The Monster Under the Bed

“Take a deep breath” sounds like a simple request. For Rachel, those four words could bring on a wave of fear before she took a single breath.After a period of illness and difficult breathing, Rachel found herself checking whether she could get a full, satisfying breath. A breath that felt right brought temporary relief. One that didn’t could send her back into checking and worrying. Daniel Lyman, host of the Pain Reprocessing Therapy Podcast, takes listeners inside 12 sessions with Rachel to show how they worked with that cycle.The first step was finding out what Rachel was afraid would happen. When Daniel asked her to get specific, she said she was afraid the next breath wouldn’t come. That was the “monster under the bed”: what an incomplete breath had come to mean. Once they could name that fear, they could choose a starting point together. Sometimes that meant simply talking about it.In one clip, Daniel asks Rachel to take a breath “of any kind.” Rachel notices how much pressure those words take off. Later, when the request for a deep breath brings the fear back, they pause. Listening to those two moments side by side makes it easy to hear why the wording, the pace, and the person’s response matter so much.As the sessions go on, Daniel explains how he adjusts the challenge one piece at a time. Some moments bring up more than either of them expects, and some weeks feel harder than others. Daniel talks through what he pays attention to when deciding whether to pause, change the exercise, or try something different. He also explains how exposure fit into their broader work on thoughts, emotions, and behavior, and why appropriate medical evaluation still matters when symptoms are new or concerning.One of the clearest signs of progress comes when Rachel says she’s starting to respond to the sensation more like she would to a hiccup. She still notices it, but it doesn’t always pull her into the same cycle of fear and checking. For clinicians, this episode offers a chance to hear the decisions behind graded exposure in real sessions. For anyone who knows what it’s like to spend a day monitoring a symptom, it offers a different way to recognize progress: how much attention, time, and freedom you get back. Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]

When pelvic pain affects movement, intimacy, or everyday life, treatment can start to feel like another place where your body is being judged. Another exercise to get right. Another appointment where someone tries to fix you. Another reason to feel disconnected from a part of yourself.What would care look like if it helped you build trust in your own body?In this episode, host Daniel Lyman talks with Cait Van Damm, a licensed pelvic floor occupational therapist, sexual health counselor, and advanced pain reprocessing clinician. Cait brings together movement, biomechanics, and pain neuroscience to support people with complex chronic pelvic pain.Her interest in pelvic health grew out of a desire to offer affirming, inclusive care to people whose needs were being overlooked. Today, that same commitment shapes how she approaches treatment: understanding the person in front of her, offering choices, and helping them become an active participant in their care.Building safety through movementCait describes how PRT changed the way she uses movement with clients. Rather than prescribing a single exercise and asking someone to work through it, she offers a menu of options and helps them find a starting point that feels manageable.For someone who associates bending forward with pelvic pain, that might begin with standing with their hands against a wall, then shifting their hips back just a little. From there, they can explore more movement while knowing they have a familiar place to return to.Cait describes moving between a foundation of safety, a zone of interest, and a zone of challenge. The pace looks different for everyone. What matters is helping people notice their sensations, experiment with movement, and build evidence that their bodies can respond differently.Why safety and challenge belong togetherFeeling safer does not mean avoiding every uncomfortable or unfamiliar experience. Cait and Daniel explore how a trusting therapeutic relationship can help people try something challenging without feeling pressured or overwhelmed.That might mean experimenting with another repetition, a new position, or a slightly larger movement. Along the way, Cait helps clients recognize what they have already done and what that tells them about their capacity for change.The goal is to help people develop the skills to understand their own bodies and make choices with greater confidence.Making room for pleasure and intimacyPelvic pain can carry layers of shame, fear, relationship pressure, and difficult medical experiences. Cait explains why open conversations about sexual health matter, and why treatment needs to begin with what the person actually wants.She also shares how she helps clients reconnect with pleasurable sensations outside of sex, whether that is a comforting texture, a favorite scent, or another small experience of delight. These moments can offer a starting point for recognizing that the body has capacity for comfort and enjoyment.When sexual pleasure or partnered intimacy is a goal, Cait describes a gradual, collaborative approach. There is no single timeline or required outcome. The emphasis stays on curiosity, consent, and the person’s own experience.Rethinking the role of dilatorsCait shares why she does not typically make dilators her first approach to pelvic pain, and how she may use them later as a tool for graded exposure.For her, the broader picture matters: movement, muscle guarding, fear, body awareness, and how someone feels about the treatment itself. She also discusses why bringing a partner into the process, when appropriate and wanted, can involve its own learning and communication.For some people, the starting point is much earlier. Simply becoming comfortable talking about pelvic anatomy or sexual health can be an important step.When structural conditions and neuroplastic pain overlapDaniel and Cait also address an important distinction: pelvic pain is not always neuroplastic. Structural conditions, biomechanical factors, and nervous system responses can exist together.Cait discusses how a painful condition can be accompanied by an additional layer of protective muscle guarding. Exploring that response does not dismiss the underlying condition or make the pain any less real.Her message to people living with pelvic pain is grounded and compassionate: your experience deserves to be believed, you deserve support, and change is possible without needing to promise a particular outcome.Find Cait Van Damm, her virtual practice, Tidal Work movement platform, and Adventures in Vaginas and Other Parts Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]

