Safe Self-Talk to Support Healing From Chronic Pain and Symptoms

Excessive negative thoughts about symptoms can worsen the sensations over time^1,2. Thinking and beliefs influence our nervous system's safety or danger, and contribute to chronic dysregulation, leading to sensitization, where the brain and nervous system begin to produce chronic pain or symptoms.

Common negative thoughts about our symptoms can sound like^1,2:

• “My symptoms are permanent, and nothing I do helps.”
• “My body is becoming more damaged each day!”
• “Something is really wrong with my body!”
• “My symptoms are only going to worsen over time…”
• “This is hopeless, my body can’t do anything!”

So, how can we shift our thinking about pain and symptoms?

In our approach, we support clients in developing safe self-talk about their symptoms, sensations, emotions, and nervous system state.

Safe self-talk about our symptoms can help the brain reappraise physical sensations and situations as safe, instead of dangerous^1,2. However, for safe self-talk to work, our words need to be credible! This is why learning how our nervous system works and relating our pain or symptoms to the criteria for neuroplastic symptoms is so important! To learn more, check out our blog post on Criteria for Neuroplastic Pain.

Examples of Safe Self-Talk for Chronic Symptoms:

• “I know I’m ok; my brain is just misinterpreting normal sensations in my body.”
• “I see how my symptoms are inconsistent, moving around, and triggered by emotions. This shows me it’s neuroplastic, and my body is healthy and capable.”
• “I don’t need to control or change these sensations. There is nothing to fix or figure out!”
• “My body is healthy. My brain is just being overprotective.”
• “It’s physically safe to move this way.”
• “I can respond to my symptoms with deep care and compassion.”
• “I don’t need to like these sensations; I just need to remember they’re safe!”

The goal of using safe self-talk is to reinforce to the brain that it’s safe to feel these symptoms, the body is safe, and movement or activities are safe. Over time, this can support the reduction or elimination of our chronic pain or symptoms ^1,2. The key to using brain retraining practices effectively is to do them consistently, but not intensely. You can practice safe self-talk throughout the day, each time you notice a negative thought about your pain or symptoms, and also while engaging in somatic practices with pain or symptoms. As you practice this strategy, please know it’s normal to feel danger and not fully believe our safe self-talk at first! Over time, safe self-talk becomes more natural, effective, and believable.

Now it is your turn to create your own safe self-talk for chronic pain and symptoms. Different phrases work for different people; effective and safe self-talk is unique to you and your symptoms. Find the self-talk that feels right for you! Remember to use the neuroplastic pain or symptom criteria you related to when building your self-talk to make it more credible.

If you need support with your healing, book in for a free 20-minute virtual consultation with one of our therapists:

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1. Gordon, A., & Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Sony/ATV Music Publishing LLC. 

2. Pain Reprocessing Therapy Center (2021). Pain reprocessing therapy training.

Medical Trauma: Causes, Signs, and Treatment

By Tanner Murtagh

Medical trauma is a common category of trauma that, unfortunately, often goes unrecognized by physicians or therapists and adequate treatment for it is rarely provided¹. It can be defined as a somatic, psychological, or cognitive stress response following a medical procedure^1,2.

As Levine³ discusses, trauma is not the event that occurred but the response of our nervous system to the event. Trauma is actually prolonged dysregulation in the nervous system, which could look like a fight, flight, freeze, and/or shutdown response^3,4.

In my experience working with clients with chronic pain or illness, a large portion of them have medical trauma. Following a surgery, scary procedure, unhelpful treatment, or generally unsupportive or stigmatizing care from medical professionals, many people, for months or years after, have chronic nervous system dysregulation and greatly fear interacting with the medical system.

