Many people live with pain that no scan can explain. The back that hurts for years though the MRI shows nothing alarming. The stomach, the headaches, the fatigue, the aches that move around. A growing body of work suggests that a good deal of chronic pain is not caused by damage to the body at all. It is a learned pattern in the brain and nervous system, and what has been learned can be unlearned.
Where the idea began: Dr John Sarno
The modern story starts with Dr John Sarno (1923-2017), a New York rehabilitation physician. He noticed that many patients with severe back and limb pain had no structural problem that matched their symptoms, and that surgery and physical treatments often failed them. He proposed that much of this pain was driven by stress and suppressed emotion, a condition he called Tension Myositis Syndrome. His books Healing Back Pain and The Divided Mind argued that once people understood the true cause and stopped fearing their bodies, the pain could fade.
Sarno was controversial in his day, partly because he worked before the brain-imaging and clinical-trial evidence that later made the idea more mainstream.
Dr Howard Schubiner and “unlearning” pain
Dr Howard Schubiner, a physician in Michigan, carried this work into the research era. His book Unlearn Your Pain describes what he calls mind-body syndrome, in which the brain keeps producing pain signals even though the tissues are healthy. His approach, Emotional Awareness and Expression Therapy, helps people notice and process the emotions and stresses that feed the pain. Clinical trials, including studies in fibromyalgia, have found meaningful improvements in many participants.
The evidence gets stronger: Pain Reprocessing Therapy
In 2021, a randomised controlled trial in JAMA Psychiatry, led by Dr Yoni Ashar with colleagues including Dr Tor Wager, tested Pain Reprocessing Therapy on people with chronic back pain. Pain Reprocessing Therapy was developed by Alan Gordon and colleagues. Around two thirds of those given the therapy were pain-free or nearly pain-free afterwards, compared with a small minority in the control groups. Brain scans showed changes in how pain-related regions were working.
The core idea: neuroplastic pain
Pain is not a simple readout of tissue damage. It is an alarm that the brain generates when it believes the body is under threat. If the nervous system becomes sensitised, the alarm can keep ringing after an injury has healed, or without any injury. Fear, worry, perfectionism, and constantly scanning the body for trouble all tell the brain that danger is real, and the pain intensifies. This is the cycle: pain, then fear and tension, then more pain.
The encouraging part is that the brain can change. If the cycle is built from learned signals of danger, it can be reversed with consistent signals of safety.
A simple daily framework
Therapist Tanner Murtagh offers a practical plan. His central point is that many people confuse learning with healing. They watch videos, read books, and understand the theory, yet never actually do the practice. Others do the opposite and pile on twenty or thirty techniques a day, confusing intensity with consistency. His alternative is to choose three practices each day for thirty days, drawn from five options:
- Embodiment practices with the pain itself. Turn towards the sensations with curiosity rather than fear. Describe them, explore them, and signal safety to your body.
- The “ADD” skill. This is a quick tool for negative thinking, taking a minute or less. Ask why the thoughts are arising, drop in and describe the thoughts and feelings, then shift to safety with a calming thought, action, or bodily cue.
- Embodiment practices with emotions. Allow yourself to feel difficult emotions and stress in the body rather than resisting them. Resistance tends to feed symptoms.
- Safety-signal practices. These include slow breathing, noticing the present moment, gentle tapping or massage, kind self-talk, and visualisation.
- Lifestyle balance. Some people live at too high an intensity, with perfectionism, people-pleasing, and constant busyness. Others live at too low an intensity, with isolation, inactivity, and endless screens. Both patterns keep the nervous system dysregulated. The remedy is to rest, play, and set limits in the first case, and to move, connect, and find purpose in the second.
Murtagh’s closing point is that brains change through repetition, and that showing up consistently matters more than doing it perfectly.
An important caution
This approach is not a substitute for medical care. Chronic pain should first be properly assessed by a doctor to rule out structural or disease causes. Signs that pain may be neuroplastic include symptoms that scans cannot explain, pain that fluctuates or moves around, and symptoms that shift with stress or emotion. Even then, a doctor should be part of the process. Murtagh himself notes that neuroplastic symptoms are only one explanation among several.
Final thought
The message running through the work of Sarno, Schubiner, Gordon, and others is one of hope. If pain is partly a learned alarm, then calm, curiosity, and patient repetition can teach the nervous system that it is safe again. For many people, that is a remedy worth trying.
A note on sources: I could not identify a “Dr Falisi” working in this field, so nothing here is attributed to that name. If you can tell me which book, paper, or website you have in mind, I will add a section drawing on it.