For many people with ME/CFS, the message from the medical system has been consistent and discouraging: there is no cure, manage your symptoms, adjust your expectations.But what happens when researchers stop asking doctors what recovery looks like and start asking the people who actually recovered?In this episode, host Daniel Lyman talks with two researchers who did exactly that.Julie Harper struggled with chronic fatigue syndrome for seven years before recovering through a mind-body approach. That experience led her to pursue a master's in psychology and conduct qualitative research interviews with eight women who had also recovered from ME/CFS. Her study asked two questions: what does recovery actually mean to people who have been through it, and how did they get there?What she found was four recurring themes across the women she interviewed, two foundational and two active.The foundational elements were a recovery mindset, meaning a belief that getting better was possible and a sense of personal agency, and an explanatory narrative, a new way of understanding why symptoms developed and why they persisted.The active elements were approaching symptoms differently, without fear and without treating every sensation as evidence of damage, and addressing the root causes, the emotional patterns, relational dynamics, and ways of living that may have contributed to the illness in the first place.Perhaps just as striking was what recovery meant to these women once they were on the other side. Not a return to their old lives, but something better. A different relationship with their bodies. And a confidence that even if symptoms returned, they would know exactly what to do.Dr. Sarah Cefai is a senior lecturer in gender and cultural studies at Goldsmiths, University of London. Her study analyzed 75 recovery interviews from Raelan Agle's YouTube channel, looking not just at what people said helped them, but at the larger story of how people move from illness to recovery.Across 75 very different stories, a few things kept showing up. 95% of participants described a mind-body shift in their understanding of their symptoms as a turning point in their recovery. 84% spoke specifically about nervous system regulation. And nearly everyone described a moment, not always dramatic, where they made a decision to keep looking for a way forward, even when the medical system had told them there wasn't one. Read the study.Dr. Cefai is also honest about what the research can and cannot tell us. The people represented in these stories are not everyone with ME/CFS. But the patterns are real, and they point somewhere useful.Both researchers arrive at the same place: recovery is possible, it tends to involve a shift in how you understand your symptoms, and the stories of people who have gotten better are worth listening to carefully. Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]

For most people who experience tinnitus, hyperacusis, or misophonia, the message from the medical system has been some version of the same thing: there is no cure, learn to cope, this is just your life now. Dr. Marcia Dewey has spent her career pushing back on that narrative, and in this episode she sits down with host Daniel Lyman to talk about why. Dr. Dewey is an audiologist who founded the Tinnitus and Hyperacusis Program at Froedtert and the Medical College of Wisconsin. After discovering neuroplasticity-based approaches through the Curable app, she began integrating PRT principles into her work with clients experiencing sound-related symptoms, and what she's seen since has changed the way she practices. What Daniel and Dr. Dewey cover: What tinnitus, hyperacusis, and misophonia actually are. Tinnitus is any sound you hear from inside your body, not just ringing. Hyperacusis is sensitivity to sounds based on loudness. Misophonia is an intense, often visceral reaction to specific sounds, usually made by other people. Three distinct experiences, but with more in common than most people realize. Why tinnitus is a symptom, not a disease. Just like pain, tinnitus is a signal, not a diagnosis. And just like pain, what you believe that signal means has an enormous effect on how your nervous system responds to it. How fear and attention keep symptoms alive. Eighty percent of people who experience tinnitus are not bothered by it. The difference between that group and the group that suffers is not the sound itself. It is the relationship with the sound, and that relationship can change. Somatic tracking for sound sensitivity. Dr. Dewey uses somatic tracking, which she calls sensation observation, with clients on their very first visit. She also uses imaginal exposure for hyperacusis, having clients imagine triggering sound environments and track what they notice in their bodies, before ever approaching the real thing. The misophonia piece. Often dismissed as hopeless or untreatable with exposure, Dr. Dewey makes the case that the same neuroplastic tools apply, just applied carefully and starting from the mildest end of the trigger ladder. Hope as a clinical intervention. One of the most moving moments in this episode is a story about an early tinnitus client who cried for twenty minutes when Daniel told him recovery was possible. He hadn't felt hope in six years. Shortly after, his tinnitus was mostly gone. If you or someone you love has been told to just live with ringing, sensitivity, or sound reactions, this conversation is worth your time. Resources mentioned in this episode: The Way Out by Alan Gordon and Alon Ziv Tinnitus: From Tyrant to Friend by Julian Cowan Hill Demystifying Misophonia by Shaylynn Hayes-Raymond Dr. Marcia Dewey on YouTube Dr. Yonit Arthur, The Steady Coach: thesteadycoach.com (free tinnitus course available under Resources) Dr. Annie Smith on YouTube Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]

