Therapy for Chronic Pain, Fatigue, & Other Physical Symptoms
Chronic physical symptoms – like pain, fatigue, itching, dizziness, or nausea – have a depleting effect. Over time, these chronic problems begin to chip away at what feels possible in life.
Diagnosis attempt after diagnosis attempt is followed by treatment attempt after treatment attempt: Physical therapy, supplements, orthotics, dietary changes, a new mattress. Often, any relief gained through these attempts vanishes sooner or later. As symptoms persist, hope dwindles.
Many people feel that the longer their chronic physical symptoms last, the more their lives narrow (and narrow, and narrow) until they’re left with just a sliver of what they want their lives to be. I realize you may no longer be able to work, exercise, socialize, relax, travel, or care for yourself or others in ways you once did.
I know what it’s like to live with chronic pain and symptoms from my own personal experience. So—setting aside my therapist hat for a moment here, wearing only my human hat—human to human, I’m really excited to share this news with you:
A new mind-body treatment for chronic pain and other chronic symptoms, called Pain Reprocessing Therapy (PRT), is effective in providing anywhere from a degree of relief to total relief from chronic physical symptoms.
Researchers have compared the effect of the treatment to other interventions like surgery or Cognitive Behavioral Therapy (previously the ‘gold standard’ in psychotherapy for chronic physical symptoms), and found higher effectiveness of treatment with PRT.
As I see it, one of the only problems with this treatment is that it sounds too good to be true, so many people don’t believe it will work and never try it. Or, they think it sounds dismissive of their experience or suggests their symptoms are actually their fault if they can be so easily, and possibly even completely, resolved with a psychotherapy treatment.
To be honest, those were among my first thoughts when I first read about PRT. I had been reading about it online, and I left the website unimpressed before I even finished reading. It sounded like a simple solution to a complex problem, so I had my doubts it could be that effective.
At some point though, information about PRT made its way back to me again. This time, as I read, the more hopeful I became, and I decided to delve deeper. A part of me was saying, “Well, if this actually works, it’s really, really important.” I know how many people suffer every single day, and I also know intimately what it’s like to feel hopelessly at war with your body.
Once I gave it a chance and read further into it, I quickly realized that PRT’s interventions are exactly the tools that had helped me overcome many of my chronic symptoms, just more neatly and effectively packaged.
I saw that PRT had concisely distilled the essential ingredients that helped me in my own journey as I engaged, over many years, in practices of meditation, yoga, exercise, physical therapy, and psychotherapy to address my struggle with chronic symptoms.
Here’s what I learned:
Findings from the past 25 years or so have shown over and over that some common perceptions of what pain is and how it works are not accurate—but this knowledge hasn’t reached the public yet, including some doctors and healthcare professionals. Many professionals do know this information, but don’t have either the time or beside manner to convey it to patients in a way that isn’t invalidating or blaming, so their patients never dive in and never benefit from it.
When the brain generates pain in response to tissue damage in the body, it’s called secondary pain because the pain is created as a result of, or secondary to, an injury. This is the kind of pain you learned about as a kid when you skinned your knee, and it’s the only kind most people are ever taught about.
Pain can also be generated in the brain when there is no structural damage at all. Further, our nervous system can get stuck, like a switch in the “on” position, continuing to generate this pain. This type of pain is called primary pain, and it is fueled by the threat-detection system and fear response of the human nervous system, which happens in the brain.
This pain is 100% real. In functional brain imaging scans, the areas of the brain that process pain are clearly being activated. There is nothing “made up” or “dramatic” going on here. But there is also no structural damage to the body prompting the brain’s generation of pain.
This changes everything about how we approach difficult-to-explain, difficult-to-treat chronic symptoms. Not only do we now know that primary symptoms exist and are real, but we know that our natural fear response perpetuates it, and how to stop it.
Side note: When I say PRT is “new”, it has been being developed, studied, and refined for two to three decades now, alongside with similar mind-body treatments such as Emotional Awareness and Expression Therapy. While that’s relatively “new” in the science world, you don’t have to worry that it’s so new it’s experimental. Mind-body research is at a wonderful stage right now, where researchers are very confident that mind-body treatments work in straightforward cases, such as lower back pain or neck pain, and have found very encouraging results in applying that solid foundation and understanding to even more complex cases, which they continue to study.
