Step one
Understanding the pattern
We explore how your pain behaves and whether protective learning may be involved.
Pain Reprocessing Therapy
Online therapy for chronic and persistent pain
Helping the brain relearn safety around persistent pain
Pain Reprocessing Therapy (PRT) is a psychological approach to persistent pain. Sometimes pain continues after tissues have healed because the brain and nervous system have learned to treat safe sensations as threatening.
The pain is real. PRT helps the brain relearn safety around these sensations, which may reduce protective responses and pain over time.
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The neuroscience
Rooted in pain neuroscience
PRT was developed by psychotherapist Alan Gordon and draws on pain neuroscience and neuroplasticity, the brain's ability to change through learning.
In a randomised clinical trial of 151 adults with primary chronic back pain, 66% of those receiving four weeks of PRT were pain-free or nearly pain-free after treatment, compared with 20% receiving placebo and 10% receiving usual care. Improvements were largely maintained one year later.
Understanding neuroplastic pain
Pain can become caught in a learned loop: sensations feel threatening, pain increases, and fear keeps the cycle going.
Sensation
Interpreted as danger
Pain increases
Fear and vigilance
Pain-fear cycle
a learned protective loop
Step two
Somatic tracking
You practise noticing sensations with more ease and curiosity.
Step three
Corrective experience
Experiencing sensations without the expected danger can help the brain update what it has learned.
How PRT works
PRT creates experiences that challenge the brain's expectation of danger. As safety learning grows, fear, protective responses and pain may ease.
Notice sensation
Curious attention
Less alarm
Fear and pain can decrease
Corrective experience
the brain updates its prediction
How this may look in therapy
We may use somatic tracking, noticing sensations with gentle, unhurried curiosity, much like watching a sunset or taking a relaxed walk along the beach. Rather than fighting or constantly monitoring pain, you practise relating to sensations with less intensity and more lightness. We may also notice neutral, pleasant or interesting sensations, broadening attention beyond pain.
Where relevant, we may explore stress, emotions and self-criticism. Emotions do not need to be forced or uncovered on demand. The work is gradual, with no need to push through pain or force change.
Before beginning PRT
Persistent pain should be medically evaluated
PRT is most suitable when persistent pain has been appropriately medically assessed and there is reasonable confidence that the sensations are safe. It does not replace medical investigation.
Curious whether PRT might support you?
If your persistent pain has been medically evaluated, you are welcome to get in touch to explore whether PRT might be a good fit.
Get in touch