What does recovery from chronic fatigue actually look like inside a therapy room? In this episode, host Daniel Lyman shares something rare: real recordings from real sessions. Over seven weeks, he worked with a client named Eric, whose chronic fatigue began after a bout of mono. The infection resolved. The exhaustion did not. Across eight session clips, you won't hear a dramatic turning point or one technique that fixed everything. You'll hear something more honest and more useful: recovery happening in real time, one small shift at a time. What Eric and Daniel worked on together: Taking breaks as a message to the nervous system. This wasn't productivity advice. For years, Eric had pushed through exhaustion without stopping, and his brain had quietly learned that rest wasn't safe, that something more urgent always came first. Taking breaks was a way of gently saying otherwise. Actually feeling emotions, not just understanding them. Eric was good at analyzing his stress. He could explain it, trace it, put words to it. What he hadn't been doing was letting himself feel it. When he finally stopped and sat with the weight of a hard situation at work, something in his symptoms shifted too. Changing what the symptoms mean. Eric had been quietly organized around the idea that something might still be physically wrong, a lingering infection, an immune system that hadn't fully recovered. Shifting that story, from "my body is damaged" to "my nervous system learned to stay on guard and hasn't gotten the update yet," changed how he related to everything that followed. Bringing joy back in. Chronic symptoms have a way of making life smaller. Hobbies disappear. Activities get quietly abandoned. Part of Eric's recovery was deliberately reintroducing the things that reminded his nervous system what safety and aliveness actually feel like. For him, that meant cycling, time with his partner, and video games. By the final session, Eric had cycled 30 kilometers, hiked five and a half kilometers with real elevation gain, noticed his concentration improving at work, and arrived at something that may matter more than any of it: he no longer believed that something was wrong with his body. If you've ever had an illness that seemed to resolve on tests but left something behind in your body, you should give this a listen. Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]

In this episode, Daniel Lyman is joined by two of the leading minds in mind-body medicine — Dr. Mark Lumley and Christie Uipi — for a candid, collaborative case discussion unlike anything we've done before. Dr. Mark Lumley is a distinguished professor of psychology at Wayne State University, co-developer of Emotional Awareness and Expression Therapy (EAET), and one of the world's leading researchers on mind-body therapies for chronic pain. Christie Uipi is a psychotherapist, Executive Director of the Better Mind Center, a key contributor to the development of PRT, and a chronic pain overcomer herself. Together, the three work through three real cases submitted by listeners: Jill from Canada has lived with vestibular migraine and Persistent Postural-Perceptual Dizziness (PPPD) for six years after a lifetime of people-pleasing, boundary struggles, and pushing through stress. The group explores dizziness as an "escalation symptom" — what happens when the body has been ignored for too long — and how unexpressed emotions may be driving the nervous system's loudest signals. Ben from Edinburgh has had chronic lower back and hip pain for 30 years. His herniated discs have largely resolved, but the pain remains — and it's worst in the middle of the night. The group digs into conditioned pain responses, the psychology of sleep and pain, and why rigidity in daily routines might be keeping the nervous system stuck. Katerina has suffered from migraines since age 20 and is now dealing with up to 20 migraine days a month. She wants to know: is migraine actually neuroplastic? Can you treat it like neuroplastic pain if there's an underlying disease process? Dr. Lumley shares findings from a recent randomized controlled trial showing a 40% reduction in migraine frequency with group EAET, and the group unpacks the tension between traditional migraine management and a neuroplastic approach. This episode is a masterclass in collaborative clinical thinking — and a reminder that no matter how long you've been suffering, there are still doors worth opening. Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]

