Guest Blog by Vanessa Blackstone, MSW, ASW

People in the chronic pain and mind-body world throw the word neuroplasticity around a lot, and if you are new to this work, it can start to feel like one of those words everyone assumes you already understand.

People say things like, “Your symptoms are neuroplastic,” or “The brain can change,” or “The brain can learn and unlearn.” And while all of that is true, it can also start to sound a little abstract, especially if you are the one living inside a body that feels like it is reacting to everything.

Because if you are dealing with back pain, migraines, IBS symptoms, tinnitus, fatigue, pelvic pain, dizziness, light sensitivity, food fear, bladder symptoms, or symptoms that seem to have taken over your life, “your brain can change” can sound a little too simple. Maybe even annoying.

Guest Blog by Rachel Amondson, MSW, PCC

“I know this sounds crazy, but it will heal him in no time.”

My eager naturopath friend was calling from California, adding her advice to the mountain of suggestions my husband and I were receiving as we tried to help him manage his autoimmune disease.

“You need to start keeping bees,” she told me steadily. “And you need to have him stung once a day.”

That was it. That was the moment my husband and I looked at each other and realized: the advice had gone too far.

Guest Blog by Christine Yarosh, PhD

Our brains have a built-in negativity bias. From an evolutionary perspective, it makes sense. The cost of overlooking something potentially threatening was far greater than the cost of overlooking something positive. Better to eat lunch than to be lunch.

We are the recipients of a nervous system that is nothing short of miraculous—and simultaneously not a great fit for the modern world. Wisdom traditions have long held that the mind takes the shape of what it rests upon. The neuroscience equivalent: neurons that fire together, wire together.

Guest blog by Dan Ratner, PsyD

If I’m you've been dealing with a symptom that just won't quit — one that's been around for months, maybe years — I want to offer you something today that has the potential to change everything: the word "chronic" is not a diagnosis. It's a doubt.

I Have Neuroplastic Symptoms. 

What are those? Neuroplastic symptoms are real pain or illness generated by the brain or nervous system rather than by disease or injury. They can occur anywhere in the body and persist for years or longer. Medical diagnostic tests tend to show little or nothing wrong.

Guest Blog By Vanessa Blackstone, MSW

We talk about safety like everyone has equal access to it. They don’t. And that changes recovery. Safety is not a switch you flip. It’s a pattern you experience. And when that pattern has included dismissal or harm, the nervous system doesn’t forget. It predicts. It prepares. It keeps you alert. I’m writing this as someone who works in neuroplastic symptom treatment, where we talk about safety constantly, and as someone who has also seen how often “safety” is assumed rather than built.

Tinnitus is the sensation of a sound inside of you. Although the majority of those who experience tinnitus are actually not bothered by it, there is a meaningful number of people who suffer not in silence. Tinnitus is driven by neuroplasticity—the brain’s natural ability to create, adapt, and change its neural pathways. Most of the time, it is a sound created by these neural pathways in the brain, not the body. These changes can be in response to actual structural damage, such as an ear infection, injury or trauma to the ear, exposure to loud sounds, or ear diseases such as Meniere’s disease or an acoustic neuroma. Tinnitus can also start with more benign changes to the ear, such as gradual hearing loss due to aging, genetic factors, or prolonged noise exposure. Of course, like many other neuroplastic conditions, tinnitus can start in the absence of any structural damage at all. In these cases, psychosocial stresses influence neuroplastic changes in the hearing areas of the brain, which are perceived as the tinnitus sound. 

How can you tell if you are still affected by ACEs?

ACEs are life events you would not want for a child of your own. They range in visibility from the traumatic (such as physical or sexual abuse) to subtle pressures to perform, to solve family problems, or to suppress emotions. Any of them can have significant long-term impacts on mental and physical health far into adulthood.

A new study of Emotional Awareness and Expression Therapy (EAET) for people with migraine has found a large benefit. The lead author is Dan Kaufmann PhD from the University of Utah who spoke at the ATNS Conference.

A Familiar Story

Recognizing when pain or illness is neuroplastic—stemming from learned neural patterns rather than tissue damage—is a challenge for millions of people. Consider the experience of Samantha Ferris. As an actress, a radio announcer, and now a psychotherapist, she felt confident that she could analyze and understand her own body. Here is her story:

“I could have cut 20 years of pain in half if only I had been ready to hear about neuroplastic conditions. My bladder pain and many other symptoms led me from doctor to doctor, with test after test, and treatment after treatment. After years of this, the symptoms only got worse. 

