Neuroplastic pain (MBS) is not an inescapable fate. It’s a human, normal, and common phenomenon. The pain is always 100% real and felt within the body, but its source, as mentioned, is not a structural or physical problem in the body itself.
The pain appears as the result of repeated activation of neural pathways that are learned by the brain and central nervous system, which are transmitted in a “closed circuit” to the body. The pain is fueled by a combination of factors such as psychological stress, negative emotions, and fear of the symptoms themselves.
Therefore, if you suffer from MBS, that’s actually good news! No matter how long you’ve had these symptoms, how strong they are, or where they appear within your body, the phenomenon is not dangerous; it’s reversible and there’s a way out. In this section, I will present two innovative treatment methods that have been researched and found to be effective in treating MBS:
Emotional Awareness and
Expression Therapy
Pain Reprocessing Therapy
Both of these methods address the hyperarousal of the brain and central nervous system (the brain’s danger response mechanism). However, they take a completely different approach to defusing this mechanism.
PRT mainly promotes changing the fear and danger response that is tied to the symptoms.
EAET, by contrast, focuses on reducing the fear of the emotions underlying the symptoms.
There is no single “correct” way to treat the pain.
When choosing a method, the patient’s personality traits, life circumstances, and unique needs must be considered. There are people who will only improve by changing their perception of their symptoms as not harmful or dangerous. In other cases, they will need to dive deeper and understand the connection between the symptoms and their emotions, stress, and conflicts. In both cases, since this "mess" wasn’t made in one day, I advise you to come equipped with an ample dose of patience and openness as you untangle it.
Your exit from the maze will be gradual, and there will be ups and downs until the brain’s danger response mechanism becomes “convinced” that you are safe.
Rewire the Brain! — PRT=Pain Reprocessing Therapy (Dr. Alan Gordon, Dr. Howard Schubiner)
The idea is that when we stop assigning threatening or dangerous meanings to the symptoms, the level of fear and worry connected to them will decrease and the danger response mechanism will stop being “sparked.”
In essence, we place our focus on breaking the vicious cycle connecting the fear to the pain and vice versa.
This may sound simple, but it’s not easy. This is a relearning process that takes time.
To help the danger response system calm down, we need to find a way to reach it and “persuade” it.
As a taste of PRT treatment, I will mention a few central elements of the treatment (you can read more in Dr. Alan Gordon’s book).
When you notice catastrophic or negative thoughts about the pain, just identify it as “a thought.” Try not to buy into it. Keep in mind that they are just thoughts and not facts! They are simply your mind’s way to keep you fearful. Whenever you notice them, keep sending your brain messages of safety, telling yourself: “There is nothing wrong with me, I am healthy and strong, these are just sensations. They are not important right now.” By reacting this way, you actually cut off the pain’s reinforcement.
Creating safety by adopting an attitude of “outcome independence”. This means that we stop categorizing days as “good” or ”bad” depending on the pain level. Instead we reframe the definition of success as feeling less scared and fearful towards the pain, putting no pressure on ourselves to heal.
This exercise helps us reprocess painful sensations so we stop perceiving them as dangerous. We do this by simply watching and paying attention to a physical sensation in the body without fear, judgment, or desired outcome, while reinforcing the idea that the sensation is safe.
Practicing gradually engaging with the triggers (certain places, certain physical activities that are tied to the appearance of pain or an increase in its intensity) to bring on the pain. This gives you the opportunity to encounter the symptoms with no fear, and sending the body messages of safety instead of dreading the experience. This way you can help your brain “unlearn” the connection between the trigger and symptoms/pain.
PRT is not a complex treatment, but it requires understanding and skill gained through experience. Most of the existing programs for self-treatment available online incorporate these elements into the content (see the Further Resources section). You can implement the method independently, and in order to do so, you can refer to Dr. Alan Gordon’s book, or use the Curable app, which provides a lot of material based on this method. You can also watch the free videos on YouTube created by a coach named Dan Bugliu, which show you how to apply the principles of the method. If you encounter any questions or difficulties, don’t give up; PRT is based on extensive research and it works! If you’re struggling with it, you can get help from a professional who is trained in PRT. It could be that the solution is simple, but you don’t see it yet. We all come to this journey from different starting points, and sometimes we need help to overcome an obstacle; it’s not your fault, don’t get stuck, it can happen to anyone and it’s solvable!Research on PRT: It’s important to mention that the goal of PRT is not to find effective ways to cope with pain, but to c it.