Episode Title: When the Work Isn't Working Season 2, Episode 1 Welcome to Season 2 of the Pain Reprocessing Therapy Podcast. Daniel Lyman, LCSW — founding member of the Pain Psychology Center and Executive Director of the Mind Body Therapy Center — takes over as host this season, bringing a deep clinical background in neuroplastic symptoms and chronic pain recovery. For the first episode, Daniel sits down with Gabrielle Jacobs, LCSW, Associate Director of the Mind Body Therapy Center, to tackle one of the most frustrating experiences in recovery: doing everything right and still feeling stuck. In this episode, Daniel and Gabrielle discuss: Why understanding PRT and healing through PRT are two different things The concept of experiential safety — and why waiting to feel safe before acting keeps people stuck How relationships (with people, work, environments, and patterns) directly impact the nervous system's ability to heal Living with intensity: why the same personality traits that make people great at life can quietly work against recovery The difference between eliminating symptoms and changing the patterns that sustain them Identity fusion — when pain becomes part of how someone understands themselves, and how to gently begin to loosen that grip Secondary gain: what the symptom might be providing, and how to give yourself that thing without needing the pain to get it Key concepts mentioned: Experiential safety and graded exposure The fear-avoidance model Somatic tracking All-or-nothing thinking in recovery Secondary gain Neuroplastic symptoms Identity and recovery About the hosts: Daniel Lyman, LCSW, is a psychotherapist and founding member of the Pain Psychology Center, where Pain Reprocessing Therapy was originally developed. He is the Executive Director of the Mind Body Therapy Center, a therapy and coaching practice serving clients worldwide dealing with chronic somatic symptoms. Gabrielle Jacobs, LCSW, is the Associate Director of the Mind Body Therapy Center and a clinician specializing in neuroplastic symptoms and chronic pain. She has been deeply involved in the clinical world of Pain Reprocessing Therapy for many years. If you found this episode helpful, please subscribe, leave a review, and share it with someone who might need to hear it. Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]

In this episode, we explore what happens when fatigue doesn’t just mean “tired”—it feels like your whole life has been taken away.Host John Gasienica sits down with Rachel, who developed severe post-viral chronic fatigue after a major COVID infection. Her symptoms—crushing exhaustion, brain fog, fear, and OCD spikes—left her doubting whether she’d ever get her life back. Together, John and Raelan Agle, a social worker and author who recovered from 10 years of ME/CFS, unpack how belief, emotion, and nervous system regulation interact when fatigue feels terrifying and permanent.You’ll hear John work with Rachel in real time on two core beliefs:“I’m physically broken.”“I’m incapable of regulating myself.”They explore how shifting from rumination and fear into sadness, grief, and healthy anger can loosen those beliefs and reduce the “monster” feeling of fatigue, even before symptoms entirely change.Along the way, John and Raelan talk about:Why people with histories of anxiety, OCD, and depression may be more vulnerable to neuroplastic fatigueHow emotional regulation (not emotional perfection) helps the nervous system feel saferWhy fatigue can feel uniquely frightening and isolating compared to other symptomsThe protective role of anger and assertiveness after medical invalidation and lossHow genuine joy, fun, and play are core nervous-system medicine, not “extras”John also shares a framework for belief in recovery:- Neuroplastic symptoms are real and can drive physical sensations.- This might actually be what’s happening in my body.- I can learn to regulate my nervous system with support.At the end of the episode, John announces that this is the last episode of Season One and his final episode as host. He shares where he’s headed next (including a Substack for clinicians) and how to keep learning about Pain Reprocessing Therapy and neuroplastic symptoms.What you’ll learn- Why severe fatigue can feel so terrifying and isolating—and why that reaction makes sense- How core beliefs like “I’m broken” and “I can’t regulate myself” keep symptoms feeling permanent- A practical way to shift from anxiety and rumination into sadness, grief, and healthy anger- How emotional regulation and belief interact to create safety in the nervous system- Why joy, play, and doing things you genuinely enjoy are powerful predictors of recovery- The “three layers of belief” about neuroplastic symptoms and where you might be stuck 0:00 – Intro: chronic symptoms, belief, and why feeling safer (not solving everything) matters2:00 – Disclaimer & PRT practitioner training mention3:00 – Meet guest Raelan Agle and her background with ME/CFS recovery6:00 – Meet Rachel: post-COVID crash, severe fatigue, brain fog, and OCD spirals14:00 – “I’m broken” vs. “I can’t regulate myself”: core beliefs behind the fear24:00 – Exploring anger vs. sadness; assertiveness as protection, sadness as grief32:00 – Live emotional work: touching grief and noticing shifts in fatigue in real time44:00 – Debrief with Raelan: why fatigue feels like a “different monster”53:00 – The role of belief, understanding the nervous system, and genuine joy in recovery1:05:00 – The three layers of belief in neuroplastic symptoms1:15:00 – Takeaways for people living with chronic fatigue and long COVID1:20:00 – John’s closing: final episode as host, what’s next, and how to stay connected Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]

