Migraine headaches: coping efficacy of guided imagery training

This study compares the effectiveness of guided imagery, (psychosynthetic approach), and biofeedback in the treatment of migraine headache. Specifically, the volunteer's subjective perception of the efficacy of the treatments is assessed. The subjects were 40 male and female volunteers presenting with migraine headache diagnosis at Sunnybrook Health Sciences Centre in Toronto, Canada. Subjects were randomly assigned to one of the three treatment conditions or to a control group. All subjects attended six sessions of training. Measures were completed pre- and post-treatment. The results did not reveal significant reduction in migraine activity in any of the treatment groups. There were no differences among the groups regarding the intake of medication. Nevertheless the implementation of guided imagery training resulted in subjective reports of improved capacity to cope with the pain and in subjective reports of a reduced perception of the pain itself, although objective measures did not indicate an appreciable change in migraine activity. Findings from the present study do not support either feedback or guided imagery training as more effective in counteracting migraines although subjective reports do favor guided imagery as having a positive influence on the perception of migraine pain. These findings are discussed from the perspective of empowering the sufferers by providing them with a more active role in dealing with the migraine triggering physiology, abandoning the "learned helplessness" typical of chronic pain syndromes. The issue of cost effectiveness is raised and it supports the use of guided imagery versus biofeedback training given the lack of theoretical agreement in the current literature.