How does chronic pain psychotherapy work?

Pain is a danger signal. If you put your hand on a hot stove, signals of pain tell you to move your hand away in order to prevent further injury. But, not all pain comes from a physical cause. When our nervous systems are stressed, our brains are on high-alert, scanning for danger. This means that our brains may interpret safe signals as dangerous, leading to pain in the absence of a structural cause. Pain psychotherapy utilizes techniques that help your brain and nervous system relearn safety through nervous system regulation, processing of trauma, safely feeling and expressing emotions, and trusting safe physical sensations in your body.

Pain is not “all in your head.” It is a real, complex mind–body experience shaped by your nervous system, past experiences, stress levels, environment, and the meanings you associate with pain.

When pain becomes chronic, the nervous system can become sensitized, staying in a heightened state of protection. This can amplify the pain signal, increase tension, and trigger fear-based patterns that make symptoms harder to manage.

Psychotherapy helps by:

1. Calming and retraining the nervous system

Through somatic practices, breathwork, grounding techniques, and nervous-system regulation, you learn to shift out of the body’s constant alarm response. Over time, this reduces pain intensity, improves sleep, and lowers baseline stress.

2. Reducing fear, catastrophizing, and emotional reactivity

Thought patterns like “this pain will never end” or “something must be seriously wrong” activate the brain’s danger systems. Counselling uses evidence-based approaches—such as ACT, CBT, and pain-reprocessing principles—to reduce fear and increase confidence.

3. Addressing trauma, stress, and unprocessed experiences

For many people, chronic pain and trauma are interconnected. Somatic therapy helps release stored tension, resolve unresolved stress responses, and build safety in the body.

4. Rebuilding daily functioning and resilience

Counselling supports pacing, boundaries, values-based planning, and energy management so you can participate more fully in life—without pushing yourself into flare-ups.

5. Supporting identity, grief, and life changes

Pain can change how you see yourself. Therapy provides space to process the emotional impact of limitations, loss, fear, and uncertainty.

Taking a biopsychosocial approach, we utilize trauma-informed, evidence-based techniques such as Pain Reprocessing Therapy (PRT), Emotional-Awareness and Expression Therapy (EAET), and internal family systems (IFS).

Learn more in our blog post “How Pain Reprocessing Therapy (PRT) is Used in Psychotherapy to Treat Chronic Pain”, or book a free 15-minute consultation with Liz to discuss your symptoms.

Who is pain psychotherapy for?

When we experience acute pain, symptoms generally last for around 3 months or less before resolving. When pain continues past 3 months, it is considered chronic. This pain has gone by many names, such as neuroplastic pain, TMS, mind-body symptoms, or psychosomatic pain.

This counselling approach is a good fit if you:

• Live with chronic pain lasting 3 months or more

• Experience pain that is unexplained or persists after medical treatment

• Feel stuck in cycles of tension, fatigue, or flare-ups

• Experience stress, anxiety, depression, or trauma connected to pain

• Want a mind–body and somatic approach

• Are looking for online therapy across BC that meets you where you are

• Want a collaborative, compassionate space focused on your lived experience

Conditions I commonly support include:

• Back, neck, jaw, and shoulder pain

• Headaches and migraines

• Pelvic pain

• Fibromyalgia

• Chronic tension

• Pain after injury

• Complex pain presentations where medical options have been exhausted

How do I know if my pain is neuroplastic?

There are key diagnostic indicators we look for when assessing for neuroplastic pain. To learn a more in-depth explanation of the diagnostic criteria, read our blog post “Understanding the Diagnostic Criteria for Neuroplastic Pain”.

1. Symptoms begin without injury (even if symptoms began with an injury, primary chronic pain may continue after the injury has structurally healed);

2. Symptoms arise during stressful periods;

3. Inconsistent symptoms;

4. Lack of structural explanation;

5. Non-physical triggers;

6. Childhood adversity;

7. Personality traits such as perfectionism, high conscientiousness, people-pleasing, anxiety proneness;

8. Co-occuring mental health conditions;

9. Family history of chronic pain.