In this episode, we explore how “thinking less” and feeling safer in the present can quiet the nervous system and ease chronic symptoms. Dr. Becca Kennedy, a board-certified family medicine physician who treats neuroplastic conditions, joins John to unpack medical invalidation, loneliness in chronic pain, and why learning to access anger, compassion, and play can unlock recovery. You’ll also hear a real coaching segment with “Sarah,” navigating vulvodynia, fear, and uncertainty with step-by-step emotional work and somatic tracking.What you’ll learnWhy certainty isn’t required for recovery—and how to “negotiate” with the brain’s demand for it.A gentle, repeatable way to sit with fear and sadness so safety messages can finally land.How practicing anger expression (safely) restores agency after medical gaslighting.Somatic tracking: Relaxing bracing and signaling “nothing to protect”.Re-introducing play and joy as evidence to your brain that you’re safe—even while symptoms are present.Rough timeline0:00 Intro — symptoms fade when we feel safer, not when we solve everything2:00 Disclaimer & PRT training mention3:00 Meet Dr. Becca Kennedy; path to neuroplastic care6:00 Vulvodynia labels: validation vs. harm7:00 Sarah’s story: yeast infection → persistent pelvic pain, despair, isolation14:00 Processing the emotions of being in pain (not just past trauma)20:00 Guided exercise: feeling fear/helplessness with compassion in the “life raft”29:00 Accessing frustration/anger and why it’s protective to express it37:00 Living with uncertainty; safety in the now vs. promises about later43:00 Safety visualization and re-introducing play50:00 Fun as medicine; nature, joy, and daily moments of ease51:00 Parting encouragement & hopeGuestDr. Becca Kennedy — Resilience Healthcare (neuroplastic conditions, long COVID, chronic pain)Mentioned/ConceptsPain Reprocessing Therapy (PRT), somatic tracking, Emotional Awareness & Expression Therapy (EAET), nervous system regulation, medical trauma, safety signals. Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]

In this episode of the PRT Podcast, host John Gasienica, LCSW, is joined by Dr. David Clarke, a board-certified physician in internal medicine and gastroenterology and co-founder of the Association for the Treatment of Neuroplastic Symptoms.John and Dr. Clarke discuss how trauma and adverse childhood experiences (ACEs) can shape chronic pain and stress, and why traditional tools don’t always work for those with PTSD. Together, they guide patient Rachel through techniques to face emotions of grief, fear, and anger, while learning to see physical symptoms as expressions of emotions rather than signs of damage.Key topics include:Understanding trauma as a driver of chronic painThe three major consequences of childhood trauma (triggers, suppressed emotions, and people-pleasing)Why stillness and compassion can feel unsafe for trauma survivorsHow to use the physiological sigh and mindfulness tools for regulationSteps to build self-esteem, self-compassion, and sustainable healingFeatured Guests:Dr. David Clarke – Physician, author of They Can’t Find Anything Wrong, expert in neuroplastic pain, co-author of Psychophysiological DisordersRachel – Patient guest sharing her journey with trauma, PTSD, and recoveryClick here to access the free meditations mentioned by John in the podcast! Resources and Additional LinksLearn More About Pain Reprocessing Therapy (PRT)Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.Patient HubPractitioner HubLearn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBodyEmail Us: [email protected]