The Approaches I Use for Chronic Pain

Pain Reprocessing Therapy (PRT)

What it is: PRT is a psychological approach grounded in pain neuroscience. It's based on research showing that chronic pain is often maintained by the brain's pain pathways, even after the body has healed. The brain has learned to read ordinary signals as dangerous. PRT helps the brain unlearn that response by teaching you to meet sensations with safety and curiosity instead of fear.

The research: In a 2022 randomized controlled trial at the University of Colorado Boulder, published in JAMA Psychiatry, people with chronic back pain received PRT, a placebo treatment, or their usual care. After four weeks of PRT, 66% were pain-free or nearly pain-free, compared with 20% on placebo and 10% on usual medical care. Most kept those gains a year later and brain scans also showed changes in the regions that process pain.

I was certified in PRT in Alan Gordon's founding training cohort in 2021, and I have trained with Howard Schubiner, MD.

Internal Family Systems (IFS)

What it is: IFS is an evidence-based model of psychotherapy built on the idea that we all have different "parts," like the part that pushes through, the perfectionist part and the self-critical part. With chronic pain, these parts can keep the nervous system on high alert, which can keep pain going. IFS helps you understand your parts and work with them, instead of fighting against them. And when you do, these parts soften and the pain softens, too.

Why I combine it with PRT: PRT teaches the brain that it's safe. IFS helps you understand why your system learned not to feel safe in the first place. I've found that together they reach what either one alone can miss.  I often say IFS and PRT are the secret handshake for healing chronic pain.

Neuroscience Education

What it is: Understanding how pain works is part of the treatment. When you learn that pain is produced by the brain/nervous system, that it can persist without ongoing damage, and that the nervous system can change, fear of the pain often dissipates. Fear is fuel for chronic pain and one of the biggest factors that keep pain going.

The research: Pain neuroscience education has been studied widely. Research shows it can reduce fear of pain and pain-related worry, and it is now a standard part of many pain treatment programs.