Pain Reprocessing Therapy, Part 3: Leaning Into Positive Sensations

In Part One, we looked at what neuroplastic pain actually is — pain generated by learned brain circuits rather than ongoing tissue damage. In Part Two, we went deeper into somatic tracking: watching pain sensations with curiosity, catching the fear-story that rides along with them, and doing a quick "what's not there" check to notice the calm parts of the body alongside the loud ones.

Part Three picks up that last thread and gives it a name. In Alan Gordon's own model, "leaning into positive sensations" is listed as one of the core PRT practices, described as learning to relate to your body with a newfound sense of ease. It isn't a footnote to somatic tracking — it's treated as its own skill, deserving its own practice time.

Why the Brain Needs This, Not Just "Positive Thinking
"It's worth being precise about what this is not. This isn't affirmations, and it isn't willing yourself to feel good. The clinical description of the PRT protocol used in the 2022 JAMA Psychiatry trial lists five components, and the last one is described plainly as inducing positive affect during periods of low pain. That's a specific mechanism, not a mood board.
The logic follows directly from the prediction model of pain we covered in Part Two. If chronic pain is partly the brain's prediction that the body is under threat, then a body that only ever gets attention when it hurts is a body the brain has very little "safe" data on. Every minute spent noticing ease, warmth, or comfort is a data point in the other direction — evidence the brain uses to revise its prediction downward over time.

What the Practice Actually Looks Like
This builds directly on the "what's not there" check from Part Two, just given more room to breathe:

• Find a genuinely comfortable sensation. Not the absence of pain — an actual pleasant one. Warm water on your hands. Sun on your arm. The relief of sitting down after standing. Sinking into a soft chair.
• Stay with it longer than feels natural. A few seconds of noticing comfort, then moving on, doesn't do much. The idea echoed across PRT-adjacent teaching is to slow down and really let the sensation register — the same way you'd linger on somatic tracking rather than rush through it.
• Let your body language match it. Relax your shoulders, soften your face, let your posture reflect ease rather than bracing. The nervous system reads posture as information, the same way it reads sensation.
• Repeat it often, in small doses. As with somatic tracking, this is a "windows, not marathons" skill — a few seconds of noticing your coffee mug's warmth or a comfortable exhale, several times a day, builds the pattern faster than one long session.

If your first reaction is "this feels silly" or "how is this supposed to help with real pain" — that reaction is worth naming and setting aside gently, the same way we handled the flinch in Part Two. Skepticism isn't a sign you're doing it wrong.

Resources to Keep You Going
Book: The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain by Alan Gordon and Alon Ziv (Avery, 2021) — the primary source for this exercise, in Gordon's own words.
Study: Ashar YK, Gordon A, Schubiner H, et al. "Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial." JAMA Psychiatry, 2022. — jamanetwork.com
Website: painreprocessingtherapy.com — official PRT resource site, where "Leaning Into Positive Sensations" is listed as a named component of the approach.
Podcast: Tell Me About Your Pain, hosted by Alan Gordon — available on Spotify and wherever you listen to podcasts.
Ready to work through this with support instead of alone? Reach out to Debra for one-on-one Pain Reprocessing Therapy.
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