Have you ever felt true relief from pain after trying something you weren’t sure would work? Maybe it was a mindfulness practice, a guided visualization, or even a sugar pill. It might have surprised you—how could something so simple make a difference?
The truth is: there is real science behind why certain treatments that seem “fake” or psychological actually lead to genuine pain relief. For people struggling with chronic pain, this might be the shift in perspective that finally brings progress.
Too often, pain sufferers are told it’s “all in your head,” a phrase that minimizes their experience and ignores how the brain and body are deeply interconnected. But new integrative therapies like Pain Reprocessing Therapy (PRT), Emotional Awareness and Expression Therapy (EAET), and Intensive Short-Term Dynamic Psychotherapy (ISTDP) are showing us that pain lives in both places—and healing can too.
As a therapist trained in these approaches, I’ve seen clients experience profound relief from back pain, migraines, pelvic pain, and other chronic symptoms through emotional processing and nervous system regulation. In this blog, we’ll explore:
- Why some “fake” treatments work
- How your brain creates and can change pain
- What emotion has to do with all of it
- What these therapies actually look like in practice
If you’re tired of trying treatments that don’t last, this might be the fresh start you need.
The Science Behind Why ‘Fake’ Treatments Work
Let’s debunk a myth right away: placebo doesn’t mean imaginary. The placebo effect is a powerful, well-documented neurobiological response in which the brain releases real pain-relieving chemicals—like endorphins—when we believe we’re receiving help.
Here’s how it works: when someone thinks a treatment will help—even if that treatment is a sugar pill or something that has no active medical ingredients—the brain can still respond by activating areas involved in pain relief, like the prefrontal cortex and periaqueductal gray. Your brain, in essence, becomes its own pharmacy.
Even more fascinating: research shows that people can experience pain relief from a placebo even when they know it’s a placebo. These are called open-label placebos. Why do they work? Because the entire context—being cared for, trusting the provider, having hope—can signal safety to the brain. And safety helps turn down the volume on pain.
Here are a few examples:
- Sham surgeries: In studies of knee surgery for arthritis, patients who underwent placebo surgery (incisions only, no actual procedure) reported the same improvement as those who had the real operation.
- Back pain studies: People with chronic back pain who knowingly took placebo pills—combined with supportive messaging—reported meaningful relief compared to those who took nothing.
- Drug trials: In nearly every clinical trial for pain medications, people in the placebo group show improvement—sometimes nearly as much as those taking the drug.
This doesn’t mean people are faking it. It means that belief, expectation, and the meaning we assign to treatment are powerful drivers in how the brain processes pain. Pain is not just about tissue damage—it’s shaped by context, memory, emotion, and perception.
Understanding the placebo effect helps us appreciate how and why brain-body therapies work—not as tricks, but as science-backed strategies that reshape pain at the source.
The Brain Creates Pain—But Also Has the Power to Change It
Why the Brain Keeps Pain Alive—and How That Changes
Not all pain comes from a current injury. Chronic pain often continues long after tissues have healed because of how the brain learns and adapts. When pain persists, the nervous system becomes more sensitive—it starts to send danger signals even when there’s no physical threat.
Think of it like a fire alarm that keeps going off even though there’s no smoke. The brain, trying to protect you, gets stuck in a feedback loop where pain signals continue to fire. This is often called central sensitization—and it’s a well-documented neurological process.
This is why people can experience very real pain even when imaging tests or lab results come back “normal.” The pain isn’t imaginary—it’s just coming from the brain’s pain processing centers, not necessarily from tissue damage.
The good news? Just like the brain can learn pain, it can also unlearn it.
How Experiential Therapy Helps Rewire Pain
Neuroplasticity is the brain’s incredible ability to change and rewire itself in response to new experiences. This means that with the right input, the brain can literally “unlearn” chronic pain.