Here’s what treatment looks like:
Getting caught up on pain science
We’ll go over how pain works and evaluate your experience with your own chronic pain (or other chronic symptoms), assessing for any presence—or absence—of evidence that points to primary symptoms as the cause.
Practicing paying attention to your pain in new ways, with your new knowledge
You’ll practice relating to your pain or discomfort in a new way, both inside and outside of session. We’ll focus on reshaping your conditioned fear response to your symptoms, cutting the symptoms off at their fuel source to decrease your brain’s continued generation of primary symptoms.
Exploring your relationship to your emotions and physical clues about emotions
The mind-body connection is powerful. The mind and the body can’t be separated; it’s all one system, processing and responding to constant feedback. The mind and its contents—our thoughts, beliefs, emotions—are all generated and stored in the brain, an organ of the body. Our brain attaches to our spinal cord, which together form the central nervous system. Even though emotions are generated in the brain, connections throughout the nervous system cause humans to experience them largely as physical sensations in the body. There is actually significant overlap between the areas of the brain where we process emotional pain and physical pain (they don’t work in two separate ‘departments’).
So, getting a better understanding of how you relate to all distressing sensations you experience—whether physical pain, interpersonal conflict, sadness, anger, or shame—is essential to learning how to dial down the volume in these parts of the brain so they aren’t stuck in a highly activated state, primed to respond in overdrive to the smallest signal.
That’s Pain Reprocessing Therapy in a nutshell.
So, can PRT help you?
PRT is for treating chronic symptoms, whether those symptoms have carried on after an initial structural injury healed or it was unclear what caused them in the first place.
No matter where you feel your symptoms in your body, if doctors can’t identify a straightforward, physical cause with a corresponding medical treatment that acts directly upon that cause with success, there is a good chance the process is taking place in the brain and we can do something about it with PRT.
PRT only treats primary symptoms generated in the brain. It can’t cure secondary symptoms resulting from a structural problem. So it’s important that we talk through your chronic symptom history to gather the facts and collect any evidence that supports or debunks that what you’re dealing with are primary symptoms.
That said, the mind-body connection is present and at work in each of us, whether we have primary symptoms or secondary symptoms. This means that even if your symptoms are secondary to a structural disease, such as rheumatoid arthritis or ulcerative colitis, your brain is likely to do what brains do and, at times, fuel the existing symptoms through the nervous system’s fear response. This is why it’s often said that emotional stress impacts our physical health, and can cause diseases to “flare up.”
For this reason, though people with symptoms that are secondary to structural damage can’t experience the complete relief of symptoms that is possible for people with symptoms that are strictly primary in nature, it's still common for them to be able to experience some improvement in their symptoms with PRT.
Chronic conditions research suggests have a “primary” component—and therefore that PRT can help with—include:
Chronic back or joint pain
Chronic tendonitis
Repetitive strain injury (RSI)
Irritable bowel syndrome (IBS)
Tension headaches / Migraine headaches
Trigeminal neuralgia / Facial pain
Burning mouth syndrome
Chronic itchiness / Pruritus / Neurodermatitis
Tinnitus
Pelvic pain
Vulvodynia
Painful bladder syndrome (PBS) / Interstitial cystitis (IC)
Temporomandibular joint dysfunction (TMD)
Chronic regional pain syndrome (CRPS) / Reflex sympathetic dystrophy (RSD)
Postural orthostatic tachycardia syndrome (POTS)
Chronic fatigue syndrome (CFS) / Myalgic encephalomyelitis (ME) / Post-exertion malaise
Fibromyalgia
Long Covid
Ehler’s-Danlos syndrome, hypermobility-type (hEDS)
Chronic Lyme disease
Epstein-Barr virus (EBV)
Multiple chemical sensitivity
Mast cell activation syndrome
Brain fog
Insomnia
The most important takeaway here is that if your chronic physical symptoms are due to nervous system processes, that would be great news because these are natural, reversible, physical processes that are initiated involuntarily. It would mean your symptoms are (say it with me!) not your fault and treatable. It would mean there’s something we can do about it, together.
If you’re interested in learning more, I would love to connect and answer any questions you have. Please feel free to use the button below to schedule a consultation call so we can talk about your specific situation.