One hypothesis is that RSD is a malfunction of the autonomic nervous system which runs our involuntary body functions such as body temperature, blood pressure, heart rate and respiration; smooth muscle function; the sweating process, etc. Biofeedback is a process of learning how to voluntarily and purposefully control these body functions with one's own thoughts. Dr. Schwartz believed it might be possible for me to gain control of these body functions with my thoughts, and thereby reduce the RSD symptoms. She taught me how to visualize my ice-cold foot being warmed by a fire and the foot gradually warming as the heat penetrated. She also reinforced the importance of visualizing myself as healthy and pain-free, walking smoothly without a limp and without pain.
I have always been a visual person. As a competitive tennis player in high school, I regularly visualized myself playing well, making tough shots, staying focused, etc. Through sports I learned that mind and attitude affect our body and our performance. With Dr. Schwartz's help, I used these techniques in my battle against RSD. It did not come easily, however, and I had to practice a lot before I could actually visualize myself walking down a path without a limp and without pain. The next step in my therapy was to visualize myself healthy and pain-free, jogging down the street. Again, it seemed to take ages but the mental scene eventually emerged, bringing a flood of confidence and a sense of control. I felt that if I could make my mind believe that I could walk properly and without pain, then possibly, in time, my body would follow suit.
A breakthrough came for me one day when I was practicing visualization. Not only did I see in my mind's eye the raging fire next to my foot but I could also visualize the constricted and narrow blood vessels in my foot opening up wide and allowing the hot blood to course through them and into my foot. Then suddenly I had a short dizzy spell and my foot simultaneously warmed up. It stopped as quickly as it had come. But I had done it and had made a breakthrough in my therapy. I had finally learned to physically warm my foot by using mental images.
During this treatment time, I was horrified to realize that since getting RSD, I had made a psychological disassociation between my brain and my foot. I had unconsciously done this in order to cope with the physical degeneration of my foot. How else can one deal with seeing a part of one's body slowly die off? I felt betrayed, shocked, and repulsed by the changes in my foot. The result of psychologically dissociating myself from the limb led to a worsening of the RSD as my brain began to shut my foot off from its life-giving functions.
With the medical team's help, I realized that healing depended upon re-integrating my dying foot back into myself. One method that worked well eventually became a nightly ritual. Every evening after work, as my husband and I were watching the news, I rolled up my pant-leg and took off all my socks (I usually wore two or three pairs all the time to try to keep warm). Then I would proceed to force myself to look at my atrophied and discolored leg and send it positive life-giving thoughts. In those several minutes each night, I opened my mind and heart back up to the dying limb. Then John would rub and massage the leg for several minutes. By having him validate and acknowledge the condition of the leg, I was more able to re-accept the limb. Rubbing my foot also increased circulation. Initially I could tolerate rubbing for only a few minutes due to resulting pain, but as my foot became desensitized to the stimulation, I learned to tolerate several minutes.
Over time, these short dizzy spells and blood flow bursts became more frequent. They would happen periodically when I was doing visualization or they would happen unexpectedly at any moment. To me, these signs indicated progress. Somehow the visualization, positive "foot talk", daily exercises, pool walks, nightly massages, and pain medications had begun to slowly turn the tide. The combination of strategies was tediously wearing down the RSD.
Part of the psychology of recovery for me meant avoiding any negative information about RSD, including negative articles, Internet chat rooms, stories, and research studies. This did not mean that I avoided all information about RSD, but instead I filtered the information, choosing to read only the positive and encouraging news and leaving the rest behind.