What If Pain Isn’t the Enemy—but Information?

For decades, pain has been framed as a warning signal—evidence of injury, damage, or pathology that must be eliminated. This framing is deeply embedded in healthcare culture and language. Yet for many people living with chronic pain—especially when imaging and tests fail to reveal ongoing tissue damage—this model creates confusion, fear, and a sense of helplessness.

Modern neuroscience offers a different and far more useful understanding: pain is not a direct readout of tissue state, but a brain-generated prediction about threat. In many chronic pain conditions, particularly nociplastic pain, central nervous system processes play a dominant role even when peripheral pathology is absent or minimal (Ashar et al., 2021; Fitzcharles et al., 2021).

This reframing does not invalidate pain. It validates it more fully. Pain is real, embodied, and protective—but it is not always accurate.

Pain as Predictive Processing

Pain emerges through predictive processing. The brain continuously integrates sensory input with prior experience, emotional context, and learned expectations to decide whether the body is in danger. When threat predictions outweigh safety signals, the brain generates pain as a protective output—even in the absence of tissue damage (Ashar et al., 2021).

Over time, this process can become self-reinforcing. Fear amplifies pain. Pain reinforces fear. The nervous system becomes sensitized—what many people describe as feeling “on high alert.” Attempts to push through or override pain often worsen symptoms, not because tissues are failing, but because the system is responding to perceived threat (Fitzcharles et al., 2021). 

Why Reframing Pain Changes Outcomes

When pain is understood as damage, fear makes sense. Avoidance feels logical. Disability often follows.

When pain is understood as modifiable brain activity, something else becomes possible: agency.

Pain Reprocessing Therapy (PRT) provides compelling evidence for this shift. In a randomized clinical trial, two-thirds of participants with chronic back pain were pain-free or nearly pain-free after treatment, with effects sustained at one year (Ashar et al., 2021). Improvements were mediated not by distraction or coping, but by reattribution—changing beliefs about pain from structural damage to mind–brain processes (Ashar et al., 2023).

Patients described learning to relate to pain as information rather than danger. Fear reduction—not force—was the central mechanism.

Where Hypnotherapy Fits

This is where hypnotherapy becomes especially relevant.

Clinical hypnosis works directly with predictive processes—attention, expectation, imagery, and meaning—to recalibrate threat appraisal at the level where pain is generated. Rather than asking patients to tolerate pain better, hypnotherapy allows them to experience safety, flexibility, and change in real time.

In practice, hypnosis helps people discover that sensation can shift without injury, that attention alters perception, and that the nervous system can learn new patterns. This experiential learning is often what allows cognitive reframing to truly take hold.

For nurses and clinicians, hypnotherapy offers a language-based, relational tool that aligns with neuroscience while fully validating the lived experience of pain.

Moving Forward

Understanding pain differently is only the first step. Change happens when insight is paired with experience.

At Calm Collective Care, we’re committed to making evidence-informed, nervous-system–based approaches accessible in ways that fit real lives. Through secure Zoom sessions, you can engage in clinically grounded hypnotherapy from the comfort of your home—without sacrificing depth, safety, or connection.

Our work is rooted in the same principles explored here: restoring agency, reducing fear, and helping the nervous system learn new patterns of response. Whether you’re navigating chronic pain, stress, anxiety, or a desire for greater clarity and resilience, our collective approach blends hypnotherapy with coaching and mindfulness-based practices to support meaningful, sustainable change.

Ways to Get Started

Guided Group Hypnosis
We offer live, guided group hypnosis sessions designed to support stress reduction, confidence, emotional regulation, and nervous system resilience. These sessions provide a structured, supportive environment for experiential learning—whether you join live or explore our growing audio library.

👉 Learn more Group Session in the Change Your Life Circle
👉 Access the ever-expanding Audio Library
 

One-on-One Hypnotherapy
For a more personalized approach, working individually with a certified hypnotherapist allows for tailored support aligned with your specific goals, history, and nervous system patterns. You can explore our team of practitioners and schedule a consultation to find the right fit.

Guest Author Spotlight:

Christy Cowgill CRNA, PMHNP-C, NC-BC, BCH, CI

Christy board-certified hypnotherapist and certified instructor of hypnosis. Her clinical practice integrates her backgrounds in psychiatric mental health and anesthesiology, with a focus on supporting clients experiencing depression, anxiety, and chronic pain. Committed to advancing trauma-informed hypnosis education for nurses, Christy advocates for clinically grounded hypnosis training pathways and is a founding member of Calm Collective Care.

References:

1. Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(1):13–23. doi:10.1001/jamapsychiatry.2021.2669 
   

2. Fitzcharles, M. A., Cohen, S. P., Clauw, D. J., Littlejohn, G., Usui, C., & Häuser, W. (2021). Nociplastic pain: towards an understanding of prevalent pain conditions. Lancet (London, England), 397(10289), 2098–2110. https://doi.org/10.1016/S0140-6736(21)00392-5 
   

3. Ashar YK, Lumley MA, Perlis RH, Liston C, Gunning FM, Wager TD. Reattribution to Mind-Brain Processes and Recovery From Chronic Back Pain: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2023;6(9):e2333846. doi:10.1001/jamanetworkopen.2023.33846 

A Different Therapeutic Stance

This model moves beyond both purely biomedical explanations and coping-only approaches. It does not ask people to endure pain more skillfully. It invites them to change their relationship with it—and in doing so, often reduces pain itself.

Befriending Pain was written to translate this science into lived experience, bridging neuroscience and hypnotherapy in language that makes sense.

Pain isn’t a life sentence—it’s information.
And understanding it changes everything.

👉 Find Befriending Pain on Amazon
https://www.amazon.com/dp/B0GKWNCNBV