By Vanessa M. Blackstone, MSW, and Olivia S. Sinaiko, LPC, authors of The Pain Reprocessing Therapy Workbook
As different as our stories have been in some ways, when it comes to our lived experience with chronic pain, there is so much that the two of us have in common. It wasn’t that long ago that each of us was stuck in our own version of the chronic pain cycle. Since adolescence, Vanessa experienced a range of chronic symptoms, including vestibular migraines, neck pain, IBS, pelvic floor pain, and chronic hives. Navigating these symptoms required a near-constant balancing act that shaped her life in countless ways. Olivia had debilitating migraines for as long as she could remember, and since her late teens had experienced recurring low back pain that was at times severe enough to prevent her from sitting in a chair for more than a few minutes at a time. Each of us had spent much of our lives either in pain, or doing everything we could to avoid it.
As far as we knew, our pain had nothing to do with our brains—rather, our symptoms resulted from posture, hormones, spinal abnormalities, environmental factors, and food sensitivities. Sure, pain did sometimes seem to flare up when we were stressed, but we also experienced pain during times of relative ease and joy. And when it came to caring for our brains, we already had our bases covered: we each had long-standing mindfulness practices, and had experienced such profound healing in therapy that we had gone on to become therapists ourselves. We had one set of brain-based skills and supports that we turned to for psychological pain—meditation, therapy, and our connections with loved ones. And, we had an entirely different set of body-based tools that we relied on for chronic pain—medication, stretching, massage, diet, ice packs, heating pads, and the near-constant effort to avoid our triggers. For each of us, it was hard to see how our brains could be at the root of pain that felt so severe and persistent. This gap in understanding left us feeling isolated at times, but also even more desperate for real solutions.
At various points along the way, well-intended people had suggested that our chronic pain might have a psychological component. At best, these comments felt unhelpful. At worst, we felt like we were being blamed for our own pain, like the “realness” of our pain was being called into question, or most often, a crushing combination of the two. One time, upon learning that Olivia had migraines, a well-meaning pain psychologist asked her if she was a perfectionist. When she replied that she was, he simply said: “You need to stop that.” Olivia felt both confused and frustrated. She couldn’t deny that she had perfectionist tendencies, but what did that have to do with her migraines? Was he implying that her headaches were somehow her fault? And even if there was a connection between her perfectionism and her pain, without a wholesale personality transplant, she didn’t see how she could just “stop that.”
If you have chronic pain, you likely share some of this lived experience, too. You may have noticed the way that your own chronic pain has encroached over time, taking up more and more of your attention until at some point it became the main focus. You’ve likely worked hard to identify your triggers, and worked even harder to avoid them. And you, too, have probably tried to address your pain in a variety of ways—and while some of what you’ve tried might have helped, most of it hasn’t. Perhaps most upsetting, at some point, you’ve likely been given the message that your pain is all in your head, or that you are somehow to blame. You may feel hopeless, helpless, or both. Trust us when we say we know the feeling.
Gratefully, each of us eventually found our way to pain reprocessing therapy (PRT), an evidence-based method of retraining the brain to accurately interpret sensory signals from the body. For both of us, PRT offered a kind of healing we hadn’t known was possible.
As it turned out, our pain did have a whole lot to do with our brains after all. We came to understand that while we weren’t to blame for the pain we experienced, we did have the power to transform it. Developed by therapist Alan Gordon, and informed by his own recovery from chronic pain, PRT offers a unique combination of neuroscience education and experiential techniques that over time interrupt the chronic pain cycle, leading to lasting relief. As each of us grew more established in our own recoveries, we began to offer PRT to clients, guided in part by the insights that we had gained from our own healing.
In the years since, we have learned so much more both with and from our clients about chronic pain and how to overcome various roadblocks to healing. For Vanessa, it is especially meaningful to work with clients who feel they are “too complex” to be helped. Seeing someone achieve a happier, more fulfilled life after feeling convinced that their current state was the best they could hope for has been a powerful reminder of what’s possible through this work. We understand how difficult it can be to trust a new approach, especially when pain has become such a familiar pattern—one you’ve worked tirelessly to fix, resolve, or address your symptoms, often investing hope only to feel disappointed. Yet even small steps in understanding and reprocessing pain can make a profound difference.
Today, we feel grateful to have the opportunity to share what we’ve learned in a new way. We have written The Pain Reprocessing Therapy Workbook to help others navigate the same transformative journey that we and so many others have gone through. By combining the basics of pain neuroscience with deliberately structured self-guided exercises, our book gives you the resources that you need to heal, one step at a time.
Vanessa M. Blackstone, MSW, citizen of the Eastern Band of Cherokee Indians, is executive director of the Pain Psychology Center.
Olivia S. Sinaiko, LPC, leads the behavioral health pain program at the Southeast Alaska Regional Health Consortium (SEARHC).
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