כשהכאב ללא מילים: עבודה עם דימויים חזותיים בטיפול פסיכוסומטי

This article examines the relationship between physical pain and psychological distress in psychosomatic conditions, with a particular focus on chronic pain lacking a clear medical etiology. It introduces a theoretical framework grounded in Motivated Cue Integration (MCI) theory (Shalev, 2021), which conceptualizes experience as a dynamic process emerging from the integration of sensory, motivational, and epistemic cues. Within this framework, the primary difficulty in such conditions is understood not as an absence of emotion, but as a disruption in the organization of experience into a coherent, integrated, and subjectively validated whole. From this perspective, bodily symptoms are conceptualized not only as expressions of distress but also as indicators that experience has not yet acquired a structure that enables processing, communication, and regulation. Building on this premise, the article proposes a clinical model that employs visual images as an intervention aimed at facilitating the emergence and organization of experience, rather than merely its interpretation. Visual images are conceptualized as phenomenological scaffolds that support the holding, differentiation, and gradual structuring of pre-verbal experience, thereby enabling a transition from undifferentiated bodily sensation to articulation of emotional meaning. Clinical vignettes illustrate how engagement with visual images facilitates the identification of experiential qualities, the organization of internal conflicts, and the validation of subjective experience. The discussion outlines the clinical implications of this model for pain psychology and rehabilitation, suggesting that this approach may contribute not only to symptom reduction but also to enhanced adaptation, increased sense of agency, and the construction of meaning in the context of chronic pain.