deeper levels of trance. Their response would be idiomotor, a yes or a no, or a nod but it was not an interactive process. So here was a patient who had such lucid imagery around his pain. I didn't hypnotize him. I just asked him to describe how the dog was chewing in order to get a better sense of the distribution of the pain and then it led into a deeper discussion. What he told me was so astounding. As the dog was talking to him, the pain eased up. You don't have to be a nuclear physicist to understand that this had some utility.
As I worked with the surgeon over time, he began a relationship with the dog. He had be-friended the dog and his pain had eased up significantly. Now I look at it a little differently. I'd say that what we had done was to utilize imagery to enhance his tolerance to pain.