Pain Reprocessing Therapy (PRT)

Online support for neuroplastic pain

Living with persistent pain can make ordinary decisions feel complicated. You may hesitate before moving, plan your day around symptoms, or find yourself checking your body for signs of another flare. Even when you have been told that an injury has healed, it can be difficult to trust that reassurance when you still hurt.

Pain Reprocessing Therapy offers a way of working with the relationship between bodily sensation, fear and the expectation of harm.

I offer PRT-informed psychological work online, drawing on my background in somatic and trauma-focused approaches. We begin with your experience, what is known medically about your symptoms, and whether this approach makes sense for you.

What is Pain Reprocessing Therapy?

Pain Reprocessing Therapy is a psychological treatment for pain in which learned brain and nervous-system processes play an important role. Often called neuroplastic pain, this can involve pain persisting after healing, with otherwise safe sensations or movements continuing to trigger a protective response.

PRT combines education with practical, experiential work to help change the interpretation of these sensations and reduce pain-related fear. The aim is to help the nervous system learn that protection may no longer be needed in the same way.

About PRT

Your pain is real. You have not chosen it, and difficulty recovering does not mean you are doing something wrong.

Could PRT be appropriate for my pain

We start by considering the whole picture: how your pain began, how it behaves, what investigations and treatments you have had, and how it affects your life.

Pain that varies, changes location or responds strongly to context may prompt us to explore a neuroplastic contribution. None of these patterns, and no normal scan on its own, establishes the cause of pain.

Appropriate medical assessment is part of this process. New, changing or unexplained symptoms need medical attention. Pain related to tissue injury, nerve damage and altered pain processing can overlap, and psychological work can sit alongside medical care.

You do not need to arrive convinced that your pain is neuroplastic. There is room for questions, uncertainty and a careful assessment of whether the explanation fits.

What happens in sessions?

I want to understand what living with pain has been like for you. This includes the explanations you have received, what has helped, what has disappointed you, and what you have become afraid to do.

From there, we may work with:

understanding how pain and the expectation of danger can reinforce each other;
noticing the thoughts, emotions and protective responses that arise around symptoms;
exploring bodily sensations through somatic tracking;
gradually rebuilding confidence in activities considered medically safe;
finding ways to respond to setbacks without making recovery another demand you must meet.

We agree on a pace that is manageable. There is no requirement to push through intense pain or prove that you can tolerate it.

Somatic tracking: a different way of attending to sensation

Somatic tracking is a central PRT practice. It involves approaching bodily sensations with curiosity and a supported sense of safety, rather than repeatedly checking for damage.

PRT techniques

In a session, I might invite you to notice the qualities of a sensation: its location, its edges, whether it changes, and what happens around it. We also notice your response. Perhaps you brace, hold your breath, become frightened, or feel an urgent need to make it stop.

I am interested in whether there is room to approach that experience a little more gently. You do not have to produce relaxation or make pain disappear during the exercise.

If attention to the body becomes overwhelming, we adjust. We might spend less time with the sensation, widen attention to the room, or first establish a steadier sense of contact and support.

When trauma or dissociation is part of the picture

My work with PRT is informed by my wider experience with trauma, attachment and dissociation.

For some people, pain is closely connected with an accident, surgery or frightening medical experience. Others describe years of feeling on guard, or moving between intense bodily awareness and feeling disconnected from themselves.

These experiences matter to how I approach the work. I may draw on Deep Brain Reorienting or other somatic approaches when trauma-related difficulties also need attention. This individualised clinical approach draws on my extensive experience and training in somatic and trauma-focused work, rather than evidence that combining these methods produces superior pain outcomes.

Trauma processing is not a requirement for everyone who seeks PRT. We work with what is relevant to you.

You can read more about my broader approach on the Chronic Pain and Neuroplastic Pain page.

What does the research show?

A randomised clinical trial involving 151 adults with primary chronic back pain compared PRT with an open-label placebo and usual care.

After treatment, 66% of participants assigned to PRT were pain-free or nearly pain-free, compared with 20% in the placebo group and 10% in usual care. Benefits were largely maintained at one year. Read the study in JAMA Psychiatry

These are encouraging findings for the population studied. They do not establish the same success rate for every pain condition or predict an individual person's outcome. Substantial pain relief is possible, but a particular result or recovery timetable cannot be promised.

Working with me

I am Dr Olesya Ovchinnikova, PhD, Psychologist FSP, full member of European Association for Body Psychotherapy.

I have completed foundational training in Pain Reprocessing Therapy two years ago, am currently undertaking Advanced Training, and am listed in the Pain Reprocessing Therapy Institute's Mental Health Clinician Directory. I am also an approved Deep Brain Reorienting practitioner.

My approach brings together psychology, somatic work and attention to the relationships and circumstances in which pain is experienced. There is room to speak about the exhaustion, frustration, uncertainty and losses that can accompany it.

Sessions take place online in English, Italian or Russian, where professional regulations permit me to work with you in your location.

An initial conversation

You are welcome to contact me to discuss your pain, what you have already tried, and what you would like help with. We can consider whether PRT, trauma-focused work or another form of support may be appropriate.

Contact me to discuss working together