When the Alarm Keeps Ringing: Going Deeper with Pain Reprocessing Therapy pt2

In Part One, we explored the core practice of somatic tracking — that gentle, curious way of zooming in on a pain sensation, reminding your nervous system it's safe, and watching what happens when you stop fighting the signal. If you tried it even once, you may have noticed something surprising: the sensation shifted. Maybe just a little. Maybe a lot. Either way, that movement is your brain beginning to update its story.
But what happens when the alarm doesn't quiet down so easily? What happens when you sit down to practice and your mind immediately argues back — "This isn't just a false alarm. This is REAL. I've had this for years."
That's where Part Two begins.

Your Brain Is Doing Its Job — Just a Little Too Well
Here's something worth sitting with: your brain developed this pain response to protect you. It isn't malfunctioning out of spite. When chronic primary pain persists long after an injury has healed (or when no structural cause is found at all), it's often because the nervous system has learned — very efficiently — that this body part is a danger zone. The brain becomes a hypervigilant watchdog, scanning constantly for trouble.
Neuroscientist Dr. Tor Wager, whose research helped lay the foundation for Pain Reprocessing Therapy, describes this as the brain running a "prediction" about the body rather than simply reporting what's there. In other words, a big part of what you feel is the brain's expectation of pain, not just tissue-level information coming in. That's not a dismissal of your experience — it's actually the most hopeful news there is. Predictions can change.
This is the heart of neuroplasticity: the brain rewires based on new, repeated experiences. Every somatic tracking session is a new data point. Every moment you observe a sensation with curiosity instead of alarm, you are quietly, persistently teaching your nervous system something different.

The Hidden Barrier: Fear of the Feeling Itself
One of the most common — and least talked about — obstacles in this work is pain-fear. Not just fear of what pain means, but a kind of reflexive flinch away from noticing it at all. Many people living with chronic pain have spent years learning to brace, distract, push through, or mentally flee the moment a sensation rises. That makes complete sense. It was survival.
But in PRT, we gently begin to reverse that reflex. The goal isn't to white-knuckle your way through discomfort — it's to approach the sensation from a place of genuine safety and curiosity, the way you might lean in to examine an interesting cloud formation rather than brace against a storm.
If you notice resistance to the practice itself — a reluctance to "go there" — that's worth being compassionate with. It's not weakness or failure. It's simply the nervous system doing what it's always done. You can even name it: "There's the flinch. Hello, flinch. I see you." That small act of acknowledgment, without judgment, is itself a form of re-appraisal.

Expanding the Practice: Three Ways to Go Deeper
Once the basic three-step somatic tracking feels familiar, here are some ways to enrich it:
1. Add the "What's Not There" check. After labeling what you do feel, gently scan for what's comfortable or neutral in your body right now. A relaxed jaw. Soft hands. The weight of your feet on the floor. The brain tends to spotlight threat and ignore safety — this exercise retrains that spotlight. Relief doesn't always begin with changing the pain; it often begins with expanding what you're paying attention to.
2. Notice the story that arrives with the sensation. Pain rarely shows up alone. It brings a narrative: "This means I'm getting worse." "I'll never be normal again." "I shouldn't have done that yesterday." When you notice the story, you don't have to argue with it — just label it. "There's the fear story. There's the frustration story." Separating the raw sensation from the interpretation it carries gives your nervous system a little more breathing room.
3. Work with "windows," not marathons. Research and clinical experience both point to the same thing: short, frequent practices outperform long, infrequent ones. Think of your nervous system like a muscle you're conditioning — brief, consistent reps do more than one exhausting session. Two minutes while your coffee brews. Ninety seconds in the parking lot before an appointment. These micro-moments accumulate into real change over time.

When Progress Feels Invisible
Healing from chronic pain is rarely linear, and that can be discouraging. Some days the sensation is quieter; others it seems louder than ever. This is normal — and it's actually part of the process. As the nervous system begins to reorganize, fluctuation is expected. The goal isn't to graph a steady decline on a pain chart. The goal is to change your relationship with the sensation — to move from terror to tolerance to, eventually, indifference.
One of the most encouraging signs of progress isn't "no pain today." It's noticing that you responded differently. You paused instead of spiraling. You stayed curious for even thirty seconds. You caught the story before it carried you away. These are the real milestones.

Resources to Keep You Going
Book: The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain by Alan Gordon & Alon Ziv (Penguin Random House, 2021). If you haven't read this yet, it's the most accessible, science-backed introduction to PRT available — written by the therapist who developed the approach. Available at PenguinRandomhouse.com.
Article: Ashar YK et al., "Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain" — JAMA Psychiatry, 2022. This is the landmark clinical trial showing that two-thirds of participants became pain-free or nearly pain-free after a short PRT program. Worth reading even just the abstract if research isn't usually your thing. (JAMA Network)
Podcast: Tell Me About Your Pain by Curable Health. A warm, practical, and deeply validating podcast hosted by Alan Gordon himself. A good next episode after the somatic tracking introduction from Part One: "Why Does Pain Linger?" — it walks through the brain-based pain model in a way that feels like a conversation, not a lecture. Available on Spotify and wherever you listen to podcasts.

The Bigger Picture
What PRT is really offering isn't just a technique — it's a fundamentally different way of relating to your body. Instead of treating it as an unreliable source of threat, you begin to approach it as a communication system that can be gently updated. One that responded to experience in the first place, and can respond again.
That shift doesn't happen in a single session. It happens in the accumulation of small moments where you chose curiosity over alarm, presence over avoidance, and self-compassion over self-criticism.
You are not broken. Your brain learned something that made sense at the time. And it can learn something new.

Ready to take this deeper with personalized support? Reach out to Debra for one-on-one healing from chronic pain with Pain Reprocessing Therapy.


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