Neuroplastic symptoms consist of ongoing pain or illness that is caused by nerve pathways in the brain, rather than disease or structural injury. These symptoms manifest in many different ways, including back pain, headaches or migraines, chronic fatigue, digestive or bowel problems, and more. It is also extremely common for people to have multiple symptoms. In our recent nationally representative study of US adults, for example, we surveyed a subgroup of the population that we identified as being highly likely to have neuroplastic symptoms. In this group, we found that 71% reported two or more symptom types.  

The Holidays Can Be a Pain

The holidays can be a joyous time. You get some time off work, see family and friends, and eat good food. But the holidays also can be a stressful time, perhaps because of interacting with family members with whom we disagree, reminders and memories of a lost loved one, time spent hosting, last-minute shopping for gifts, or wondering whether the effort, the cost, and the compromises will add up to the holiday feeling for which we had hoped. For some people, holiday stress can lead to neuroplastic symptoms. It is often not a coincidence when back pain or other symptoms flare up at this time of year.

Those With a Clear Explanation vs. Those Without

What Are Neuroplastic Symptoms? 

Tens of millions of Americans suffer from ongoing pain or illness. In many cases, people cannot get a clear explanation for their condition even after consulting many different medical professionals. Even when patients do receive a clear explanation and treatment for their chronic symptoms, research shows it is common for them to get little benefit, with pain or illness often persisting for years. Recent evidence points to a potential common cause: neuroplastic symptoms. 

One of the things that has struck me in my work with mind body symptoms is how so many of the symptoms really all amount to the same thing: an experience in the mind getting played out in the body through any number of systems. But one way to think about these systems—musculoskeletal, neurological, digestive, circulatory, etc.—is that they present the kinds of symptoms that are easily expressed within that system.

You play a sport, and you get injured.  That’s straightforward, right?  Sometimes it is. You sprain your ankle, x-rays are negative, wear an ankle brace, do some rehab, and you’re mostly healed in three weeks.

But sometimes it isn’t. Sometimes, pain persists in the shoulder, knee, or back, even when the physical therapist or sports doctor says you’re healing “nicely.” They may do X-rays or an MRI scan.  But there’s not much showing up. Occasionally, what shows are “normal abnormalities,” but these do not clearly explain your pain.

I have been treating patients with pain for decades.  Nearly every patient with chronic pain (more than six months of pain) has associated fears. Often, the fear relates to the uncertain future.  Will the pain be resolved?  Will I get worse?   Fear fuels the pain.

In the extreme, it becomes “Will I end up in a wheelchair?” I ask about and listen to these fears. I believe they are crucial in unraveling the pain cycle and moving out of the pain circuit in the nervous system. Too often, these fears relate to prior statements by the health profession. 

In 2017 the PPD Association crowdfunded over $100,000 from over 500 donors in 24 countries around the world. This allowed the Boulder (Colorado) Back Pain Study to expand from two study groups by adding a third group that would receive Pain Relief Psychotherapy.

150 patients who had suffered back pain without signs of nerve damage (such as muscle weakness, loss of reflexes, numbness, bowel or bladder dysfunction) were selected for the study. Back pain duration was an average of ten years. The patients were randomly divided into three groups and treated either with (1) their usual medical care, (2) a placebo (fully disclosed to participants) injection into the spine, or (3) two one-hour sessions of Pain Relief Psychotherapy every week for four weeks.

Neuroplastic psychology has been successfully used to treat patients with Long Covid. Twenty-three adults under the age of 60, averaging nine months of Long Covid symptoms that they described as “High” or “Very High,” were enrolled. Participants received Psychophysiologic Symptom Relief Therapy (a form of neuroplastic psychology) during a 13-week (approximately 44-hour) course.

Once you begin looking for psychosocial causes of pain or illness (Neuroplastic Symptoms) in patients, you find it repeatedly. The same is true for research scientists.

A study from the University of Michigan looked at the electronic health records of over 2 million people in three groups: people with Covid, people with influenza, and people with no infection during a routine health appointment. They determined which of these people had a “chronic overlapping pain condition” (COPC) causing widespread pain often associated with fatigue or problems with sleep, memory, or mood. Next, they assessed whether having a COPC predicted a person’s subsequent development of Long Covid.

Mental health apps have been controversial. Do they work for chronic pain?

In a controlled trial from British Columbia, 198 subjects with chronic pain (non-cancerous) for an average of 13 years were randomly given either the app Curable (at no charge) or their usual care. Curable uses a biopsychosocial model aligned with the approach advocated by the ATNS.