How to blend mindfulness with safety re-appraisal:  Pain Reprocessing Therapy in everyday language
Chronic primary pain (back pain, tension headaches, fibromyalgia, IBS and more) often lingers because the brain keeps mis-labelling normal body messages as threats—like mistaking a garden hose for a rattlesnake. Somatic tracking shows your nervous system—moment by moment—that the signal is uncomfortable but not dangerous. In a landmark clinical trial, two-thirds of participants were pain-free or nearly pain-free four weeks after a Pain Reprocessing Therapy (PRT) program that centered on this skill. (JAMA Network)

The 3-Step “Safety” Version
Time needed: 2–3 minutes, 3–5 times a day. Short & frequent exercises beat long & infrequent.
1  Get curious: Find a comfy position, breathe slowly, and zoom in on the sensation. Label its size, shape, texture, edges. For example: “Golf-ball spot, warm pulse, right of my spine.”
2  Re-appraise for safety: Remind yourself—out loud or silently—why the signal is safe. Ground your words in evidence you trust (clear scan, doctor’s check-up, everyday activities you can still do). For example: “My MRI was clean. Muscles & nerves are healthy. This is just my brain’s false alarm.”
3  Keep it light: Watch what the feeling does—shift, swell, drift—without trying to fix it. Sprinkle in humor, calming imagery or a smile to keep the mood relaxed. For example: “Look at that… it’s floating upward like a soap bubble.”
Notice variability. If the sensation moves or changes intensity, that’s live proof it isn’t stuck tissue damage—celebrate it!

Pro-Tips for Sticking Power

• Evidence first. Review any normal imaging or exams so your safety words feel true.
• Tone > words. A calm, matter-of-fact voice reassures the brain more than pep-talk volume. Let go of criticism and judgment toward self, body, pain sensations.
• Drop the goal. The point is to observe, not to “make pain leave.” Relief often follows once the alarm de-escalates.
• Use micro-sessions. Waiting in line, sitting in traffic, commercial breaks—perfect two-minute practice slots.

Hear & Practice🎧 Podcast guide – Tell Me About Your Pain episode “What Is Somatic Tracking—and How Can It Help My Pain?” offers a free, 15-minute audio you can replay anytime. (Spotify)

Want to Dive Deeper? 
Journal article Ashar YK et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain. JAMA Psychiatry, 2022. (JAMA Network)
Book Alan Gordon & Alon Ziv. The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain. Penguin Random House, 2021. (PenguinRandomhouse.com)
PodcastTell Me About Your Pain (Curable Health). Start with the episode linked above. (Spotify)

Key Takeaway: Every time you pair curious attention with a clear safety message (and a dash of light-heartedness), you teach your brain, “This hurts, but it isn’t harmful.” Do that often enough and the over-protective alarm quiets down—opening the door to real, lasting relief.

Reach out to Debra for one on one healing from chronic pain with Pain Reprocessing Therapy. 

#PainReprocessingTherapy #ChronicPainRelief #Mindfulness #SafetyReappraisal #SomaticTracking #PainScience #NervousSystemHealing #MindBodyConnection #PainManagement #PRT #ChronicPainSupport #Neuroplasticity  #DebraEngLCSW #TraumaInformedCare

Internal Family Systems (IFS), developed by Dr. Richard Schwartz, and Polyvagal Theory, introduced by Dr. Stephen Porges and applied clinically by therapists such as Alexa Rothman, offer a powerful and integrated framework for understanding trauma, self-regulation, and healing.
IFS conceptualizes the psyche as a system of "parts"—inner subpersonalities with distinct roles, emotions, and histories. Schwartz (2021) states, “All parts are welcome. They have good intentions, even if their strategies are extreme.” At the core of the system is the Self (Energy or Leadership), described as a calm, compassionate, and curious center capable of leading the internal system toward healing.
Polyvagal Theory describes how the autonomic nervous system shifts between states of safety, mobilization (sympathetic), and immobilization (dorsal vagal), each affecting one’s capacity for connection and self-regulation. Alexa Rothman (2023) notes, “Polyvagal Theory gives a physiological foundation for understanding why certain parts take over and how safety shapes internal experience.”
The intersection of these models becomes clinically potent when therapists guide clients in tracking physiological states while engaging internal parts. Protectors in IFS often correlate with sympathetic arousal—fight-or-flight states—while exiles may emerge when the system enters a dorsal vagal state, linked to numbness or collapse.
Therapists informed by both models aim to create a neuroceptive environment of safety, allowing clients to access Self-energy—an internal state of calm presence. Rothman emphasizes co-regulation and body-based awareness: “By bringing awareness to the nervous system, we can support parts in feeling seen and safe enough to unburden” (Rothman, 2023).
Integrating IFS and Polyvagal Theory supports a trauma-informed, compassionate approach to therapy that is attuned to both psychological and physiological processes. Together, these frameworks offer a more comprehensive path toward healing, self-regulation, and Self-leadership. Schedule with Debra to explore how these models can help you in your healing journey. 

