Pain Reprocessing Therapy In Bothell & Online Throughout Washington State
Therapy for Chronic Pain
Your Body Used to Handle Everything.
You were the athlete, the adventurer, the reliable one who volunteered for every physical project. You prided yourself on how much you could take on.
Now you’re “the person with back pain.”
New colleagues at work only know this version of you: the one who works from home most days, who sometimes winces when standing up, who can’t commit to after-work plans. They can’t imagine you as the person who used to backpack through Mount Ranier, or play competitive sports. And honestly, some days you can barely remember that person either.
Many people with chronic pain describe feeling like they’ve lost their identity, saying, “I miss who I used to be” or, “I don't know who I am anymore”¹.
Your back started hurting three years ago. Then your neck. Now your wrists ache when you type, your jaw clenches at night, and you wake up stiff every morning. You’ve been to physical therapy. You tried yoga, acupuncture, and that expensive new mattress. Your doctor says your MRI looks fine and suggests you “manage your stress better.”
When pain dictates whether you can attend your kid’s soccer game, accept a job opportunity, or even sit through dinner with friends, when it becomes the lens through which you evaluate every single decision, it starts to feel like it’s written over everything else that makes you who you are.
You’re grieving the person you were, the one who went dancing until 2am and then hiked Rattlesnake Ledge the next day. Now, you watch your friends post photos from weekend camping trips while you’re home with a heating pad. Again.
Chronic Pain Is Real, Even When Tests Are Normal — But So Is Hope
About 85% of people with chronic back pain don’t have structural damage that explains their pain⁴. The same is true for many other chronic pain conditions. When imaging comes back normal but you’re still hurting, your nervous system, not your body, may be the source.
The pain is completely real. Studies using brain scans show that people experiencing this type of pain have the exact same brain activity as people with pain from actual tissue damage; there's nothing imaginary about it⁵. But here’s what happens: when the brain experiences pain repeatedly, the pathways get strengthened and sensitized, and over time, the brain learns to keep sending pain signals⁶.
Think of it like a smoke alarm. Normally, when you injure yourself (ie, you sprain your ankle), your body sends danger signals to your brain, and you feel pain. That pain protects you by telling you to rest and let the injury heal. After several weeks, the ankle heals, the danger signals stop, and the pain goes away.
But sometimes the alarm system gets stuck in the “on” position. The brain starts misinterpreting safe messages from the body as dangerous, essentially sending false alarms even when there's no fire⁵. When these pathways are activated repeatedly, they become like a "speed dial." The brain gets better at producing that pain signal⁶, the same way you get better at playing piano through practice.
Fear and avoidance fuels this cycle. When you avoid bending forward because you're afraid it will hurt, you're teaching your brain that bending is dangerous. When you tense up in anticipation of pain, you're confirming to your nervous system that there's a real threat. This creates a vicious cycle: fear reinforces pain, and pain reinforces fear⁷.
Here’s good news: Just as pain can be learned, it can also be unlearned⁵. Your brain is capable of rewiring itself at any age. When you teach your brain that those signals are actually safe, the pain can fade.
My Approach to Chronic Pain Therapy
I bring together somatic therapy, understanding of how past difficult experiences affect the body, and nervous system work with Pain Reprocessing Therapy principles. Many clients with chronic pain have experienced trauma, lived in high-stress environments, or went through significant life challenges around the time their pain began.
I help you understand how your specific nervous system learned these pain responses and what’s keeping them going. We look at your history, how you respond to stress, your emotional life, and how your body has adapted over time.
I also recognize that the wellness industry can sometimes make things worse. When you’re trying new approaches, supplements, and treatments, monitoring every body sensation, and researching every possible diagnosis, these tactics can keep your nervous system in a state of constant alert. In therapy, you and I will work to calm that system down while building genuine confidence in your body’s ability to heal.
This work requires active participation. You’ll practice techniques between sessions and experiment with approaching sensations differently. But you won’t be doing it alone.
Here’s what we’ll do together
How Pain Reprocessing Therapy Helps You Unlearn Pain — in Only 4-12 Sessions
I use Pain Reprocessing Therapy (PRT), an evidence-based approach developed specifically to address pain caused by the nervous system. In a study published in JAMA Psychiatry, 66% of people who underwent PRT reported being pain-free or nearly pain-free after just 4 weeks of treatment, and 98% experienced significantly reduced pain levels¹². These improvements were maintained a year after treatment.
