Pain Reprocessing Therapy – Retraining the Brain for Chronic Pain Recovery

I found myself wondering recently: who watched Dr Rangan Chatterjee on Channel 4 – The Drug-Free Doctor?

In the programme, he explored three very common conditions I see every week in my GP surgery: diabetes, depression and chronic pain. What stood out was how powerfully lifestyle factors and mind–body approaches – including pain reprocessing therapy – helped people recover, often without relying on medication alone.

It was encouraging to see these ideas reaching a wider audience. It was also a pleasure to see Georgie Oldfield and Irralee, both senior practitioners and teachers within SIRPA (the Stress Illness Recovery Practitioners Association), sharing this work so clearly and compassionately.

What Is Pain Reprocessing Therapy?

Pain Reprocessing Therapy (PRT) is an evidence-based, neuroscience-informed treatment for chronic pain and persistent physical symptoms. Rather than focusing solely on the body, it works with the brain and nervous system, helping them to unlearn pain.

PRT forms a core part of the training taught by SIRPA, which supports health professionals to work safely with stress- and trauma-related illness using mind–body medicine.

This approach does not suggest pain is imagined.

Your pain is real.
However, in many cases, ongoing pain is not being driven by ongoing tissue damage.

How Pain Reprocessing Therapy Works in the Brain

Pain is a protective signal generated by the brain. When there is injury or disease, this system is essential. But sometimes the brain can remain stuck in survival mode, continuing to produce pain long after tissues have healed.

The brain learns through association. If pain occurs during periods of stress, fear, trauma, illness, or emotional overload, the nervous system may begin to interpret normal sensations as dangerous.

Neuroscience captures this learning process with the phrase:

Over time, these pain pathways become deeply ingrained. Pain signals are produced automatically and unconsciously, not by choice, but because the brain believes it is protecting you.

Pain Reprocessing Therapy helps by:

• Educating you about pain and the brain
• Reducing fear around symptoms
• Creating new signals of safety
• Gradually retraining pain pathways

Nervous System Dysregulation and Chronic Symptoms

A key concept in pain reprocessing therapy is nervous system dysregulation.

When the nervous system is exposed to chronic stress, trauma, or emotional pressure, it may become stuck in survival states such as:

• Fight – muscle tension, anger, anxiety
• Flight – restlessness, hypervigilance
• Freeze – shutdown, exhaustion, low mood

In these states, the body prioritises survival over healing. This can contribute to a wide range of symptoms, including:

• Chronic pain
• Persistent fatigue
• Irritable bowel syndrome (IBS)
• Interstitial cystitis and bladder pain
• Headaches and migraine
• Dizziness and other medically unexplained symptoms

These symptoms are genuine and distressing. They persist not because nothing is wrong, but because the nervous system is stuck in protection mode.

The Impact of Unexpressed Emotions, Trauma and Chronic Stress

An often overlooked factor in chronic pain is the role of unexpressed emotions.

Emotions such as anger, grief, fear, or sadness are physiological experiences. When emotions are repeatedly suppressed — often because it didn’t feel safe or acceptable to express them — they continue to activate the nervous system beneath the surface.

Alongside trauma and long-term stress, emotional suppression can:

• Keep the brain on high alert
• Reinforce pain pathways
• Maintain physical symptoms over time

Pain reprocessing therapy gently brings awareness to these emotional and nervous system patterns, helping the brain learn that it is now safe to feel, process and release.

Key Principles for Recovery with Pain Reprocessing Therapy

Recovery is not about fixing a broken body. It is about teaching the brain and nervous system that the danger has passed.

Key elements include:

• Education about pain neuroscience
• Reducing fear and threat responses
• Developing emotional awareness
• Learning to observe sensations with curiosity rather than alarm
• Supporting nervous system regulation
• Gradually returning to movement and normal life

A healthy nervous system is flexible, able to move between activation and rest. Pain reprocessing therapy restores this flexibility, allowing symptoms to ease naturally over time.

A Compassionate, Science-Based Way Forward

If you have been told “there’s nothing wrong” or “you’ll have to live with it”, pain reprocessing therapy offers a hopeful alternative.

Your symptoms make sense. Your nervous system has been trying to protect you. And with the right support, the brain can learn safety again.

To explore how pain reprocessing therapy and mind–body medicine may support your recovery from chronic pain or persistent symptoms, visit the resources on my website or get in touch to find out more.