References

• Schwartz, R. C. (2021). No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model. Sounds True.
• Rothman, A. (2023). "Using Polyvagal Theory to Deepen IFS Work." The One Inside Podcast with Tammy Sollenberger, April 3, 2023. https://open.spotify.com/episode/2gjbK7DLBBKc4kVPUrqcoF
• Rothman, A. (2022). "IFS and Polyvagal Theory: A Conversation with Alexa Rothman." YouTube, posted by The IFS Institute. https://www.youtube.com/watch?v=JdvFMUxXrGg
• Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W. W. Norton & Company.

#InternalFamilySystems #IFSModel #PolyvagalTheory #TraumaHealing #SelfRegulation #Neuroception #TraumaInformedTherapy #SelfLeadership #MindBodyConnection  #AlexaRothman #RichardSchwartz #StephenPorges #CompassionateTherapy #TraumaRecovery #BodyBasedTherapy #PsychotherapyTools #DebraEngLCSW

Chronic conditions—whether physical or mental—often have complex causes that go beyond just genetics. While traditional treatments typically focus on managing symptoms, there's growing evidence that combining psychotherapy with lifestyle changes could offer a more effective solution. This integrated approach could transform how we treat chronic conditions, tackling both the mind and the body.

What is Epigenetics?
Epigenetics studies how environmental factors, such as stress, diet, and lifestyle, can affect the way our genes are expressed. Unlike genetic mutations, which change the DNA sequence itself, epigenetic changes influence how genes are turned on or off. This means our experiences—emotional, physical, and environmental—can impact the way our genes function, potentially contributing to or alleviating chronic conditions like heart disease, diabetes, autoimmune disorders, and mental health issues such as depression and anxiety.

How Psychotherapy Helps
Psychotherapy, especially approaches like cognitive behavioral therapy (CBT), mindfulness and polyvagal theory, and trauma-focused therapy, plays a key role in managing the psychological aspects of chronic conditions. These therapies help individuals work through stress, trauma, and negative thought patterns that can worsen physical health.

Studies have shown that therapy can lower stress hormones like cortisol and improve overall well-being. By managing emotional stress, psychotherapy can reduce the strain on the body, potentially influencing the expression of genes related to chronic conditions. In this way, psychotherapy does more than address mental health—it could have a direct impact on physical health too.

Combining Psychotherapy and Epigenetics
When psychotherapy and epigenetics are combined, the treatment becomes more holistic. For example, someone suffering from an autoimmune disorder might find relief not only through medication but also by addressing the emotional stress that triggers their condition. Research suggests that reducing stress through psychotherapy could influence how immune-related genes are expressed, leading to better outcomes.

This integrated approach offers a personalized treatment plan that considers both the psychological and genetic factors involved in chronic conditions. By understanding the role of emotional health in gene expression, therapists and doctors can develop more effective treatments that address both the mind and the body.

Conclusion
The integration of psychotherapy with lifestyle changes could revolutionize how we treat chronic conditions. By addressing both the mental and genetic aspects of illness, patients may experience reduced symptoms and a better quality of life. As research in both fields progresses, this approach could become a cornerstone of modern healthcare, offering hope for those struggling with chronic conditions.

Debra Eng, LCSW is Certified in Integrative Medicine for Mental Health. She is extensively trained in this area. Contact her today for your free consultation. 

References
Book: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk.  
   This book explains how trauma affects both the brain and body and the potential for healing through therapy. It links mental health to physical health, emphasizing the role of emotions in influencing bodily functions.

