Neuroplastic Pain, Chronic Illness, and Healing: Understanding Pain Beyond Structural Injury
Why Not All Therapies Work the Same for Chronic Pain
There are many therapeutic approaches that can support healing, and each has value depending on what you’re going through. For example, Eye Movement Desensitization and Reprocessing (EMDR) is a well-established, evidence-based treatment for trauma and PTSD, and it can be helpful for people whose pain is closely tied to unresolved traumatic experiences.
However, when it comes specifically to neuroplastic or chronic pain, the research base for EMDR is still developing and somewhat limited. Systematic reviews show that while EMDR can reduce pain and emotional distress, studies are relatively small, varied, and less consistent compared to more targeted pain-focused approaches (Tesarz et al., 2014; Singla et al., 2025). (NCBI)
In contrast, therapies like Pain Reprocessing Therapy (PRT) and Emotional Awareness and Expression Therapy (EAET) were specifically designed to treat chronic and neuroplastic pain.
PRT works directly with the brain’s interpretation of pain signals, helping the nervous system learn that the body is safe.
EAET focuses on identifying and processing emotional patterns, such as suppressed feelings, stress, or relational conflict - that can keep the nervous system in a heightened, pain-producing state.
Importantly, research suggests that EAET can even outperform more traditional therapies for chronic pain. In clinical trials, EAET has shown greater reductions in pain compared to cognitive behavioral therapy, along with improvements in emotional well-being and functioning (Yarns et al., 2020; Lumley et al., 2017). (PubMed)
Why This Matters for Your Healing
If you’ve already tried different therapies and still feel stuck, it may not mean you’ve failed, or that healing isn’t possible. It may simply mean the approach didn’t fully match how your pain is being generated.
Some therapies focus primarily on coping, some on trauma processing, and others, like PRT and EAET, focus more directly on changing the underlying pain pathways in the brain and nervous system.
That difference can be significant.
In my work, I integrate approaches that are not only evidence-based, but specifically aligned with how neuroplastic pain operates. This allows us to move beyond just managing symptoms and toward actually shifting the patterns that keep pain going.
And just as importantly, you don’t have to spend your time in therapy trying to explain or justify your experience. We start from the understanding that your pain makes sense, and we work from there.
I also draw on both Pain Reprocessing Therapy and Emotional Awareness and Expression Therapy in my own life to help manage flares and support nervous system regulation. I needed to experience and practice these approaches to understand their impact even after decades of living with Complex Regional Pain Syndrome (CRPS). Living with CRPS has also shown me since I was a kid that healing is not linear, and what helps can shift over time. Approaching chronic conditions with ongoing curiosity and a willingness to keep learning can be one of the most valuable skills for navigating uncertainty, adapting to change, and discovering what truly supports your well-being over time.
While these approaches can be powerful for many people living with neuroplastic or sensitized pain, they are not a one-size-fits-all solution and may not work for everyone. For many, meaningful change comes through a combination of approaches, including medical care, rehabilitation, lifestyle supports, and other therapeutic modalities alongside psychotherapy.
Still, when pain is influenced by the nervous system, this work can offer a different way of understanding symptoms, one that reduces self-blame, brings clarity, and opens the door to new possibilities after feeling stuck for a long time.
If you are at a point where you are exhausted from trying to make sense of your pain alone, you don’t have to continue doing that without support. I would be honored to help you explore what may be contributing to your experience and what a more supported path forward could look like.
References
Singla, A., Futela, P., Arora, K., Toussaint, L., Ahmad, Z., Baptista, A. M., Anstine, C. V., Hurt, R. T., Philpot, L. M., & Mohabbat, A. B. (2025). Eye movement desensitization and reprocessing for chronic pain: A systematic review. Journal of Primary Care & Community Health.
Tesarz, J., Leisner, S., Gerhardt, A., Janke, S., Seidler, G. H., Eich, W., & Hartmann, M. (2014). Effects of eye movement desensitization and reprocessing (EMDR) treatment in chronic pain patients: A systematic review. Pain Medicine, 15(2), 247–263. https://doi.org/10.1111/pme.12303
Yarns, B. C., Lumley, M. A., Cassidy, J. T., Steers, W. N., Osato, S., Schubiner, H., & Sultzer, D. L. (2020). Emotional awareness and expression therapy achieves greater pain reduction than cognitive behavioral therapy in older adults with chronic musculoskeletal pain. Pain Medicine, 21(11), 2811–2822. https://doi.org/10.1093/pm/pnaa145
Lumley, M. A., Schubiner, H., Lockhart, N. A., Kidwell, K. M., Harte, S. E., Clauw, D. J., & Williams, D. A. (2017). Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: A cluster-randomized controlled trial. Pain, 158(12), 2354–2363. https://doi.org/10.1097/j.pain.0000000000001036