
Show Notes
Rumination—those endless loops of worry, symptom monitoring, and "what if" thinking—can make chronic pain worse by keeping the nervous system stuck in a state of high alert. In this episode, therapist John Gasienica works with Leslie, a new mom struggling with chronic pelvic pain and obsessive thoughts about her symptoms.
John, alongside expert therapist Callie Klebanoff, breaks down the Pain Reprocessing Therapy (PRT) blueprint for disrupting rumination and retraining the brain to feel safe. They discuss:
- Why rumination is one of the biggest roadblocks to pain recovery. - How overthinking reinforces pain pathways in the brain. - Practical strategies for shifting from fear-based thinking to self-compassion. - A real-time session where Leslie learns to calm her nervous system and reduce pain.
If you’ve ever felt stuck in your thoughts about pain, this episode will give you the tools to break free from the cycle and start healing.
More from Pain Reprocessing Therapy Podcast
What does it look like to feel safer in your body when movement, touch, or sex has become associated with pain? In this episode, host Daniel Lyman talks with pelvic floor occupational therapist, sexual health counselor, and advanced PRT clinician Cait Van Damm about bringing pain reprocessing principles into pelvic health. Cait shares how she uses movement, curiosity, and patient choice to help people build confidence in their bodies, why safety and challenge can work together, and how pleasure and intimacy can become part of recovery when those are meaningful goals. They also discuss her approach to dilators, the importance of inclusive care, and how structural conditions and neuroplastic pain can overlap. Throughout the conversation, Cait returns to a central message: your pain is real, you deserve care, and your body has capacity for change.
What can we learn about chronic fatigue syndrome by listening to the people who actually recovered from it? In this episode, host Daniel Lyman sits down with two researchers who set out to answer exactly that question. Julie Harper conducted in-depth interviews with eight women who recovered from ME/CFS after struggling with it herself for seven years. Dr. Sarah Cefai analyzed 75 recovery stories from Raelan Agle's YouTube channel, looking for the patterns that kept showing up across very different people and very different journeys. What they found has a lot in common with what pain reprocessing therapy sees again and again: a shift in how symptoms are understood, a growing sense of agency, and a different relationship with the body. If you or someone you love has been told that chronic fatigue syndrome is something you just have to learn to live with, this episode is for you.
If you've ever been told that tinnitus, hyperacusis, or misophonia are conditions you simply have to manage and live with, this episode is going to offer you a different perspective. Host Daniel Lyman sits down with Dr. Marcia Dewey, an audiologist who founded the Tinnitus and Hyperacusis Program at Froedtert and the Medical College of Wisconsin and has spent years integrating neuroplasticity-based approaches into her work. Together they break down what these three conditions actually are, how fear and attention amplify symptoms, where structural issues end and neuroplastic processes begin, and how tools like somatic tracking, imaginal exposure, and safety learning can help people change their relationship with sound and, in many cases, dramatically reduce their symptoms.
What happens when the infection clears but the symptoms don't? In this episode, host Daniel Lyman shares recordings from eight real therapy sessions with a client named Eric, who had been living with chronic fatigue for years after a bout of mono. You'll hear Eric describe the weight of his exhaustion, the fear and confusion that surrounded it, and the beliefs that kept him stuck. And you'll hear what actually changed, not through a single breakthrough moment, but through a series of small shifts that gradually taught his nervous system it was safe. By the end of the episode, Eric is cycling, hiking, concentrating better at work, and beginning to trust his body again.
Host Daniel Lyman is joined by Dr. Mark Lumley, founder of Emotional Awareness and Expression Therapy (EAET), and Christie Uipi, psychotherapist and co-developer of Pain Reprocessing Therapy, to discuss three real patient cases: vestibular migraine and dizziness, chronic back pain with nighttime flare-ups, and migraine with uncertainty about neuroplastic diagnosis. Together they explore how emotions, conditioning, and the nervous system intersect — and what treatment might actually look like for each person.