Understanding Pain Reprocessing Therapy
In the past decade or so, there have been significant discoveries in the field of neuroscience in regard to the brain’s experience of pain, especially chronic pain. Through this research, we’ve been able to fine-tune our radar for identifying which regions of the brain are responsible for interpreting pain, we’ve gathered new information on how our emotional states and daily habits influence our perception of pain, and we’ve unlocked significant findings related to how the brain has the power to *generate* pain in the absence of physical injuries. Brain-generated pain is better known as “neuroplastic pain,” and this concept is at the core of a new therapeutic approach called Pain Reprocessing Therapy.
Developed by Alan Gordon and his team at the Pain Reprocessing Therapy Center in Denver, Colorado, PRT serves to address chronic pain by shifting the way our brain perceives and responds to pain. PRT is rooted in the understanding that most chronic pain experiences have both psychological and emotional components, and overtime, the pain becomes (largely) a “learned” experience. Meaning, the brain develops a habit of hypervigilance and becomes familiar with remaining in a state of high alert, even in the absence of injury or after the body has healed. And when the brain is on high alert, it is more likely to misinterpret safe signals in the body as dangerous. As you can imagine, this creates *quite* the feedback loop, which PRT names the “fear-pain cycle.”
This may be a helpful analogy for better understanding the foundation of PRT: Imagine your brain’s threat detection system as a TSA agent at the airport. If you have a predisposition for, or developed a nervous system with a high alert default, your brain has become an exhausted (and potentially delusional) TSA agent. The agent is always on the lookout for reasons to be fearful, struggling to trust the metal detector and mechanisms designed to accurately identify threats, and they tend to take matters into their own hands by rejecting clearance all together, even if the evidence suggests there is no danger. This is exactly what a high alert brain does as it receives information about sensations within the body. The PRT approach would suggest that we compassionately recognize that this TSA agent is trying their best to keep us safe, while also acknowledging this high alert state may be doing more harm than good unintentionally. Providing our TSA agents updated safety manuals and adequate rest can make all the difference in the airport running smoothly.
With the evidence that supports (most) chronic pain having some degree of “learned pain” or “brain-generated pain,” PRT emphasizes the goal of aiding people with “retraining” their brain to more accurately identify pain triggers and responses. By increasing overall sensations of safety within the body, the brain can turn down the volume dial on it’s experiences and begin to trust that it no longer needs to stay in a state of high alert. Reprocessing how we interpret and respond to pain can reduce, or even eliminate, our experiences of chronic pain.
The main components of PRT include:
Psychoeducation: Learning about the mind-body connection and how psychological factors can influence perceived physical sensations sets the foundation for understanding neuroplastic, or brain-generated pain. Building this knowledge base gives us the clarity to identify the experience of pain as an intersection between physical sensations and emotional states. Much of the early sessions of PRT include sifting through research on the “fear-pain cycle” and the prevalence of neuroplastic pain (which, spoiler, is quite overwhelming!).
Emotional Awareness: In PRT sessions, you would be encouraged to gently explore your emotions associated with your experiences of chronic pain, particularly those that may have been suppressed, resisted, or ignored. This intentional practice supports us with learning to identify patterns that contribute to our experiences of pain (ex. Noticing increased back pain after a stressful commute).
Somatic Tracking: This mindfulness technique is the backbone of PRT! Somatic tracking involves focusing on physical sensations in the body associated while simultaneously tending to the emotions tethered to those sensations. Overtime, this practice fosters confidence as we learn to curiously approach sensations within our bodies without judgment, and thus, with reduced fear. Somatic tracking is a compassionate approach used to collect a bank of “corrective experiences” using intentionally guided exposure.
Re-defining Pain: Through a blend of additional mindfulness techniques, guided imagery, and cognitive restructuring, PRT provides the space for individuals to re-write their pain narratives. Fear and anxiety are eventually replaced with, or can exist alongside, compassion, understanding, and acceptance.
Continued Practice: Especially for those with a history of neuroplastic pain, it is important to continue cultivating mind-body awareness and practicing somatic tracking. Finding ways to integrate these insights, skills, and strategies into daily living promotes sustainable change and increased confidence.
PRT is an effective treatment model for many with chronic pain, but perhaps most beneficial for those grappling with the emotional roots of their pain experiences. PRT is as much a tool to provide physical relief as it is a tool to provide emotional relief. As we begin to unravel our pain narratives, we are given the opportunity to compassionately shed layers of fear, hurt, and grief as we make room for a more expansive story.
**Although PRT was developed by a clinical therapist and most certainly is suited best for this practice setting, providers across disciplines, and across the globe are becoming certified in this treatment approach due to it’s groundbreaking discoveries on pain experiences. See (website) for more information and explore the directory of providers who have received certification in PRT.**
More information:
Click here for a list of additional learning resources on the official PRT website.
Click here for Alan Gordon’s book, “The Way Out.”
Click here for PRT podcast link.
Click here to explore a PRT accredited app called “Curable”
Read this article to learn more about PRT.
