AT PAIN PSYCHOTHERAPY CANADA WE SPECIALIZE IN TREATING CHRONIC PAIN AND SYMPTOMS

Studies have shown that chronic pain and symptoms such as back pain, fibromyalgia, pelvic pain, neck pain, migraines, headaches, IBS, fatigue, dizziness, and tinnitus are often not structurally caused, but occur in the brain due to learned neural pathways^1,2. At Pain Psychotherapy Canada, we specialize in treatment approaches that help our clients heal these brain and nervous system issues.

For example, a recent study completed in Boulder, Colorado found the majority of participants with chronic back pain, who received Pain Reprocessing Therapy, were pain free or nearly pain free one year later². Furthermore, somatic (body-focused) therapies are shown to reduce pain symptoms³.

Over the years, non-structural chronic pain and symptoms have gone by many names, including Tension Myoneural Syndrome (TMS), Mind-Body Syndrome, Psychophysiologic Disorder, Psychosomatic Pain, Somatic Pain, Somatoform Disorder, Somatic Symptom Disorder, Nociplastic Pain and Neuroplastic Pain. While people diagnosed with these conditions may feel invalidated, studies show us pain with no structural/physical cause is real and occurs in the brain^1,4.

“Pain is a danger signal”^5,6. It’s job is to protect you. However, our pain systems can become over-protective, activating pain in the absence of structural problems, or persisting after an injury has healed. The brain misinterprets safe signals from the body as painful due to learned beliefs about the body, emotions, and the state of our nervous system⁶. When this miscommunication occurs, it is known as neuroplastic pain or mind-body concerns. With appropriate treatment it can be reversed.

A helpful analogy is to think about neuroplastic pain like an over-protective guard dog. A knock at the door may be a friendly visitor, but the reactive dog becomes too alarmed and starts barking. Research shows us that when the brain receives signals from the body, “cognitive and emotional factors have a critically important influence on pain perception”⁷, meaning an over-protective brain can generate too much pain. Our job is to help you retrain the pain system in your brain, so it becomes less reactive and pain-generating.

A question that we commonly hear is: Why does our brain react this way to safe physical sensations?

To help our clients reduce or eliminate pain, our treatment model focusing on increasing the sense of safety in the brain and nervous system. This involves changing unhelpful beliefs, increasing your sense of safety with physical sensations and emotions, regulating your nervous system, processing trauma, improving social and environmental safety, and gradually getting back to activities.

1. Changing Thoughts and Beliefs

   Gathering evidence for physical safety:

   Most often, our work begins with an assessment for neuroplastic pain. We engage in a detailed assessment, where we look for evidence that a client’s pain is not behaving in ways consistent with a structural injury or disease. Gathering evidence your pain is neuroplastic is a very important step toward changing your beliefs about your pain, increasing safety in your body, and shifting your reaction to sensations^2,6.

   Developing safer thinking patterns and beliefs

   Chronic pain invites the mind to think negatively. Many of our clients experience fixation on their symptoms, negative views about their bodies, worry about the future, fear of activities that may cause pain, self-judgment, and spend a lot of time trying to diagnose or find a cure. We help our clients shift toward more helpful, hopeful, compassionate, and empowered thinking habits that increase their safety and reduce pain.





2. Retraining the Brain through Gradual Exposure

   Practicing safer responses to physical sensations

   Strategies from Pain Reprocessing Therapy help “retrain the brain to respond to sensations from the body properly, and subsequently break the cycle of chronic pain”⁶. Somatic tracking is one of the primary techniques utilized in Pain Reprocessing Therapy, which can be understood as a form of exposure that utilizes three aspects: mindfulness, safety reappraisal, and positive affect induction^5,6. The aim of somatic tracking is to help clients facilitate corrective experiences, where they feel safe with sensations occurring in their body. This heals the communication between mind and body, reducing pain over time.

   Understanding conditioned responses

   Research on brain activity shows us how, unlike new or acute injuries, chronic pain involves the activation of our memory systems⁹. Pain is a protector, and our brains make associations between pain and the activity/condition that was happening when it flared up⁶. This means the next time you engage in a similar activity or condition (examples can include movements, foods, weather, noises, crowded places, etc.) our brain may become over-protective and generate more pain. By gathering evidence of physical safety and education on how the pain system works, our clients often realize their brain is being over-protective in many conditions that are physically safe.

   Reducing fear-based avoidance

   The principles of exposure therapy are important in our approach. As our clients gain confidence in their safety, we help them reduce avoidance behaviours and gently expand their movement and activity. Through gradual exposure, our brains gain new evidence for safety by witnessing us engaging in tasks that used to feel dangerous or impossible⁶. When the brain realizes it no longer needs to protect us, fear and pain sensations go extinct⁶. This allows our clients to engage more fully in life again.





3. Processing Emotions

   Learning to feel safe with emotions

   Studies have found that similar areas of the brain are activated during both emotional pain and physical pain, and resisting or supressing difficult emotions can increase pain sensations^10,11. We help our clients learn to fully feel and allow difficult emotions their body, cultivating a sense of safety. By increasing our safety with our emotions, pain and symptoms reduce¹².

   Developing strategies that allow emotions to help and guide us

   At our clinic we utilize somatic therapies and Emotional Awareness and Expression Therapy to support clients in better approaching, understanding, and allowing emotions in their body¹². Our goal is to help our clients in becoming fully embodied beings, where the emotions and sensations they feel in their bodies become helpful signals that can guide them toward self-expression and their values.





4. Treating Trauma and Regulating the Nervous System

   Developing polyvagal skills to regulate the nervous system

   When our nervous system becomes chronically dysregulated and stuck in a fight, flight, freeze, or shutdown state, we become prone to developing chronic pain, chronic fatigue, and IBS^13,14,15,16. Factors that can contribute to nervous system dysregulation include trauma^17,18, Childhood adversity¹⁹, Chronic stress¹⁹, Burnout²⁰, Social Isolation²¹, Perfectionism²², Suppressing difficult emotions²³, Poor sleep²⁴, and premature birth^25,26. Our therapists use a Polyvagal-informed approach to support clients in developing a better relationship with their nervous system and gain skills to regulate it.

   Processing trauma

   To facilitate nervous system regulation, we help our clients process trauma, utilizing somatic experiencing, somatic attachment, Accelerated Resolution Therapy (ART), EMDR, Radical Exposure Tapping, and Prolonged Exposure Therapy. These approaches help our clients process memories and reduce the cognitive and emotional impacts of past events, leading to reduced nervous system reactivity and greater safety. A safer and more regulated nervous system experiences less chronic pain and symptoms.





5. Increasing Social Safety

   Improving Relationships

   Experiencing concerns with attachment, conflict, loneliness, boundaries and abuse can create a sense of danger in our mind and body, causing and amplify pain²⁷. We utilize systemic approaches to help our clients increase safety and improve relationships with family, intimate partners, friends, and workplaces.

   Addressing the impacts of systemic oppression

   Chronic stress from oppression of our body, sexuality, gender, racial identity, cultural differences, and/or neurodiversity can cause and amplify pain^28,29. We utilize affirming and anti-oppressive counselling approaches to help our clients develop a sense of safety within their bodies and identities, navigate oppression, and increase their social safety to improve mental health and reduce pain.

To begin your journey out of chronic pain, contact us today and schedule a free 20-minute consultation with one of our therapists!