Where therapy helps

Pain doesn’t stop at the body

Chronic pain reshapes how you sleep, what you say yes or no to, how you talk with the people you live with, and how you think about the future. It can become the loudest voice in your day, even on the days it’s relatively quiet.

By the time most people come to therapy for pain, they’ve already had a long road of appointments, scans, medications, and explanations that didn’t quite land. Sometimes they’ve been told the pain is real but there’s nothing more that medicine can do. Sometimes they’ve been left wondering what kind of help is even on offer at this point.

Therapy can’t take chronic pain away. The work isn’t medical, and it doesn’t replace the medical care you have in place.

What therapy can do is change the relationship between you and your pain: how much attention it claims, how much it dictates your decisions, how much weight it has on your mood and sleep and the things you used to enjoy. Pain often stays present in the work. The aim is for it to take up less of you.

My approach

How I work with chronic pain

ACT (Acceptance and Commitment Therapy) is the main approach I use for chronic pain. The work helps you build psychological flexibility: practical skills for moving towards what matters to you while pain is part of the picture, rather than spending all your energy fighting it or trying to think your way out of it. There’s good evidence behind this approach for chronic pain, and it’s where most modern therapy for pain is headed.

EMDR (Eye Movement Desensitisation and Reprocessing) comes in where it fits. Pain experiences often come tangled with trauma, such as a difficult medical event, an accident, or repeated dismissal in healthcare. EMDR has specific tools for working with that.

CBT (Cognitive Behavioural Therapy) shapes how I think about evidence-based practice. My BABCP accreditation grounds the wider approach in proven traditions, even as I draw on what’s most helpful for the person in front of me.

The blend depends on what you’re carrying. Many people I work with start with ACT and never need anything else. Others need a few sessions of EMDR alongside, or some classic CBT skills for sleep or worry. The work fits you.

Conditions

Pain conditions I work with

If your condition isn’t listed, that doesn’t mean it isn’t a fit. The free consultation is the right place to check.

In sessions

What we’ll actually work on

Pain therapy isn’t generic. It works because it focuses on the specific things pain has been doing to your daily life. The work usually covers some combination of these:

• Pacing and energy management. Finding patterns of activity that fit the body you have now and the things that matter most to you. The aim is workable rhythm rather than boom-and-bust.
• Reducing fear-avoidance. Pain often teaches us to brace, withdraw, or avoid. Some of that is sensible. Some of it shrinks your life further than the pain itself does.
• Sleep and mood. Pain disrupts both. Both, in turn, make pain harder to manage. We work the loop.
• Communication with healthcare. Getting more out of appointments. Asking better questions. Advocating for yourself when you’re tired of advocating.
• Identity and meaning. Pain changes who you thought you were going to be. Therapy is one place to do the slow work of finding yourself again, with the body you have now.

Read more

Articles I’ve written about chronic pain

• When scans are clear but the pain is real: next steps

  What to do when imaging keeps coming back normal but the pain hasn’t gone away.

• How to communicate pain effectively to your GP

  A structured way to describe pain in ten-minute appointments so nothing important gets lost.

See all articles →