Podcast: The Dhru Purohit Podcast– Episode with Dr. Bruce Lipton on "How Epigenetics Can Rewire Your Brain and Body".  
   In this episode, Dr. Bruce Lipton explains how our thoughts, emotions, and environment can influence gene expression and health outcomes. His insights provide a deeper understanding of how psychotherapy and epigenetics are intertwined in healing chronic conditions.

Journal Article:  "Psychological Stress and Epigenetic Regulation of the Immune System" by Patricia M. McEwen, published in NeuroImmunology and NeuroInflammation (2020).  
   This article explores the relationship between stress and epigenetic changes in the immune system, shedding light on how psychological factors contribute to chronic conditions.

By combining the insights from psychotherapy with the science of epigenetics, we are moving toward a more complete and personalized approach to treating chronic health issues.

#ChronicIllness #Epigenetics #Psychotherapy #IntegratedHealth #MindBodyHealing #TraumaInformedCare #CBT #PolyvagalTheory #MentalHealthMatters #LifestyleMedicine #StressReduction #AutoimmuneSupport #ChronicPainManagement #HolisticTherapy #MentalAndPhysicalHealth #PersonalizedCare #DebraEngLCSW

Vagal toning refers to the stimulation and strengthening of the vagus nerve, a key component of the parasympathetic nervous system. This nerve plays a vital role in regulating stress responses, emotional balance, and overall mental health.

What Is the Vagus Nerve?
The vagus nerve, the tenth cranial nerve, connects the brainstem to various organs, including the heart, lungs, and digestive tract. It supports functions such as heart rate regulation, digestion, and emotional modulation (Breit et al., 2018).

Vagal Tone and Mental Health
Vagal tone is a measure of the nerve’s activity and is closely tied to heart rate variability (HRV). Higher vagal tone is associated with emotional regulation, resilience, and adaptive stress responses (Porges, 2007). Lower tone is often linked to anxiety, depression, and dysregulated stress systems (Thayer & Lane, 2000).

Benefits of Vagal Toning

• Stress Reduction: Enhances parasympathetic response and reduces cortisol levels (Tracey, 2002).
• Emotional Regulation: Facilitates adaptive emotional processing (Porges, 2011).
• Improved Sleep: Associated with deeper, more restorative sleep (Kraus et al., 2007).
• Enhanced Social Engagement: Supports feelings of connection and safety (Porges, 2003).

Ways to Improve Vagal Tone

• Breathwork: Deep, slow breathing increases vagal activity (Zaccaro et al., 2018).
• Cold Exposure: Brief cold exposure activates the vagus nerve (Sierra-Fonseca & Gosselink, 2018).
• Meditation: Mindfulness practices improve vagal tone and emotional regulation (Gerritsen & Band, 2018).
• Singing or Humming: Stimulates the vagus via vocal cords (Porges, 2011).
• Exercise: Regular movement enhances HRV and vagal tone (Sandercock et al., 2005).
• Social Connection: Supportive relationships positively influence vagal function (Kok et al., 2013).

The Role of Therapy
Psychotherapy can play a central role in supporting vagal toning. Through various modalities—such as cognitive-behavioral therapy (CBT), somatic experiencing, or polyvagal-informed therapy—clients learn to regulate stress, process emotions, and develop greater body awareness. Therapists may incorporate breathwork, guided relaxation, or mindfulness techniques that directly engage the vagus nerve.
In particular, therapy helps by:

• Enhancing self-awareness of physiological and emotional states
• Teaching coping strategies that promote parasympathetic activation
• Creating a safe relational space, which itself can improve vagal tone through co-regulation

​Vagal toning is a foundational aspect of mental wellness. By combining physiological techniques with therapeutic support, individuals can cultivate greater emotional resilience, reduce stress, and improve overall psychological functioning.

