Glossary of Mindbody Terms
Acute pain: Pain due to a variety of physical/ structural issues (injury, fever, infection, labor, etc.) that lasts for four weeks or less.
Amplification: When the level of pain is more significant due to an increased level of fear or hypervigilance.
Avoidance behaviors: Any action taken to escape from/ get rid of the pain.
• External - Changing physical position/ engaging in physical activity to reduce the pain
• Internal - Shifting attention away from a painful sensation to another sensation (i.e., the breath)
Bottom-up processing: The process in which sensory receptors receive input of sensory information from the external environment and send them to the brain for perception.
Behavioral exposures: Resuming life activities with guidance on reframing the pain, communicating messages of safety, and focusing on positive sensations/ non-pain goals.
Chronic pain: Pain that persists long after an injury has healed/ the normal course of healing (usually over three months) despite medication/ treatment.
1. Primary - No underlying condition adequately accounts for the pain
2. Secondary - An underlying condition accounts for the pain
Conditioned response: When the brain creates associations between specific activities and adverse outcomes to protect us from repeating dangerous behaviors.
Corrective experiences: Exposure to a fear-inducing stimulus resulting in a reduction of fear.
Danger signals: When the brain reacts to a perceived threat for survival.
• Anxiety - A fear/ worry in anticipation of a perceived threat in someone’s external environment. Evolutionarily, this danger signal helps us fight harder or escape quickly (fight or flight).
• Depression - A feeling associated with a loss of energy, motivation, and hope. Evolutionarily, this danger signal helps us reserve resources necessary for survival/ encourages the enemy to leave us alone (freeze).
• Fatigue - A feeling of low energy and a strong desire to sleep that interferes with daily activities. This danger signal warns us that our system needs to rest and recover
• Itchiness - A feeling that causes scratching or rubbing to defend against bugs or parasites, causing the sensation
• Nausea - A feeling that prevents us from continuing to eat something dangerous
Delayed onset: Experiencing pain only after completing an activity but not during it.
Empowerment: Helping patients view the pain as an opportunity to achieve a corrective experience to neutralize fear.
Evidence (gathering and reinforcing): Gathering counter-evidence to reinforce that the pain is due to central processes, not structural problems in the body.
Experiential evidence: When patients engage in activities/ somatic tracking and see a reduction in pain reinforcing a neuroplastic diagnosis.
Extinction burst: A phenomenon where patients have a spike of intense pain just as their fear and symptoms decrease.
“Failed back surgery syndrome”: A common phenomenon where people experience continued back pain after spinal surgery.
Fear: A feeling induced by a perceived danger that heightens alertness, sensitivity, and the desire to escape 17. High alert/ hypervigilance: An elevated state of constantly scanning the environment for danger/ potential threats. Being in a state of high alert may contribute to the misinterpretation of neutral stimuli.
Mindfulness: The awareness that emerges through paying attention intentionally, in the present moment, and without judgment.
Mixed pain: A combination of neuroplastic and physically-caused pain.
Negative behavioral patterns: The tendency to engage in familiar abusive/ neglectful patterns that activate danger signals.
Neural pathways: A series of brain-connected neurons that send signals to one another. Neural pathways are responsible for helping us learn new behaviors and activities that are stored in learned memory.
Neuropathic pain: Pain that is generated because of damage to the nerves.
Neuroplastic pain: When pain persists after an injury has healed or has no apparent physical cause. Neuroplastic pain is caused by the brain misinterpreting safe messages from the body as if they are dangerous. But, when the brain learns and changes in response to pain, it can become chronic (“Neuro” refers to the brain and other parts of the nervous system. “Plastic” means developed or changed).
Other names for neuroplastic pain include:
• Central sensitization: A condition where the central nervous system learns to be overly sensitive to non-threatening stimuli
Pain System Hypersensitivity
• Mindbody syndrome
• Nociplastic pain
• Psychophysiologic disorder (PPD)
• Tension Myositis Syndrome (TMS): A name given by Dr. John E. Sarno to a condition of psychogenic musculoskeletal and nerve symptoms
Perceived Danger Pain
Neuroplasticity: The brain’s ability to learn and change.
Neutral sensations: Paying attention to sensations that aren’t painful or pleasant. It may be easier for patients to attend to something neutral rather than something with a history of fear. This can also be used if patients have difficulty finding a pleasant sensation.
Nociceptive pain: Pain that is generated because of damage to body tissue.
