Pain Reprocessing THerapy in Bothell and Online Throughout Washington State
Chronic Pain Therapy in Spokane & Eastern Washington
Your Body Was the One Thing You Could Always Count On
You've been dealing with this long enough to know the pattern: the pain shows up, you push through it, you try whatever your doctor recommends, and for a while it feels like you're making progress. Then it comes back, or it moves somewhere new, or it settles into a low hum that never fully goes away.
You've done the rounds: the orthopedic clinic off South Regal, the physical therapy appointments in Spokane Valley, maybe a pain management referral that ended with a prescription and a follow-up in six months. Each provider addressed one piece of it, but nobody has looked at the whole picture. Nobody has been able to explain why you're still hurting when every scan says you shouldn't be.
Meanwhile, you're making choices you didn't used to have to make. You skip the Sunday pickup basketball game at the Y because you know how Monday will feel. You drive to the grocery store on South Hill instead of walking because you're not sure your back will hold up for the return trip. You used to spend weekends at Bowl and Pitcher or hiking the bluffs above the Spokane River, and now you're calculating whether it's worth the two days of recovery afterward.
You can learn more about Pain Reprocessing Therapy, including who it works best for and what changes in the weeks after we start, on my chronic pain therapy page.
When the Diagnosis Doesn’t Match the Pain
About 85% of people with chronic back pain don't have structural damage that explains what they're feeling. The same is true for many cases of neck pain, migraines, fibromyalgia, repetitive strain injuries, IBS, and conditions labeled "idiopathic" — a medical term that means the cause is unknown.
Your pain is completely real. Brain imaging shows that people with this kind of pain have the same brain activity as someone with a visible injury. There's nothing exaggerated or imaginary about it.
What's different is the source. When pain continues long after an injury has healed, or shows up without an injury at all, your brain may have learned to keep producing danger signals even when there's nothing structurally wrong. Think of it like a smoke alarm that got stuck in the "on" position — the original fire is out, but the alarm keeps blaring. Your brain strengthens this response through repetition, the same way any pattern gets stronger over time. And the way you respond to pain feeds the cycle: when you avoid the movements that have hurt before, when you brace before getting out of the car because your back always seizes at that moment, when you stop making plans because you can't predict how your body will feel, your brain reads all of that as confirmation that the threat is real.
The world gets smaller. The pain persists. And you adjust to a version of your life that's built around accommodating something nobody can fully explain.
This pattern can reverse. Your brain learned this response, and it can unlearn it.
Pain Reprocessing Therapy: a different approach for chronic pain
I use Pain Reprocessing Therapy (PRT), an evidence-based approach specifically designed to address pain generated by the nervous system rather than structural damage.
PRT works by helping your brain relearn how to interpret signals from your body. Right now, when you bend down to pick something up off the floor or sit at your desk for an hour, your brain reads those normal sensations as dangerous and produces pain to protect you, even though nothing is actually being damaged. Through guided exercises, we work together to help your nervous system recognize that those sensations are safe, gradually turning off the false alarm that's been keeping you in chronic pain.
This is different from pain management strategies that teach you to cope with pain indefinitely. The goal is to reduce or eliminate the pain itself by addressing what's actually driving it.
I also combine PRT with body-based therapy and trauma treatment (EMDR) because chronic pain often exists alongside other things your body has been carrying. Maybe the pain started during a major life stressor, after years of physically demanding work, or during a period when everything felt like it was falling apart. Maybe you've been holding tension and stress in your body for so long you've stopped noticing it.
Pain Reprocessing Therapy combined with trauma work addresses both the pain signal and whatever else has been keeping your whole system on high alert.
In a clinical trial published in JAMA Psychiatry, 66% of participants reported being pain-free or nearly pain-free after treatment, and 98% experienced significant reduction. Those results held a year later.
Your Life Can Change After Therapy for Chronic Pain
You drive to Riverside State Park on a Saturday morning and hike the Bowl and Pitcher loop without spending the night before deciding whether your back can handle the uneven terrain. You do the full loop, you take photos at the suspension bridge, and you stop for lunch in Kendall Yards on the way home because you feel like it, not because you need to sit down.
You shovel your driveway after a Spokane snowstorm without the dread that's become automatic. You clear the whole thing, you salt the walkway, and the next morning your back is a little tired but not locked up. You drive to work without the heating pad wedged behind you.
You sit through a three-hour dinner at a restaurant downtown with friends and you're engaged in the conversation instead of shifting in your chair, checking the time, counting how much longer until you can stand up. When someone suggests moving to the bar for another round, you go.
You sign up for the adult ski league at Mt. Spokane, the one your coworker has been pushing you to join for two winters. You ski the full day, you're sore the next morning the way skiers are supposed to be, and you go back the following weekend.
You stop turning down camping trips to Priest Lake or fishing weekends on the Spokane River because you can't trust your body to hold up for two days away from home. You pack the truck, you sleep on a cot in the cabin, you carry the cooler down to the water, and you don't spend the whole time managing yourself.