References

• Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus nerve as modulator of the brain–gut axis in psychiatric and inflammatory disorders. Frontiers in Psychiatry, 9, 44.
• Gerritsen, R. J., & Band, G. P. (2018). Breath of life: The respiratory vagal stimulation model of contemplative activity. Frontiers in Human Neuroscience, 12, 397.
• Kok, B. E., et al. (2013). How positive emotions build physical health: Perceived positive social connections account for the upward spiral between positive emotions and vagal tone. Psychological Science, 24(7), 1123–1132.
• Kraus, T., et al. (2007). BOLD fMRI deactivation of limbic and temporal brain structures during vagus nerve stimulation in epileptic patients. Brain Stimulation, 1(1), 27–35.
• Porges, S. W. (2003). The polyvagal theory: Phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42(2), 123–146.
• Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143.
• Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. Norton.
• Sandercock, G. R., Bromley, P. D., & Brodie, D. A. (2005). Effects of exercise on heart rate variability: Inferences from meta-analysis. Medicine and Science in Sports and Exercise, 37(3), 433–439.
• Sierra-Fonseca, J. A., & Gosselink, K. L. (2018). Tau and cold stress-induced suppression of the hypothalamic-pituitary-gonadal axis. Neuroendocrinology, 107(3), 270–282.
• Thayer, J. F., & Lane, R. D. (2000). A model of neurovisceral integration in emotion regulation and dysregulation. Journal of Affective Disorders, 61(3), 201–216.
• Tracey, K. J. (2002). The inflammatory reflex. Nature, 420(6917), 853–859.
• Zaccaro, A., et al. (2018). How breath-control can change your life: A systematic review on psychophysiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, 353.

#VagalToning #VagusNerve #PolyvagalTheory #StressReduction #EmotionalRegulation #MentalHealth #MindBodyConnection #Breathwork #Mindfulness #SomaticTherapy #CBT #TraumaInformedTherapy #Resilience #TherapyTools #SelfRegulation #ParasympatheticNervousSystem #Neurophysiology #DebraEngLCSW

The hypothalamic-pituitary-adrenal (HPA) axis is a central component of the body’s stress response system. It governs the release of cortisol, which helps manage acute stress. However, prolonged or repeated exposure to stress can lead to HPA axis dysfunction—a state of dysregulation that affects the brain, body, and emotional well-being.

Effects of Chronic Stress on the HPA Axis
When stress is chronic, the HPA axis can become either overactive or underactive. This may lead to sustained high cortisol levels or a flattened cortisol rhythm, impairing sleep, energy levels, immune function, and emotional regulation. HPA axis dysfunction has been linked to conditions such as depression, anxiety, PTSD, and chronic fatigue (Yaribeygi et al., 2017).

Therapy can support the resolution of HPA axis dysfunction and nervous system dysregulation by addressing the psychological and behavioral contributors to chronic stress responses. Specifically:

1. Regulation of Stress Response: Approaches like somatic experiencing and trauma-informed therapies help downregulate hyperaroused or hypoaroused states, thereby reducing chronic activation of the HPA axis.
2. Enhancing Interoception and Safety: Therapies that focus on bodily awareness and creating internal experiences of safety can shift the nervous system from survival modes (e.g., fight, flight, freeze) to regulation.
3. Processing Trauma: Addressing unresolved trauma can reduce maladaptive stress patterns that sustain dysregulation.
4. Developing Coping Skills: Therapy fosters resilience through emotional regulation, mindfulness, and adaptive coping strategies that reduce the intensity and duration of HPA activation.
5. Therapeutic Relationship: A safe, attuned therapeutic alliance can itself act as a corrective experience for relational and autonomic dysregulation.

Conclusion
Addressing HPA axis dysfunction requires a multidimensional approach, with nervous system regulation at its core. Regular use of these tools may support both physiological and psychological recovery, promoting resilience and mental clarity over time.

​References
Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI Journal, 16, 1057–1072. https://doi.org/10.17179/excli2017-480
Pascoe, M. C., Thompson, D. R., Jenkins, Z. M., & Ski, C. F. (2017). Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. Journal of Psychiatric Research, 95, 156–178. https://doi.org/10.1016/j.jpsychires.2017.08.004
The Huberman Lab Podcast. Episode: "How to Control Your Stress Response" by Dr. Andrew Huberman. Accessed at: https://www.hubermanlab.com/episode/how-to-control-your-stress-response

#HPAaxis #StressResponse #ChronicStress #Cortisol #NervousSystemRegulation #TraumaInformedTherapy #SomaticTherapy #EmotionalRegulation #Mindfulness #Resilience #StressManagement #MentalHealth #PTSDRecovery #TherapeuticAlliance #Interoception #StressDysregulation #Psychotherapy #MentalWellness #DebraEngLCSW