Nociceptors: Specialized peripheral sensory receptors that detect painful stimuli.
“Normal abnormalities”: The idea that even “abnormal” findings on an MRI often don’t line up with the experienced physical symptoms and are typically “normal” signs of aging or wear/ tear to the body.
Outcome independence: When the patient’s emotional state no longer depends on their pain level.
Pain: Your brain's response to danger signals sent by sensory receptors in the body. We experience pain to protect us from causing further tissue damage.
Pain beliefs: Represent a patient’s conceptualizations of pain and what pain means for them.
Pain-fear cycle: Pain triggers feelings of fear. Fear makes the brain more likely to misinterpret safe signals as dangerous, which causes more pain. More pain leads to more fear. More fear leads to more pain.
Pain Reprocessing Therapy (PRT): A system of psychological techniques that retrains the brain to interpret and respond appropriately to signals from the body, breaking the cycle of chronic pain.
Pivot: Adjusting to your patient’s reactions during a somatic tracking exercise.
Placebo: A treatment/ medication often used in research studies designed to deceive participants into thinking they are receiving treatment when they are not.
Placebo effect: The beneficial impact/ improvement in health from taking a placebo, which is mainly due to the patient's belief that the drug is real.
Positive affect induction: Anything you can say to help break the intensity/ lighten the mood during somatic tracking so that patients can attend to sensations through a lens of safety (humor, stories, and analogies).
Positive feedback loop: This occurs when the product of a reaction leads to an increase in that reaction. With pain, when the response to the symptoms includes fear, the patient will be more fearful in the future.
Positive sensations: Focusing on pleasant feelings instead of pain.
“The Process”: A set of strategies aimed at maximizing corrective experiences and minimizing retraumatization to overcome pain gradually.
Psychoeducation: Educating patients on how pain can develop and persist and the importance of breaking the pain-fear cycle. The first step in PRT treatment.
Psychophysiologic Disorders (PPD: This is the clinical term for mindbody symptoms, meaning symptoms that are caused by neural pathways that develop in response to stress, trauma, and repressed emotions. These learned neural pathways are anatomical changes in the brain, which means that the resulting symptoms are generated in the brain and not “in your head.” The symptoms are very real and can be chronic and debilitating, but the good news is that they are also benign and curable!
Prefrontal cortex: The part of the brain responsible for learning and making meaning. With neuroplastic pain, there is increased activity in this area of the brain.
Preoccupation: The tendency to run toward a familiar physical feeling. Often, patients are running away from a physical sensation associated with stillness.
Reinforcement: The reaction to a feared stimulus that either encourages the brain to interpret it as dangerous or safe in the future.
Relapse: When the pain returns because of an injury, perceived injury, stressful event, or because the patient falls back into old negative behavioral patterns.
Retraumatization: Exposure to a fear-inducing stimulus resulting in an increase in fear.
Safety reappraisal: Anything you can say to help a patient feel safe, specifically during a somatic tracking exercise.
Secondary gain: When a patient benefits from their pain symptoms in some way, decreasing their motivation to get better.
Self-compassion: The communication of authentic feelings of love, care, and safety to one’s self.
Setbacks: When patients have an "off day" or week. Having setbacks may be an opportunity to build resilience, ultimately leading to a reduction in fear and a greater capacity to recover.
Shame: A learned feeling of humiliation and self-loathing that is not necessarily related to a specific behavior/ event.
Somatic tracking: A technique to retrain the brain to correctly interpret signals from the body by attending to a painful sensation through a lens of safety, thereby deactivating the pain.
• Active somatic tracking: Patient is engaged in physical movement
• Passive somatic tracking: The patient is stationary
Somatosensory cortex: A region of the brain responsible for receiving and processing sensory information from the body.
Symmetrical symptoms: When pain develops in the same part of the body but on opposite sides (ex, both wrists, both ankles, etc.), it is unlikely that the pain is rooted in a physical problem.
Symptom imperative: When symptoms change location in the body or become replaced by another condition after pain begins to improve in one area.
Top-down processing: Internal predictions about what a patient expects to feel based on past experiences.
Ulterior motive dilemma: When patients desire a specific outcome during somatic tracking, it prevents them from achieving a corrective experience.
Whitecoat phenomenon: The tendency to blindly trust a physician simply because they are a physician.
(c) Pain Reprocessing Therapy Center/PRT certification training