What is Pain Reprocessing Therapy? How Can it Help Me Heal?

Tanner Murtagh, MSW, RSW & Alex Klassen, MSW, RSW

Tanner’s Story:

For 3.5 years I experienced widespread chronic pain that spread and worsened over time.

In an attempt to reduce my chronic pain, I did what most people do.  I underwent examination with several physicians, MRIs and x-rays, physiotherapy, chiropractic work, tried pain medication, and explored several other physical treatments. However, all these physical tests and treatments did not resolve my pain. In fact, my pain worsened.

My story sounds like many stories we hear. “The medical system has failed me. I can’t figure out what’s wrong. No treatment is helping.”

Unfortunately, medical procedures typically have poor results when it comes to reducing or eliminating chronic pain and symptoms.  Surgery, injections, or narcotic pain medications are not significantly more effective than placebo treatments or conservative treatments¹.

So, what is the solution to healing chronic pain and symptoms?

The answer lies in the brain

Chronic pain, fatigue, dizziness, or other physical symptoms are often neuroplastic, meaning they are caused by changes in brain that amplify and generate symptoms in the absence of structural problems^2,3.

When our brain and nervous system feel in emotional danger, chronic pain or symptoms can be triggered and perpetuated^2,3. Over time, through repetition, the brain gets better at generating pain/symptoms. Essentially, your brain learns to produce pain/symptoms to (over)protect you. To heal, it is vital to understand the science; a significant portion of chronic pain and symptoms are neuroplastic⁴.

After 3.5 years of pain, I came across research and education that helped me better understand my symptoms. Learning about neuroplastic pain/symptoms opened a new path, where I could change my perspective and focus on retraining my brain, rather than fixing my body.  By increasing my sense of physical safety, engaging in brain retraining exercises, processing my emotions, and regulating my nervous system, I was able to fully heal. I have now been pain-free for years.

What is Pain Reprocessing Therapy?

Pain Reprocessing Therapy (PRT) is an evidence-based psychological approach focused on rewiring the brain out of chronic pain.  In a clinical trial, 66% of participants who received PRT became pain-free or nearly pain-free after 9 sessions⁵. Over 98% of participants in the study had pain reductions.

In our Somatic Safety Method course, utilize self-assessment, education, and brain retraining tools from PRT.  These evidence-based strategies are key in helping our community members heal, helping them increase their sense of safety and reduce pain/symptoms.

Creating Safer Beliefs about Your Body, Pain or Symptoms 

Insights and practices from PRT help us understand how neuroplastic pain/symptoms work, assess our own pain/symptoms, realize the body is not permanently damaged, and develop a sense of hope.  Retraining our brain to think differently about our body and symptoms, with less fear, frustration, or fixation, and more safety, leads to pain or symptoms reducing overtime².

Unfortuntately, negative thinking and nervous system dysregulation worsens pain and symptoms over time². This is why changing our thoughts and beliefs is so important. We can utilize safety messages like:

• “I know I’m ok; my brain is just misinterpreting normal sensations in my body”
• “I see how my symptoms are inconsistent, moving around, and triggered by emotions. This shows me it’s neuroplastic and my body is ok”
• “I don’t need to fear these sensations. There is nothing to fix or figure out!”
• “My muscles and tendons are healthy. My nerves and ligaments are perfectly intact. My brain is just sensitized and overprotective”
• “It’s physically safe to move this way”
• “I don’t need to like the sensations; I just need to remember they’re safe!”

Using safety messages consistently when you notice yourself having negative thoughts about your body or an activity supports your brain in rewiring².

Visualizing Yourself Healing and Moving Your Body

Visualization is another great tool PRT provides to retrain the brain. By visualizing yourself being pain or symptom free, or imagining safe engagement in an activity and movement, you can teach your brain the body is healthy and capable. Our course provides several visualization practices and guides, helping you build a practice step-by-step.

Somatic Tracking

When we feel pain and symptoms, we also typically experience fear, frustration, despair, or avoidance.  These negative emotional responses worsen our symptoms over time because they increase the level of danger and dysregulation our brain is feeling².

Somatic tracking is a skill that helps us respond to pain/symptoms differently.  We can cultivate a sense of lightness, curiosity, calmness, and compassion with what we’re feeling². By changing our emotional response to symptoms, we increase safety in our brain and nervous system, leading to a reduction of pain/symptoms over time². Our course provides an in-depth education on somatic tracking, and several practices to help you retrain your brain.

For further information and tools, sign up for free resources below!

Graded Exposure to What You Fear

When we feel chronic pain/symptoms, we start avoiding anything that could be triggering them. This can include avoidance of certain movements, positions, activities, environments, foods, sounds, or emotions. Unfortunately, when our pain/symptoms are neuroplastic, the avoidance reinforces our sense of danger, increasing pain/symptoms over time. It becomes a vicious cycle; more symptoms cause more avoidance, and more avoidance causes more symptoms. Many of our clients have been stuck in this cycle for years.

Recovery is possible because, when it comes to neuroplastic pain/symptoms, the movement or activity isn’t actually what triggers our pain or symptom! Pain/symptoms occur because our brain has learned to view the condition as dangerous². It’s trying to protect us, by mistake.

Healing involves slowly, gently, and compassionately approaching movements and conditions we fear. We know that approaching these conditions can be REALLY SCARY! This is why starting small and stacking up little wins is the best approach.  Over time, we teach the brain it’s safe, breaking the mistaken associations that have been causing pain/symptoms and holding us back from life².

Leaning into Pleasant Sensations

The brain is really good at hyper-focusing on unpleasant sensations in the body. To retrain the brain, a consistent practice of sensing and savoring more pleasant sensations can cultivate nervous system regulation and help the brain more easily gravitate to positivity in the future². These practices can look like:

• Feeling the warmth of the sun on your skin
• Tracking the pleasant sensations of breathing slowly
• Noticing loose or relaxed sensations in your body
• Attending to sights or sounds that are calming
• Enjoying a warm coffee or tea
• Using soothing touch (with your own body, or connecting with a pet or person)

Conclusion

As you can see, PRT offers many useful skills and insights to retrain the brain out of chronic pain/symptoms.  The Somatic Safety Method course combines the most effective practices from PRT, along with other evidence-based strategies from Emotional Awareness and Expression Therapy, Polyvagal Theory, Mindfulness, Qigong, and more, to help you heal.

References:

1. Deyo, R. A., Mirza, S. K., Turner, J. A., & Martin, B. I. (2009). Overtreating chronic back pain: time to back off?. Journal of the American Board of Family Medicine : JABFM, 22(1), 62–68. https://doi.org/10.3122/jabfm.2009.01.080102
2. Pain Reprocessing Therapy Center (2021). Pain reprocessing therapy training. 
3. Gordon, A., & Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Sony/ATV Music Publishing LLC.
4. Woolf C. J. (2011). Central sensitization: implications for the diagnosis and treatment of pain. Pain, 152(3 Suppl), S2–S15. https://doi.org/10.1016/j.pain.2010.09.030
5. 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