Causes of medical trauma can include:

• Confusing, scary, or conflicting opinions and information from medical professionals
• Proper education about a procedure not being provided prior to it occurring
• Compassionate support not being provided prior, during, or after a procedure
• Stigma from medical professionals, family, or friends, such as being mistreated or being made to feel “crazy”
• Onset of symptoms due to another health crisis or injury that caused a great sense of danger prior to a procedure
• Experiencing great fear prior to a procedure or surgery occurring
• A sense of inescapable attack was felt before and during a procedure⁵
• A procedure was unsuccessful or had a bad outcome, resulting in symptoms worsening
• Hope is repeatedly gathered and broken by failed treatments or interventions

Signs of medical trauma can include^5,6:

• Prior, during, and/or after a medical procedure a person experiences the following physical symptoms:
• Flight response: anxious, panic, on edge, racing heart, difficulties breathing, tingling, dizziness, racing thoughts, or excessive worry
• Fight response: irritated, angry, racing heart, shortness of breath, high anger towards medical professionals, or rigid movements
• Freeze/shutdown response: shutdown, numb, drowsy, dissociation, floaty sensations, exhaustion, low muscle tone, numbness, poor immune function, or disconnection
• Following the procedure a person has a heightened dysregulated response to routine medical appointments or interactions
• Avoidance of future medical appointments, assessments, or procedures
• Injuries from the procedures, such as scars from a surgery, take longer than normal to heal
• Somatic symptoms, as medical trauma can trigger and perpetuate chronic somatic symptoms such as chronic pain, fatigue, dizziness, and other symptoms

Preventative therapy for medical trauma

Getting psychological treatment prior to an upcoming medical procedure is one of the best ways to prevent medical trauma from occurring⁵. A well-trained therapist can support somatically processing unpleasant sensations related to upcoming procedures and cognitively processing negative thinking and beliefs regarding it. A therapist can also help in setting up the conditions for a more somatic sense of safety to occur during and after the procedure. This could include⁵:

• Supporting the individual in educating themselves about the procedure
• Helping the individual in advocating for themselves with the medical team to receive what they need to feel safe
• Aiding an individual in identifying resources of safety they can use during the procedure (e.g. music, supportive person, blanket, or item)
• Supporting an individual in writing a script of instructions for the surgeon or medical team
• Helping an individual gain exposure to being in the hospital while processing sensations

Therapy for Medical Trauma

Once medical trauma has occurred and you have identified it, it can be vital to seek the support of a trained therapist in the area. Our therapists specialize in treating clients with chronic pain or illness and, because of this, are experienced in helping clients in overcoming medical trauma. Collectively, our therapists utilize the following approaches to treat medical trauma:

• Somatic Experiencing
• EMDR
• Somatic Attachment Therapy
• Emotional Awareness & Expression Therapy
• Accelerated Resolution Therapy (ART)
• Radical Exposure Tapping
• Prolonged Exposure Therapy

If you are ready to begin healing from medical trauma or need support to prevent future occurrences, book a free 20-minute consultation with one of our therapists.

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1. McBain, S., & Cordova, M. J. (2024). Medical traumatic stress: Integrating evidence-based clinical applications from health and trauma psychology. Journal of traumatic stress, 37(5), 761–767. https://doi.org/10.1002/jts.23075

2. Birk, J., Kronish, I., Chang, B., Cornelius, T., Abdalla, M., Schwartz, J., Duer-Hefele, J., Sullivan, A., & Edmondson, D. (2019). The Impact of Cardiac-induced Post-traumatic Stress Disorder Symptoms on Cardiovascular Outcomes: Design and Rationale of the Prospective Observational Reactions to Acute Care and Hospitalizations (ReACH) Study. Health psychology bulletin, 3, 10–20. https://doi.org/10.5334/hpb.16

3. Levine, Peter A. (1997). Waking the tiger : healing trauma : the innate capacity to transform overwhelming experiences. Berkeley, Calif. :North Atlantic Books,

4. Dana, D. (2018). The polyvagal theory in therapy: Engaging the rhythm of regulation. W W Norton & Co.

5. Somatic Experiencing International (2021a). Somatic Experiencing Intermediate year Module 2.

6. Somatic Experiencing International (2021b). Somatic Experiencing Beginner year Module 1.