Experiential therapies like PRT, EAET, and ISTDP work by helping clients reprocess pain signals and shift the brain from threat mode to safety. These approaches don’t just talk about pain—they actively change the way pain is experienced.
- PRT teaches clients to relate to pain with curiosity instead of fear
- EAET guides people to feel emotions that may have been repressed
- ISTDP focuses on uncovering unconscious conflicts that keep the nervous system stuck in overdrive
When the nervous system learns that it’s safe again, pain often begins to fade. Clients report measurable improvements in pain reduction, better sleep, and greater emotional resilience.
This isn’t about ignoring the pain or pretending it doesn’t exist—it’s about treating it at the source: the brain.
What These Therapies Look Like in Practice
PRT: Creating Safety and Changing the Narrative
Pain Reprocessing Therapy (PRT) helps clients relate to their pain in a new way. Instead of bracing against it or fearing it, they learn to observe it with curiosity and signal safety to the brain. Techniques include:
- Somatic tracking: noticing the pain without judgment
- Mindfulness: building awareness and interrupting fear-pain cycles
- Cognitive reframing: understanding pain as a brain-generated signal rather than evidence of damage
Over time, this retrains the brain to interpret sensations differently—which often leads to pain becoming less intense and less frequent.
EAET and ISTDP: Accessing Emotion to Ease Pain
Both Emotional Awareness and Expression Therapy (EAET) and Intensive Short-Term Dynamic Psychotherapy (ISTDP) help clients explore avoided emotions that may be fueling physical symptoms.
- In EAET, clients identify and express emotions like anger or grief that have been pushed down. Techniques like role-play or expressive writing are often used.
- In ISTDP, the therapist helps clients notice subtle shifts in tension or resistance, gently guiding them to access deeper emotions and unconscious conflicts.
These therapies aren’t about talking endlessly—they’re about feeling emotions in real-time and noticing what shifts in the body. When the emotional system calms, the nervous system often follows.
Try this: Ask yourself: What emotions are hardest for me to feel or name? What physical symptoms tend to show up when I avoid them? That might be the place to start.
What to Expect and When to Consider These Therapies
These experiential approaches may feel different from what you’re used to. They don’t just aim to reduce symptoms—they help you change how your brain and body interpret and respond to pain. By working with emotion, attention, and perception, these therapies rewire how pain is processed from the inside out.
What you might experience:
- Less frequent or intense pain flare-ups – As your brain shifts out of threat mode, pain signals often become less frequent and less overwhelming.
- Improved sleep and emotional balance – With your nervous system more regulated, many people report sleeping more soundly and handling stress with greater ease.
- A shift in perspective – You may start to feel less fearful of your symptoms and more confident navigating your body’s signals.
These therapies may be worth considering if:
- You’ve tried medication, injections, or physical therapy without lasting relief.
- Your pain doesn’t match what imaging or labs show—there’s no clear structural cause.
- Stress, conflict, or emotional suppression seem to make symptoms worse.
- You’re curious about how emotion, memory, and perception shape your pain—and ready to explore a different kind of healing.
For many people, the turning point comes when they realize: their pain isn’t “imagined,” but it is being processed—and shaped—by the brain. And that means it can change.
Final Thoughts: Rethinking What Works for Chronic Pain
The science behind pain has evolved—and so should our treatments. What we once dismissed as “just a placebo” now tells us something powerful: the brain’s belief system can drive measurable pain relief.
Therapies like PRT, EAET, and ISTDP aren’t based on wishful thinking. They are grounded in neuroscience, built around the principles of neuroplasticity, and offer real strategies for changing how pain is experienced.
If you’ve been exploring pain management without medication, or wondering why traditional approaches haven’t helped, this may be a new path worth considering.
Want to take the next step?
- Visit the Chronic Pain Therapy Services page to learn more about how I work.
- Explore related blog posts:
- Check out my free resources for practical tools, tips, and next steps
Relief is possible—and it often starts by shifting how your mind and body communicate.