A large study conducted in 2021, known as the Boulder Study, showed that this is possible. In the study, 151 people suffering from chronic back pain were divided into 3 groups: one that underwent PRT treatment, one that received a placebo (a saline injection), and a control group (who continued routine treatments). After the treatments, more than half of the patients in the PRT group (66%) reported full recovery from the pain.
This recovery rate was much larger than in the other groups, by a significant margin (20% from the placebo group and 10% from the control group). These findings remained consistent a year after the experiment. I highly recommend downloading the audiobook version of Alan’s book (he has a very calm and pleasant voice):
Research on EAET: The method is supported by extensive research conducted in recent years. It was compared to treatments from parallel methodologies and found more effective in reducing physical pain among people suffering from MBS (patients included in the study suffered from Irritable Bowel Syndrome, fibromyalgia, pelvic pain, and musculoskeletal pain). Furthermore, it was found to be more effective in reducing pain compared to other therapeutic methods such as CBT and approaches that emphasize education about pain (ED) as well as the control group (3).
Interview with Dr Schubiner about EAET:https://podcasts.apple.com/us/podcast/emotional-awareness-expression-therapy-for-chronic/id1360477037?i=1000504816597
Nichole Sachs — JournalSpeak
What’s Involved in JournalSpeak?
JournalSpeak involves a daily writing practice where the only guideline is to give voice to what’s happening “behind the scenes” in your emotional world. Writing can help release things a person is hiding from others or even from himself; hidden and threatening feelings and things that won’t be spoken aloud. It’s an intimate conversation a person conducts with themselves that allows them to release, in a safe environment, that which they never dared to say about important events that occurred in the past, stresses, or worries in the present.The emphasis is to write with maximum honesty — from a “raw” place, without worrying about phrasing or grammar, just as emotions flow.
You can even yell or cry while you write. Just let it all out. No one is supposed to read it — not even the patient themselves. The goal is to make space for repressed parts of yourself.20 minutes after the writing is complete, the document is destroyed (tear up the paper or delete the text).Nicole recommends preparing a list of topics to write about and choosing one from that list each day. It can contain events that occurred in the past/in your childhood, central traumas, stressors from the present, and personality traits that add stress to your life (for example the tendency to please others, low self-esteem and the need to prove yourself worthy, not feeling good enough, a tendency to get hurt easily, a tendency for catastrophic thinking etc.).
The focus is on the emotions that arise and not on the story, and the goal is to allow the feeling to come up, give it space to exist, and feel it in your body with radical acceptance of whatever comes up, while transmitting messages of safety and self-compassion throughout. There is no need to do anything with the emotion that comes up — to fix it, change it, or forgive. Just be with the feelings, identify them, feel them in your body, and let them pass naturally.When you finish writing, it’s a good idea to put down your pen and calm your body and mind. For example, you can focus on the positive things happening in your life, things that evoke joy or anticipation or gratitude. We must make room for these thoughts and the positive feelings that come with them and observe them. Afterwards, you can meditate or practice guided relaxation.
A podcast episode where Nicole describes the method: https://www.curableheal
th.com/podcast/journaling-and-physical-pain
MBS pain is 100% real and felt within the body, but its source is not continued harm to the body itself, and therefore it is completely reversible and not dangerous. New, evidence-based psychotherapeutic approaches for treating MBS do not focus on finding ways to live with the pain, but rather to heal from it (reduce or even eliminate it completely).
PRT — A method focusing on decreasing the fear connected to the symptoms themselves, primarily through cognitive and behavioral techniques (somatic tracking, breaking the avoidance cycle, reducing fear through positive affirmations, etc.).
EAET — A short-term dynamic therapeutic method focusing on understanding the connection between tension, emotions, and symptoms. Its goal is to break the cycle of repression and avoidance of expressing feelings that can lead to a reduction in pain. The central techniques involve a combination of developing awareness of emotions and the ability to feel, experience, and release them in a safe way through words or through the body.
JournalSpeak is one method for independent emotional processing. Most methods for self-healing found online incorporate this technique, primarily because it’s very simple, effective, and accessible for anyone who wants to deepen their awareness of the emotions that may be involved in the appearance and perpetuation of pain.
