Pain Reprocessing Therapy
Pain reprocessing draws on neuroscience, somatics, and techniques from pain reprocessing therapy (PRT) and emotional awareness and expression therapy (EAET) to help reduce or eliminate symptoms caused by neuroplastic (mind-body) pain.
Neuroplastic pain is not caused by ongoing damage to the body. Instead, it results from the brain interpreting signals from the body as pain, even after the body has healed from injury, or when there is no structural cause for pain. Although neuroplastic pain is generated by the brain, the pain it causes is excruciatingly real. Pain is our body's alarm system, designed to protect us. However, that alarm system sometimes becomes overprotective, interpreting stress, emotions, or other experiences as signs of danger and producing pain in response.
Here’s the encouraging news: the same neuroplasticity that allows your brain to learn pain also allows it to unlearn pain. We will address cognitive, behavioral, and emotional patterns and work to retrain your brain’s interpretation of and response to signals from your body. By interrupting the fear-pain cycle that perpetuates pain, we can create new patterns that support symptom reduction and relief.
What Will We Do?
Pain reprocessing work is highly individualized and will support you to:
Learn about neuroplastic pain and recovery (neuroscience is fun!)
Gather and reinforce personalized evidence that your pain is neuroplastic or has neuroplastic elements
Learn and practice tools for responding differently to pain
Increase nervous system regulation
Address pain triggers, including emotional and social/environmental threats
Identify and implement tools for self-care
Reintroduce and begin new activities to live life the way you envision
Create a relapse prevention plan
Our brains are neuroplastic and capable of change, but healing involves daily personal practice. I’ll be here to support you along the way.
Pain Reprocessing May Be Helpful If...
You’ve been told that your pain is medically unexplained
Your pain from an acute injury has not resolved in the typically expected timeframe
Your pain began without any physical event
Your pain moves around your body
Your pain levels are inconsistent throughout the day
Your pain is triggered by specific activities or conditions (e.g. stress, work, sitting in the car)
Imaging reveals “normative” findings, including degenerative disc disease or bulging discs (these are frequently found in people without pain)
Note: Neuroplastic pain has many names, including: primary pain, nociplastic pain, psychophysiologic disorder (PPD), neural circuit disorder, tension myositis syndrome (TMS), mindbody syndrome (MBS), and central sensitization. If you’ve been diagnosed with any of these, pain reprocessing may help your recovery.
The Science of Chronic Pain Treatment
Breakthroughs in pain science are transforming how we understand and treat chronic pain. Recent studies have shown that some forms of chronic pain are often not due to structural causes, but rather are psychophysiologic processes that can be reversed (see references 1, 2, and 3).
An NIH-funded 2021 randomized clinical trial of pain reprocessing therapy (Ashar et al.) (4) was the first evidence-based study proving the efficacy of PRT. 98% of participants in the PRT group improved, and 66% were either pain-free or nearly pain-free after four weeks of PRT, compared to only 20% of participants in the placebo group and 10% of participants in the usual care group. PRT patients reported a significant reduction in fear and catastrophizing and 52% remained pain-free or nearly pain-free at a one-year follow-up. The average duration of participants’ pain was 10 years.
Eight recent brain-focused studies of pain treatment (5) have shown that emotional awareness and expression therapy (EAET) may reduce pain levels in patients with fibromyalgia, chronic pelvic pain, and medically unexplained symptoms. Notably, the largest trial found superiority of EAET over cognitive-behavioral therapy for fibromyalgia.
1. Castro WH, Meyer SJ, Becke ME, Nentwig CG, Hein MF, Ercan BI et al. (2011). No stress – no whiplash? Prevalence of ‘whiplash’ symptoms following exposure to a placebo rear-end collision. International Journal of Legal Medicine, 114, 316-22.
2. Bigos SJ, Battié MC, Fisher LD et al. (1991) A prospective study of work perceptions and psychosocial factors affecting the report of back injury. Spine, 16(1),1-6.
3. Baliki MN, Petre B, Torbey S, Herrmann KM et al. (2012). Corticostriatal functional connectivity predicts transition to chronic back pain. Natture Neuroscience 15, 1117-1119.
4. Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D. (2022). Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA psychiatry, 79(1), 13–23. https://doi.org/10.1001/jamapsychiatry.2021.2669
5. Lumley, M. A., & Schubiner, H. (2019). Emotional Awareness and Expression Therapy for Chronic Pain: Rationale, Principles and Techniques, Evidence, and Critical Review. Current rheumatology reports, 21(7), 30. https://doi.org/10.1007/s11926-019-0829-6
“We saw large and long-lasting reductions in pain, so big that we created a category that hasn’t been used much in the research before: ‘pain-free or nearly pain-free.’”