What Therapy Can (and Can’t) Help With When You Have a Chronic Condition

If you’re living with a chronic condition, you might be begrudgingly considering therapy as another “check off” on your never-ending list of treatments, tests, doctors, and medications. Despite everything you’ve tried, the pain is still there.

 

So when someone suggests therapy, skepticism makes sense. But here’s the thing: seeking therapy for chronic pain doesn’t mean that “it’s all in your head.” It isn’t.

 

Therapy isn’t about dismissing your symptoms or pretending your body isn’t struggling. It’s a place to explore why pain may be lingering, how the nervous system can get stuck in protection mode, and whether there’s a way to create even a small amount of relief or safety along the way.

 

From there, we can begin to understand what’s actually happening in chronic pain and where therapy can, and can’t, help.

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Understanding Chronic Pain: When the Nervous System is on High Alert​

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Chronic pain isn’t always a sign of ongoing injury or damage in the body. This might explain why your countless doctor visits, scans, and tests haven’t solved the issue.

 

From a neuroscience perspective, pain signals are sent to the brain to protect you. Its job is to detect potential threats and keep you safe. But in some people, the nervous system becomes overly protective. It starts reacting to sensations as if they’re dangerous, even when the body itself is safe.

 

Think of it like a fire alarm. A well-functioning alarm goes off when there’s real smoke or fire. But when an alarm becomes too sensitive, it might blare every time you make toast. The sound is loud and real, even though there’s no actual danger.

 

Chronic pain can work the same way. The pain is real, but it comes from a nervous system that has learned to stay on high alert. Over time, harmless sensations can trigger pain simply because the brain has learned to associate them with threat.

 

We see this outside of pain too. If you’re afraid of spiders or heights, your body reacts instantly (heart racing, muscles tensing) even when you’re not in physical danger. With chronic pain, this protective response can become long-standing.

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The Pain–Stress Cycle​

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When pain shows up, it often triggers fear: What if this gets worse? What if this never goes away? Is this something serious?

 

That fear activates stress hormones. Stress heightens pain signals. Over time, the brain learns a simple equation: pain = danger.

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Understanding Pain Reprocessing Therapy (PRT)​

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Pain Reprocessing Therapy (PRT), developed by Alan Gordon, LCSW, founder of the Pain Psychology Center in LA, helps people with chronic pain by rewiring how the brain interprets pain signals.

 

PRT offers a new way to understand and relate to chronic pain, especially when medical testing hasn’t identified an ongoing structural cause. It helps people see that their pain may be a false alarm originating in the brain rather than ongoing damage in the body.

 

And I cannot stress this enough: PRT does not mean the pain isn’t legitimate. The pain is very real — what’s different is the source.

 

When people begin to understand pain as a sensation rather than a sign of danger, the nervous system can start to rewire and shift out of threat mode. Over time, this can reduce the intensity and frequency of pain.

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What Therapy Can’t Do​

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Therapy has its limits and is not a cure-all. Chronic conditions require a collaborative approach involving doctors, mental health professionals, physical therapists, and other specialists.

 

Therapy alone can’t:

• Guarantee that pain will disappear forever

• Cure structural or inflammatory disease

• Replace medical care

• Work instantly or without effort

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What Therapy Can Do​

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Therapy can help shift the way you respond to pain when it arises. Because chronic pain is often driven by the brain, this shift is often what leads to meaningful relief over time.

 

Focusing only on eliminating pain can reinforce the pain–stress cycle. Therapy instead reduces fear and urgency around pain, giving the nervous system room to recalibrate.

 

For many people, therapy can:

• Reduce pain intensity and frequency (though not for everyone)

• Decrease fear and hypervigilance around symptoms

• Improve emotional regulation and stress response

• Help you feel less controlled by your body

• Gradually rebuild trust in your body

• Support grief, frustration, and burnout that often come with chronic illness

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Relating to Pain Differently: A Path to Safety and Relief​

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One of the most powerful shifts PRT teaches is separating the pain itself from the fear about the pain.

 

This often means learning to:

• Notice when anticipation or catastrophizing is amplifying pain

• Separate physical sensation from the story your mind tells

• Respond to pain with curiosity instead of panic

• Build tolerance for sensation without spiraling

 

Repeated experiences of meeting pain with calm and safety help rewire the brain. The nervous system learns it doesn’t need to sound the alarm so loudly or so often.

 

The goal isn’t zero pain. It’s less fear, more flexibility, and more agency. Through PRT, many people experience meaningful relief. And even when pain doesn’t fully disappear, suffering often decreases significantly. Life begins to feel bigger than the symptoms.

 

Therapy doesn’t erase the reality of living with a chronic condition, but for many it changes the experience of it. And sometimes, that shift is everything.

 

I’m Jessie Latin, a Licensed Marriage and Family Therapist in Los Angeles. I’m passionate about working with women and teens struggling with chronic conditions and pain. I strongly believe that the pain of chronic sufferers deserves a voice, a witness, and the chance to find what meaningful relief feels like. I offer free 15-minute consultations to see if we might be a good fit!