That question is a completely fair one — and if you have been disappointed before, I don't expect you to simply take my word for it. What I will say is this: most treatments for chronic pain are designed to address the body at the tissue level — the disc, the muscle, the joint. If your pain is primarily being generated by the nervous system rather than ongoing tissue damage, those treatments will give you temporary relief at best. They are treating the symptom without addressing the mechanism. This approach works at the level of the nervous system itself — which is where persistent pain lives in most people. It is genuinely different in mechanism, not just in method. I would rather you come in skeptical and discover it works than come in hopeful and be disappointed again.

Ongoing pain itself is so frustrating, when it's combined with years of sincere effort, mounds of resources, and confusing or dismissing experiences without much or any change - it can be devastating. Many of my clients report that our work together has helped them to connect many different dots - frameworks, practices, pain science, trauma work, body awareness, emotional capacity, etc - in a way that allows something to finally click. Oftentimes people with chronic pain have been doing many of the right things, but the way they go about doing those things actually gets in the way of the results they want. Kind of like how you could ask someone for help with something in different ways and get very different responses. Depending on your attitude, body language, word choice, volume, etc - you can either signal a kind welcome request or a demanding hostile one. Each approach will influence your chances of being met with resistance or being met with cooperation. I help people to learn how to approach healing chronic pain in ways that are more likely to elicit cooperation from the nervous system, instead of adding onto the sense of pressure and danger that is already so familiar.

Neuroplastic pain (also called primary pain, Central Sensitization, or Nociplastic Pain) refers to chronic pain that persists not due to ongoing physical injury, but because the nervous system has rewired itself to maintain pain signals even after the original cause has healed. This altered neural pattern is a result of neuroplasticity—the brain’s ability to reorganize itself—which, in cases of trauma or prolonged stress, can cause the nervous system to become hypersensitive or stuck in a state of distress. These changes in the brain/nervous system are reversible.

Absolutely not. All pain is real pain. All pain is also produced with help from the brain, even the pain that occurs when you fall and scrape your knee. Your pain is very real. In the case of neuroplastic pain, it's the damage that is being mis-perceived by the brain. Just like any other system in the brain can malfunction, so can our pain system. Fortunately it can also be taught how to return to normal.

While not fool proof, this short quiz is a good place to get a sense if your pain may be neuroplastic. If you think you are dealing with pain caused by structural damage or a disease it is important to get seen by a medical professional to assess these possibilities.

Not exactly — and the framing matters here. Stress and emotions don't cause pain the way a virus causes flu. What they can do is influence the state of the nervous system, which regulates pain signals. A nervous system that has learned to be in a persistent state of threat — for any reason — generates more pain, more consistently. That learning can happen because of physical injury, emotional events, chronic pressure, or the accumulation of years of stress. It is not a character flaw or a sign of weakness. It is the nervous system doing exactly what it was designed to do — and doing it too much, for too long. The goal of this work is to give the nervous system new information, so it can update that response and ease out of the pain cycle.

You do not have to be at rock bottom to deserve help. That belief — that you need to be suffering enough to justify care — is itself often part of the pattern that keeps people in pain. The threshold for seeking support is entirely yours to set. If your pain is affecting your quality of life, your relationships, your sleep, your work, or your sense of yourself, that is enough. You do not need to prove the severity of your suffering to anyone, including yourself. In a free initial call, I will simply listen and ask some questions to help you decide together whether this feels like the right fit. There is no obligation.

Pain Reprocessing Therapy has been studied in a randomized controlled trial published in JAMA Psychiatry in 2022, led by Dr. Yoni Ashar and colleagues at the University of Colorado. In that study, 66% of participants who received PRT reported being pain-free or nearly pain-free at the end of treatment, compared to 20% in the placebo group and 10% in the usual care group. 98% of participants who received PRT reported improvement in their pain. Those gains were also largely maintained at one-year follow-up. The approach is grounded in decades of pain neuroscience research, including work on central sensitization, neuroplasticity, and the predictive processing model of pain. I am happy to share specific research with you or to talk through how the evidence applies to your particular situation.

Due to the unique features of each individual and their pain and brain, there is not a one-size-fits-all answer to this question. That being said, in the Boulder Back Pain Study 98% of people saw improvements and 66% of people were pain free or nearly pain free after 4 weeks (2 sessions per week). Many people begin to understand their pain differently within the first session or two and find meaningful change within 6-12 sessions. Significant trauma history or multiple diagnosis can change this number.

We go at your pace — always. PRT does involve paying attention to emotions, because the emotional state of the nervous system is relevant to pain. Some clients find that emotional material becomes relevant naturally as the work unfolds; others focus primarily on the sensory and cognitive aspects of their pain experience and make significant progress that way. I will never push you into territory you are not ready for. What feels safe to you is what we work with — and that tends to expand over time, as trust develops.

PRT and related nervous system approaches to chronic pain are relatively new to the clinical landscape, and insurance systems are slow to recognize emerging evidence-based treatments. Most insurance-covered pain treatment is still organized around the structural model — physical therapy for tissue, medication for symptoms, surgery for anatomy. The out-of-pocket cost of this work is real, and I won't pretend otherwise. What I can say is that for people who have spent years on treatments that haven't held — appointments, prescriptions, procedures — the cumulative cost of those approaches often substantially exceeds the investment in this one. I also offer a free initial call so you can decide whether it's the right fit before committing to anything.