PRT works by helping your brain relearn how to interpret signals from your body. When pain persists without structural cause, your nervous system has essentially learned to sound a false alarm. Through specific techniques, we work together to help your brain update this outdated danger signal and recognize that your body is safe.
The Chronic Pain Therapy Process Explained
Investigating What Drives Your Pain – We examine when your pain started, how it behaves throughout the day, what makes it better or worse, whether it moves or changes unpredictably. We look at what was happening in your life when the pain began—was there significant stress, major life changes, or emotional challenges? We gather personalized evidence that points to brain-generated pain rather than tissue damage. This investigation helps you understand why your specific pain indicates a nervous system issue.
Relearning What Pain Means – You learn exactly how pain works in the brain and why persistent pain doesn't necessarily mean your body is broken or damaged. This understanding is essential for recovery. Research shows that people who experienced the largest drops in their belief that pain indicates injury had the largest drops in actual pain levels⁴. We work to shift your relationship with pain from "something is terribly wrong with my body" to "my nervous system learned this and can unlearn it."
Paying Attention Differently — This is a core PRT technique that helps you develop a completely new relationship with pain sensations. Instead of tensing against pain or trying to push through it, you learn to pay attention to sensations with curiosity rather than fear. We use specific methods like body awareness, sensation exploration, and mindful attention to help you see these signals as safe rather than dangerous. This approach combines being present with your body, reminding yourself you’re safe, and bringing in positive feelings to help you attend to the sensation in a way that turns off the pain signal⁵.
Working with Emotions and Your Nervous System – Pain often gets worse during stress or gets triggered by emotional experiences your body hasn't fully processed. Many people with chronic pain have histories of high stress, perfectionism, difficult childhoods, or are carrying emotions they haven't had space to feel. We address what keeps your nervous system on high alert, any past difficult experiences, and emotional factors that can fuel the pain cycle. This isn't about your pain being "emotional"—it's about understanding how your nervous system responds to stress and learning to help it calm down.
Breaking the Activity-Pain Connection – Often, the brain creates associations between certain physical activities and pain onset: walking leads to back pain, typing leads to wrist pain, bending leads to neck pain⁵. We work systematically to break these learned connections so you can engage in physical activities without triggering pain. This involves gradually returning to movements you’ve been avoiding, done in a way that retrains your brain’s interpretation of these activities.
Pain Reprocessing Therapy Works Differently For Chronic Pain
If you’ve been in physical therapy for months or managing pain for years, you might be skeptical about promises of quick results.
Here’s why PRT works differently:
Traditional pain treatment assumes pain is permanent and focuses on management, teaching you to pace activities, modify movements, and accept limitations. This approach can take months or years with only incremental improvements.
PRT addresses the source: the learned neural pathways creating pain. In the clinical trial, participants received 8-9 sessions over 4 weeks. At one-year follow-up, over half remained pain-free without ongoing treatment.
Most people complete chronic pain therapy in 4-12 sessions depending on how long they’ve had pain and whether other factors (like trauma or high stress) need to be addressed. Once you’ve retrained your nervous system, you’ll have the skills to maintain results independently.
Pain Reprocessing Therapy works by helping your brain relearn how to interpret signals from your body. When pain persists without structural cause, your nervous system has essentially learned to sound a false alarm. We’ll work together to help your brain update this outdated danger signal and recognize that your body is safe.
Your Life Can Change After Chronic Pain Therapy
If you’ve been through other treatments, you’ve probably been taught pain management strategies: how to pace yourself, modify activities, accept your “new normal.” Those approaches assume the pain is permanent. Pain Reprocessing Therapy starts from a different premise: if your nervous system learned this pain, it can unlearn it. Rather than managing pain for the rest of your life, the goal is eliminating or dramatically reducing it.
After successful treatment, clients return to hiking trails they’d given up. They sleep through the night without waking up in pain. They play on the floor with their kids without fear of consequences, garden and exercise again, engage in physical intimacy without discomfort or anxiety. They lift groceries, sit through movies, take road trips, and engage in all the activities they have been avoiding.
