Pain Reprocessing Therapy is a research-backed method of treating chronic pain, specifically neuroplastic pain (read my post on neuroplastic pain to learn more). Because neuroplastic pain is caused by a misinterpretation of the brain, it is treated by rewiring the neural circuits of the brain.
This process is not a quick fix or a miracle drug. The beautiful thing is that there are no side-effects but it does mean that you have to put in the work of rewiring the brain.
Now how does that work? How do you rewire the brain?
For some this is easy. In Dr. Sarno’s book, “Healing Back Pain: The Mind-body Connection”, he talks about how some people were cured of chronic pain simply by reading his book. They merely needed to know that their condition is due to neuroplastic pain and that there really was nothing wrong with their body.
For others, it is more difficult. This is where the majority of people fit in. Especially if the pain has lasted for years or decades, it will take time to essentially “unlearn” the pain.
Pain Reprocessing Therapy
Pain Reprocessing therapy (PRT), a term coined by the Pain Psychology Center, has built upon the work of Dr. Sarno by creating effective methods of rewiring the brain. These methods were tested during the Boulder Back Pain Study. As a result of the study, 66% of the participants who were assigned to the PRT group were pain-free or nearly pain-free and 98% had some reduction in pain. After a year the results still held. Which is incredible when you think about how these people had pain for years, and, in some cases, decades.
There are five components of PRT including:
- Education about pain science
- Attending to sensations through a lens of safety,
- Gathering personal evidence
- Addressing other emotional threats
- Gravitating toward positive sensations
PRT is different than other psychological methods of healing pain because the emphasis is on psychoeducation. An important part of healing is understanding what is causing the brain to create and perpetuate the pain. Understanding that the pain is not caused by a structural problem allows you to find “chinks in the armor” or times when the pain is not consistent with structural pain. Finding more and more evidence of neuroplastic pain helps the brain to realize that the sensations are safe.
Attending To Sensations Through a Lens of Safety
A major goal of Pain Reprocessing Therapy is decreasing the fear around the stimulus of pain. People who have chronic pain often get caught in a pain-fear cycle. For example, growing up I heard so many messages about how herniated discs in the spine create pain. I saw people close to me that had bulging or herniated discs, and their pain never seemed to go away.
When I started having back pain myself, my brain was already primed to think that this pain would not go away. Then I received the MRI results that I had two bulging discs in my spine.
That terrified me.
Looking back, as the fear surrounding the pain increased, the pain itself increased. I remember many nights not being able to sleep stuck thinking about how the pain was never going to go away. It was at this time that my pain was the worst.
I wasn’t sure if it would ever go away.
The reason this happens is that pain is a danger signal, usually signaling that there is a problem in the body but can make mistakes. When the fear around the pain increases, the pain increases. Then, when the pain increases, the fear increases creating the perfect storm to keep a person in chronic pain.
PRT uses various techniques to reframe the story around the pain and reduce fear. Examples of this include changing thoughts of fear into thoughts of safety by “talking” to the brain (essentially telling yourself that you are safe). Even just receiving a diagnosis of neuroplastic pain can decrease fear. A lot of the fear that perpetuates chronic pain is related to the fear of something physiologically wrong and when that is taken away the fear decreases.
Another effective approach to decrease the fear surrounding pain is to practice mindfulness. Mindfulness, put simply, is bringing one’s attention to the present moment.
So much of the time, especially among chronic pain sufferers, is spent ruminating about the past or anticipating a future that hasn’t happened yet. For me, I would constantly either relive events leading up to my injury or worry about activities that I might not be able to do in the future. This kept my brain in a constant state of high alert and when the brain is in high alert.
When the brain is in a state of high alert the sympathetic nervous system is activated. This is the branch of the autonomic nervous system that responds when you are in fight or flight. Evolutionarily the sympathetic nervous system takes over when you are in a stressful situation, such as running away from a bear. In a sympathetic state, blood pressure increases, heart rate increases, and stress hormones such as cortisol are released.
This is a great reaction when you need to run away from a bear but not so much when you are trying to go to sleep but you can’t seem to stop worrying.
When the brain is constantly in a sympathetic state it never gets a chance to be in the parasympathetic state–the state where the body is able to rest, digest food, repair the body and relax the mind.
Practicing mindfulness keeps the brain in the present moment. In this example, the brain would know that it is safe in bed and that there is nothing to worry about.
Gathering Personal Evidence
Along with education about chronic pain in general, it is important to have a strong conviction that your pain is neuroplastic and not caused by structural problems. This can be done by creating your own evidence sheet.
You can do this by making a list, either on a piece of paper or electronically, of evidence that your pain is neuroplastic. This can include some of the signs of neuroplastic pain or times that you have found when you don’t feel pain. For example, maybe you get back pain when sitting but you noticed that you did not feel pain when you were watching one of your favorite TV shows. That experience could go on your list.
Then you can review your list periodically when you need a reminder. Especially if you have been given a diagnosis it is important to continually reinforce the fact that the pain is neuroplastic.
The important thing, however, is not to approach this with a sense of intensity. You don’t have to write down every example that you find. The point is simply to be curious and to shift your perspective of the pain.
Addressing Other Emotional Threats
Addressing emotional threats can be done in a variety of ways. If there has been a lot of psychological traumas in the past, it may be best to meet with a therapist. If not, talking through emotions with a coach may be all that is needed. For others, journaling may be the best method. Regardless of the approach, it is important to shift the focus from the physical to the emotional.
For me, something simple that really has helped is journaling about my emotions. Early on in the process of healing, I would journal about my day through the lens of my emotions. Linking how I felt each day with my symptoms helped me to see the connection.
Leaning Into Positive Sensations
Mindfulness can also help cure chronic pain by focusing on positive sensations throughout the day. So much of the time when we are in pain that is all the brain is focused on. By focusing on positive sensations, it trains the brain to focus more on these positive feelings and less on the pain.
Positive sensations could include focusing on the sensation of the breath coming in and out, the feeling of warm water during a shower or a bath, the taste of food as you are eating, or really anything else that is enjoyable to you.
It can also include leaning into positive emotions. Noticing times when you are feeling positive, joyful, or any other emotion is important to help the brain focus more on those emotions.
Take the Next Step to Get Out of Pain
If you would like to learn more and find out if your pain could be neuroplastic schedule your free 30-minute consultation and find out if Pain Reprocessing Coaching could help heal your pain.