Creative activities can influence pain perception through various mechanisms:

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• Distraction and redirecting attention: When the brain is occupied with tracing lines, choosing colours or repeating patterns, attention is temporarily directed towards another activity. This does not make the pain go away, but it can cause it to recede into the background for a moment. A recent review article on the role of visual art therapy in migraine describes distraction, an altered perception of pain and psychosocial relief as possible contributing factors. At the same time, the authors emphasise that research specifically on migraine is still limited (Smirnoff & Pham, 2024).
   

• Managing stress and emotions: Art can help to give visible form to feelings of powerlessness, anger or being overwhelmed. Things that were previously difficult to grasp or put into words take on lines, colours and shape. This can help people to recognise and express their inner tension. A review of art therapy approaches for chronic pain reports improvements in pain, mood, stress and quality of life in the majority of the studies included – though it also highlights the varying quality and methodology of the studies (Raudenská et al., 2023; Barnett & Vasiu, 2024).
   

• Visualization and communication: Painting one’s own pain can help to make one’s experiences visible and thus easier to talk about – particularly when the right words are lacking during an attack. A picture can serve as a starting point for discussions with doctors or therapists. Art therapy is explicitly described in the literature as a non-verbal form of expression through which feelings, desires and experiences can be expressed (Barnett & Vasiu, 2024).  Furthermore, visualisations of one’s own pain can provide valuable insights into the emotional world of those affected by pain conditions and positively influence communication between doctors and patients (Philips et al., 2015; Ali et al., 2025).

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• Visualization and learning: Colouring in brain structures, blood vessels or possible pathological processes can make medical information more accessible. In this way, it may be easier to understand certain relationships and link them to one’s own experiences. However, there has so far been only limited direct research into the specific combination of colouring and knowledge of migraine. The book’s educational function should therefore be understood as a plausible pedagogical approach rather than a scientifically proven therapeutic effect. Note that, Schmeck et al (2014) demonstrated in a study that drawing pictures can positively support learning among schoolchildren.

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Some of the exercises in this book are based on the principles of biofeedback, which is also used in the treatment of migraine (Nestoriuc & Martin; 2007). Biofeedback involves consciously perceiving physical signals – such as muscle tension, skin temperature or heart rate – and, where possible, influencing them. The aim is to support the body’s own regulatory processes, for example through rest, breathing and relaxation. Biofeedback is also recommended as a non-pharmacological approach in the current guidelines for the treatment and prevention of migraine (Diener et al, 2025).

Colouring in blood vessels, brain structures or pain pathways is not biofeedback in the technical sense, as no physiological parameters are measured. However, it can be used as a visual exercise to support body awareness, breathing and self-observation. Rather, the exercises draw on specific principles: the conscious awareness of one’s own body, linking sensations with images, and focusing on calm, repetitive movements.

For example, by colouring in blood vessels, brain structures or pain pathways, you can try to

•  become more aware of your body: How does my head feel right now?

•  to link inner sensations with external images, colours and shapes,

•  to observe your breathing and the pace of your movements,

•  to find a calm, repetitive rhythm for as long as it feels comfortable and manageable.

This is not a substitute for medical or therapeutic treatment and does not constitute a promise of a cure. However, it can serve as a small, self-directed space for practice – a visual notebook for your own mind, in which there is room for knowledge, body awareness and feelings.