Therapy for Chronic Pain and Persistent Physical Symptoms

When pain persists and nobody can tell you why

Many people come to me with symptoms that have been investigated and found to have no clear physical cause: persistent pain, fatigue, gut problems, tension that will not release.

The symptoms are real. Being told that scans are clear is usually heard as being told the pain is imagined, and that is not what it means. What is often happening is a nervous system that has become oversensitised, still reading the environment as dangerous and protecting you accordingly. Pain produced this way is sometimes called neuroplastic pain, and it hurts exactly as much as pain from an injury, because it is produced by the same system.

Why a nervous system becomes oversensitised varies from person to person. Usually something has taught it to stay on guard.

If your symptoms have not been medically investigated, start with your GP. This work sits alongside medical care rather than in place of it.

Why we may not start with breathing exercises

People often arrive expecting to be handed a set of techniques: breathing, stretching, tracking sensations, calming the body in the moment. Those things have their place and I do teach them.

They tend not to be where we start. A brain that is still detecting threat will keep producing the response, and so we spend time on what it is responding to: old experiences, current pressures, the patterns underneath the symptoms. Anxiety, people-pleasing, trauma, whatever is keeping the system on alert.

My reasoning is that observing a sensation calmly is difficult while the fear response is still being generated below conscious thought, faster than any decision to stay calm. BWRT®, my main approach, works at that level, changing the response itself. Once that shifts, the in-the-moment tools become something you can actually use.

If you are looking for Pain Reprocessing Therapy

Pain Reprocessing Therapy is part of my training, and the psychoeducation at the heart of it is where we start: understanding what neuroplastic pain is, and why real symptoms can be produced by a nervous system that has learned to expect danger. That happens from the consultation onwards, and it runs through The Safety Signal.

Where I work differently is the sequence. Rather than moving straight to tools such as somatic tracking, we work first with the responses producing the symptom, and tracking comes later, when relevant.

If you want a course of therapy built primarily around symptom mapping and tracking from session one, a PRT-led practitioner will suit you better for therapy, and I would say so at the consultation.

Therapy, or the programme

There are two ways of working with me on persistent pain:

1:1 therapy is what this page describes: working directly with the responses your nervous system is producing.

The NeuroSomatic Reboot™ is a self-paced programme with coaching support from me. It is education and structured practice rather than therapy, and for some people it is enough on its own.

You do not need to decide before we speak. If you come for therapy expecting something closer to coaching, teaching, or a symptom-management programme, say so at the consultation. It is a fair thing to want, and it is better established before we start than discovered later.

**If you have read The Safety Signal or worked through the Morning Reset**

You will arrive already thinking in terms of safety signals and root causes, and possibly expecting the 1:1 work to continue where the writing left off. It will feel different from the outset.

The book and the programme are there to help you understand what is happening and to give you things to practise. Therapy goes underneath that: we work directly with the responses your nervous system is producing, rather than adding to what you have to manage them with. Understanding is not the main mechanism of change here, which is why sessions may look less like teaching than you expect.

If you would like to read more first

I have written about persistent pain and the nervous system for Psychreg:

The link between the brain and chronic pain, on how pain is produced and maintained by the nervous system
When the body shakes and the mind blames itself, on a different approach to essential tremor

There is also more on the somatic therapy and psychotherapy page about how I work generally, and on how BWRT® works. Other writing, talks and radio interviews are on the press and talks page.

A free initial consultation

The consultation is a conversation about you: what has been happening, how long, what you have already tried, and what you would like to be different. There is no obligation to book anything afterwards, and I will give you my honest view of what would actually help, including when that is something other than working with me.

I work online, and in person in Lisburn and Belfast.

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