What Is Chronic Pain? A Mind Body Medicine Approach to Pain, Fatigue and Persistent Physical Symptoms

I recently attended a masterclass in Manchester with Dr. Howard Schubiner, a leading expert in mind body medicine and pain reprocessing therapy. It was an inspiring and deeply validating experience.

What stood out most was the growing body of research supporting this work, and the sense of being surrounded by a community who truly understand chronic pain and persistent physical symptoms from a mind-body perspective. I am very much looking forward to Dr Schubiner's new book being released later this year.

But what exactly is chronic pain?

And how does it relate to other ongoing symptoms such as fatigue, anxiety, migraine, dizziness, IBS, bladder pain, or conditions like fibromyalgia and FND?

Understanding Chronic Pain and Persistent Symptoms

In mind body medicine, pain is not simply a signal of damage in the body. Instead, pain is an output of the brain — a protective response based on the brain’s interpretation of danger.

This applies not only to chronic pain, but also to a wide range of conditions, including fatigue, anxiety, migraine, dizziness, pelvic pain, and symptoms such as:

• Irritable Bowel Syndrome
• Fibromyalgia
• Functional Neurological Disorder
• Interstitial Cystitis
• Vulvodynia
• Complex Regional Pain Syndrome

These symptoms are real, often distressing, and can have a significant impact on quality of life. But they are frequently driven by how the brain and nervous system are functioning, rather than by ongoing structural damage.

The Brain’s Alarm System

A helpful way to understand this is through a simple analogy.

Imagine a car alarm that has become too sensitive. Instead of only going off when there is a real threat, it sounds when someone simply walks past.

The alarm system is not broken — it is just set at a higher level of sensitivity.

In the same way, in chronic pain and related conditions, the brain becomes more sensitive to perceived danger. This process is known as central sensitisation.

Pain, fatigue, migraine, IBS, and other symptoms can arise when the brain is trying to protect you — even if there is no actual harm occurring in the body.

A Dysregulated Nervous System

When the brain perceives danger — whether due to chronic stress, unprocessed emotions, personality traits, or past experiences — it activates the autonomic nervous system.

This is your body’s built-in alarm system.

When working well, this system moves fluidly between states of alertness and calm. But in many people with chronic pain or persistent symptoms, the system becomes dysregulated.

Think of it like a seesaw tipped too far towards stress and protection.

When this happens, the brain may begin to misinterpret normal sensations or emotions as dangerous. To try to protect you, it sends out warning signals — which you experience as symptoms such as pain, fatigue, dizziness, digestive issues, or anxiety.

These symptoms are:

• Automatic and unconscious
• Designed to protect you
• Often linked to emotional or psychological stress
• Reversible with the right approach

Learned Neural Pathways

Over time, the brain can develop learned neural pathways — patterns that become more established the more they are repeated.

A helpful way to think about this is like a well-worn path through a field. The more you walk it, the clearer and easier it becomes to follow.

These patterns can be reinforced by:

• Fear and focus on symptoms
• Emotional tension or unexpressed feelings
• Certain personality traits, such as being highly responsible or self-critical
• Past trauma or ongoing life pressures

This helps explain why symptoms can persist even when scans and tests are normal, or when an injury has long since healed.

The Good News: The Brain Can Change

One of the most hopeful aspects of mind body medicine and pain reprocessing therapy is that the brain is plastic — it can change.

This means that chronic pain, fatigue, migraine, IBS, fibromyalgia and other persistent symptoms are often reversible.

Recovery involves gently retraining the brain and nervous system to recognise that you are safe.

This includes:

• Understanding how symptoms are created
• Reducing fear around those symptoms
• Regulating the nervous system
• Allowing and processing emotions safely
• Building new, healthier neural pathways

This is not about ignoring symptoms or “thinking positively.” It is about working with the brain in a compassionate, evidence-based way.

It is a process of unlearning danger and relearning safety.

A Compassionate Way Forward

Living with chronic pain or persistent symptoms can feel like carrying a heavy rucksack — filled with stress, past experiences, and physical discomfort.

The aim of this work is to help you gradually put that rucksack down.

With the right understanding and support, your nervous system can begin to settle. And as your brain starts to feel safe again, symptoms can reduce — and often resolve.

Frequently Asked Questions

• What is chronic pain in mind body medicine?

  Chronic pain in mind body medicine is understood as a real physical experience created by the brain and nervous system, often in response to perceived danger rather than ongoing injury or damage.

• Is pain reprocessing therapy effective for chronic pain?

  Pain reprocessing therapy helps retrain the brain to interpret sensations as safe rather than dangerous. Research shows it can significantly reduce or resolve chronic pain by addressing neural pathways and fear responses.

• Can stress cause physical symptoms like IBS, migraine or fatigue?

  Yes. Chronic stress and nervous system dysregulation can lead to symptoms such as IBS, migraine, fatigue, dizziness, and pain. These are real symptoms caused by the brain’s protective responses.

• What is central sensitisation?

  Central sensitisation is when the nervous system becomes more sensitive to signals, causing pain or symptoms even when there is no ongoing physical damage. It is common in chronic pain and persistent physical symptoms.

• Are mind body symptoms reversible?

  Yes. Because these symptoms are driven by brain and nervous system patterns, they can often be reversed by retraining the brain through approaches like pain reprocessing therapy and nervous system regulation.