They make career decisions based on what they want, not what their body can tolerate. They stop introducing themselves through their pain and reconnect with hobbies and interests they’d abandoned. They feel like themselves again instead of a body with pain attached.
They stop calculating pain levels before making plans and say yes to social invitations without anxiety. They focus during work meetings instead of tracking body sensations, feel present with family instead of distracted by discomfort. They plan trips without extensive contingency planning, accept invitations without first checking how their body feels, and commit to activities knowing they can follow through.
Most importantly, they trust their body again instead of treating it like an enemy. They experience hope about the future instead of resignation.
Who this approach works for…
This approach is designed for people dealing with chronic pain that doesn’t have a clear medical explanation or has persisted long after an injury should have healed
Common conditions include: back pain, neck pain, migraines, IBS/GERD, fibromyalgia, repetitive strain injuries, pelvic pain, post-surgical pain that won’t resolve, or any condition labeled “idiopathic” or blamed on age.
You suspect there’s a mind-body component but haven’t found anyone who takes that seriously
You want to be defined by more than your pain
This approach isn’t right for everyone…
You’re involved in ongoing legal matters related to your pain (disability claims, lawsuits, worker’s comp)
You believe conventional medicine has the answers and you aren’t open to mind-body approaches
You are dealing with active substance abuse or severe untreated mental health conditions
You haven’t had a medical evaluation to rule out conditions requiring medical treatment
You don’t have to be 100% convinced your pain is mind-body related to start. What matters is openness to exploring this possibility when traditional treatments haven’t worked.
Online Chronic Pain Therapy for Washington Residents
If you've been told your pain is just part of getting older or that there's nothing left to try, and you're somewhere in Washington wondering whether therapy could actually help, I'd like to talk to you. I see clients via telehealth across the state, including in Seattle, Bellevue, Tacoma, Vancouver, and Spokane.
I see clients via telehealth on Tuesdays and Wednesdays between 8am-6pm. I also offer in-person sessions on Mondays at my Bothell office through summer 2026.
Get started in chronic pain therapy today.
Instead of being defined by chronic pain, you can be defined by what matters to you: your values, your relationships, your work, and your ability to be present for the life you want to live. I can help you get there.
About Ingrid Johnston, LMFT, MDFT
Chronic pain therapist
I've been working with people experiencing chronic pain since 2014, integrating body-based therapy with an understanding of how the nervous system creates and maintains pain. I’ve completed Pain Reprocessing Therapy training and hold advanced certification in Medical Family Therapy and Collaborative Medicine from Seattle Pacific University.
My approach combines somatic therapy, trauma treatment, and nervous system regulation, modalities that address both the physical experience of pain and the emotional factors that keep it active. I’ve completed extensive training in EMDR, somatic therapy for trauma, and working with the body’s stress responses.
I understand this work both professionally and personally. I’ve navigated my own path through chronic pain recovery and learned firsthand how pain can take over your identity, your plans, and your sense of what’s possible. I know what it’s like to be told your imaging looks fine while your body is screaming otherwise. And I know what it takes to reclaim your life from pain; not by managing it forever, but by addressing what’s driving it.
Many of my clients are dealing with both chronic pain and other complex experiences: religious trauma, high-stress careers, perfectionism, or past difficult experiences their bodies haven’t fully processed. I specialize in working with people who have complicated presentations and need someone who can address multiple layers at once.
I’m a member of the American Association for Marriage and Family Therapy (AAMFT) and licensed to practice throughout Washington State.
Licensed Marriage and Family Therapist: Washington State License #LF61033631
Questions?
FAQs About Chronic Pain Therapy & Pain Reprocessing Therapy
Don’t see you question asked and answered here? Check out my FAQ page.
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In the clinical trial, most people began experiencing significant pain reduction within 4 weeks of treatment, with 66% reporting being pain-free or nearly pain-free by the end of treatment. However, everyone’s timeline is different. Some people notice changes within the first few sessions, while others need more time to retrain their nervous system. We typically work together for several months to ensure lasting results.