Pain stops being the first thing you plan around.
Schedule Your First Session
Schedule Your First Session
Who is Pain Reprocessing Therapy For?
You have chronic pain that doesn't have a clear structural explanation, or pain that has lasted long after an injury should have healed. This includes back pain, neck pain, migraines, IBS, fibromyalgia, repetitive strain injuries, pelvic pain, post-surgical pain that persists despite successful surgery, and conditions where Spokane-area doctors haven't been able to identify a definitive cause.
You suspect there's more going on than what shows up on a scan, or you've started to notice that your pain worsens with stress and improves when you're relaxed or distracted. Or maybe the mind-body connection is a new idea, and you're willing to explore it because the conventional route hasn't given you lasting results.
This approach may not be the right fit if you’re involved in ongoing legal matters related to your pain, such as disability claims, worker's comp, or lawsuits. It also may not be right if you're looking exclusively for medical or pharmaceutical solutions and aren't open to exploring how your brain and body interact, or if you haven't had a medical evaluation to rule out conditions requiring medical treatment.
You don’t need to be fully convinced. Willingness to explore the possibility is enough.
Get Started in Chronic Pain Therapy
I work with clients throughout Spokane and Eastern Washington via telehealth. PRT doesn’t require hands-on treatment; the work is conversation-based, involves guided exercises you practice during and between sessions, and is just as effective over a secure video connection as it is in person. You'll learn techniques in the environment where your pain actually shows up, which is where the real change happens.
If you're dealing with pain that doctors can't fully explain and you're looking for a different kind of answer, reach out. We'll talk about your situation and whether this approach makes sense for what you're dealing with.
Serving Spokane and Eastern Washington
Including Spokane Valley, Liberty Lake, Cheney, Airway Heights, Medical Lake, and surrounding areas.
About Ingrid Johnston, LMFT, MDFT
Spokane & Eastern Washington chronic pain therapist
I’m a Licensed Marriage and Family Therapist in Washington State, specializing in chronic pain therapy.
I’ve completed Pain Reprocessing Therapy training and hold advanced certification in Medical Family Therapy and Collaborative Medicine. My approach combines somatic therapy, trauma treatment, and nervous system regulation.
I understand this work both professionally and personally. I've navigated my own path through chronic pain and learned firsthand how pain can take over your identity, your plans, and your sense of what's possible for your life.
I’m a member of the American Association for Marriage and Family Therapy (AAMFT) and the Washington Association for Marriage and Family Therapy (WAMFT).
Licensed Marriage and Family Therapist: Washington State License #LF61033631
Questions?
FAQs About Chronic Pain Therapy
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Individual sessions are $300 for 50 minutes. I don't accept insurance directly, which means I'm not limited by what an insurance company decides is medically necessary or how many sessions they'll approve. You pay at the time of the session, and I provide a superbill you can submit to your insurance for potential out-of-network reimbursement. Many PPO plans reimburse a portion after your deductible is met. I recommend calling the number on the back of your insurance card before your first session to ask about your out-of-network mental health benefits.
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Most pain management programs assume the pain is permanent and teach you to cope with it: pacing strategies, relaxation techniques, medication, learning to accept a smaller life. Pain Reprocessing Therapy has a different goal. Rather than helping you build your life around the pain, PRT works to reduce or eliminate the pain itself by retraining the brain patterns that are generating it. In the clinical trial published in JAMA Psychiatry, 66% of participants were pain-free or nearly pain-free after treatment, and those results held a year later.
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No. You can continue with any medical care, physical therapy, or other treatment you’re receiving. Some clients find that as their pain decreases, they naturally need less of their other interventions, but that's a decision you make with your other providers over time.
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A few indicators: your imaging or tests have come back normal or don't fully explain the level of pain you're experiencing. Your pain has persisted long after an injury should have healed. Your pain moves around, or it started during or after a stressful period in your life. You've noticed that stress makes it worse and distraction or relaxation makes it better. You don't need all of these to be true, but if a few of them sound familiar, your pain may respond well to this approach.
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You don’t need to be convinced, you just need to be open. Many of my clients come in skeptical, and that’s fine. The research is strong enough that you don’t have to take it on faith. What matters is a willingness to try something different after the conventional route hasn't given you lasting results. Where this approach tends not to work is when someone is certain that only a medical or surgical solution will help and isn't willing to explore other possibilities, or when there's an active legal case connected to the pain, like a disability claim or lawsuit, because the incentive structure works against the recovery process.
Get started in chronic pain therapy today in Spokane or anywhere in Eastern Washington.
If you’ve tried other approaches and you’re still in pain, this might be the missing piece. Reach out to ask questions or schedule a first session.
Get In Touch
Contact Ingrid
Please complete the form, and I will be in touch within 48 business hours.
Office and mailing address:
19803 North Creek Parkway, Suite 205
Bothell, WA 98011
In-person in Bothell & online across Washington