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PRT is most effective for pain caused by the nervous system rather than structural damage. This includes most cases of chronic back pain, neck pain, migraines, fibromyalgia, IBS, and other conditions where medical imaging shows no structural cause. It’s less effective for pain caused by active tissue damage, infections, tumors, or progressive diseases. That’s why a thorough assessment is the first step.
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Yes. Even when pain begins with a real injury, it often persists long after the injury has healed because the nervous system has learned the pain response. If your pain has lasted beyond the normal healing timeline (typically 3-6 months), continues despite healed tissue, or varies unpredictably, neuroplastic pain may be maintaining it even if it started with an injury.
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No. You can continue your current medications, physical therapy, or other treatments while doing PRT. Many people find they naturally reduce or eliminate these treatments as their pain decreases. However, it’s important to work with your medical providers on any changes to medications or treatment plans.
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CBT for pain typically focuses on managing pain through coping strategies, thought modification, and behavior changes, essentially learning to live better with pain. Pain Reprocessing Therapy works to eliminate pain by retraining the brain to correctly interpret body signals. While both are evidence-based, PRT aims for pain elimination rather than pain management.
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Sessions typically involve education about how your specific pain works, somatic tracking exercises where you pay attention to sensations in new ways, processing emotions or stress that may be fueling the pain cycle, and gradually approaching movements or activities you’ve been avoiding. We also work with any trauma, perfectionism, or life stress that keeps your nervous system on high alert.
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No. This isn’t about positive thinking, affirmations, or convincing yourself the pain isn’t real. The pain is completely real, and changing your thoughts alone won’t eliminate it.
Here’s what happens: Your brain has learned to produce pain as a protective response, even when there’s no tissue damage to protect you from. This learned response is maintained by fear: when you interpret pain as dangerous, your nervous system stays on high alert and keeps producing pain signals.
Pain Reprocessing Therapy works by teaching your brain to accurately interpret body signals again. This requires specific techniques; not just thinking differently, but actually experiencing sensations in your body differently, working with fear responses, and systematically breaking the connections between activities and pain.
It’s more like retraining yourself out of a fear than positive thinking. If you’re afraid of dogs, you don’t overcome it by telling yourself “dogs are great!” You overcome it through gradual exposure that teaches your nervous system dogs aren’t actually dangerous. PRT does the same thing with pain signals.
The reason it works is because the pain has been learned, not by damaged tissue. Retraining that learned response can eliminate the pain quickly.
Schedule Your First Session Today
Schedule Your First Session Today
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
References
- Medical Humanities. (2023). "Who I used to be": Chronic pain, identity paralysis, and forging a new sense of self. Synapsis. https://medicalhealthhumanities.com
- Dahlhamer, J., Lucas, J., Zelaya, C., et al. (2021). Chronic pain among adults — United States, 2019–2021. Morbidity and Mortality Weekly Report (MMWR), 70(17). Centers for Disease Control and Prevention.
- Pain Reprocessing Therapy Center. (2025). Neuroplastic pain: How the brain creates & unlearns chronic pain. https://www.painreprocessingtherapy.com
- This Might Hurt Film. (n.d.). Pain reprocessing therapy — See how it works. https://www.thismighthurtfilm.com
- Pain Psychology Center. (n.d.). How it works. https://painpsychologycenter.com
- TMS Pain Free. (n.d.). What is neuroplastic pain. https://www.tmspainfree.com
- Gordon, A. (2021). How the brain causes chronic pain & how to stop it. HealthCentral. https://www.healthcentral.com
- American Psychiatric Association. (n.d.). Chronic pain and mental health often interconnected. Psychiatry.org. https://www.psychiatry.org
- Pitcher, M. H., et al. (2024). Co-occurrence of chronic pain and anxiety/depression symptoms among US adults. PAIN, 165(3). https://journals.lww.com/pain
- National Council on Aging. (n.d.). How does chronic pain affect older adults' mental health? https://www.ncoa.org
- King Edward VII's Hospital. (2025). Understanding the impact of chronic pain on mental health. https://www.kingedwardvii.co.uk
- Ashar, Y. K., Gordon, A., Schubiner, H., et al. (2021). Retraining the brain to treat chronic pain. NIH Research Matters. National Institutes of Health. https://www.nih.gov