In this episode, we explore what happens when fatigue doesn’t just mean “tired”—it feels like your whole life has been taken away.

Host John Gasienica sits down with Rachel, who developed severe post-viral chronic fatigue after a major COVID infection. Her symptoms—crushing exhaustion, brain fog, fear, and OCD spikes—left her doubting whether she’d ever get her life back. Together, John and Raelan Agle, a social worker and author who recovered from 10 years of ME/CFS, unpack how belief, emotion, and nervous system regulation interact when fatigue feels terrifying and permanent.

You’ll hear John work with Rachel in real time on two core beliefs:

“I’m physically broken.”

“I’m incapable of regulating myself.”

They explore how shifting from rumination and fear into sadness, grief, and healthy anger can loosen those beliefs and reduce the “monster” feeling of fatigue, even before symptoms entirely change.

Along the way, John and Raelan talk about:

• Why people with histories of anxiety, OCD, and depression may be more vulnerable to neuroplastic fatigue
• How emotional regulation (not emotional perfection) helps the nervous system feel safer
• Why fatigue can feel uniquely frightening and isolating compared to other symptoms
• The protective role of anger and assertiveness after medical invalidation and loss
• How genuine joy, fun, and play are core nervous-system medicine, not “extras”

John also shares a framework for belief in recovery:

- Neuroplastic symptoms are real and can drive physical sensations.

- This might actually be what’s happening in my body.

- I can learn to regulate my nervous system with support.

At the end of the episode, John announces that this is the last episode of Season One and his final episode as host. He shares where he’s headed next (including a Substack for clinicians) and how to keep learning about Pain Reprocessing Therapy and neuroplastic symptoms.

- Why severe fatigue can feel so terrifying and isolating—and why that reaction makes sense

- How core beliefs like “I’m broken” and “I can’t regulate myself” keep symptoms feeling permanent

- A practical way to shift from anxiety and rumination into sadness, grief, and healthy anger

- How emotional regulation and belief interact to create safety in the nervous system

- Why joy, play, and doing things you genuinely enjoy are powerful predictors of recovery

- The “three layers of belief” about neuroplastic symptoms and where you might be stuck

0:00 – Intro: chronic symptoms, belief, and why feeling safer (not solving everything) matters

2:00 – Disclaimer & PRT practitioner training mention

3:00 – Meet guest Raelan Agle and her background with ME/CFS recovery

6:00 – Meet Rachel: post-COVID crash, severe fatigue, brain fog, and OCD spirals

14:00 – “I’m broken” vs. “I can’t regulate myself”: core beliefs behind the fear

24:00 – Exploring anger vs. sadness; assertiveness as protection, sadness as grief

32:00 – Live emotional work: touching grief and noticing shifts in fatigue in real time

44:00 – Debrief with Raelan: why fatigue feels like a “different monster”

53:00 – The role of belief, understanding the nervous system, and genuine joy in recovery

1:05:00 – The three layers of belief in neuroplastic symptoms

1:15:00 – Takeaways for people living with chronic fatigue and long COVID

1:20:00 – John’s closing: final episode as host, what’s next, and how to stay connected

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]

In this episode, we explore how “thinking less” and feeling safer in the present can quiet the nervous system and ease chronic symptoms. Dr. Becca Kennedy, a board-certified family medicine physician who treats neuroplastic conditions, joins John to unpack medical invalidation, loneliness in chronic pain, and why learning to access anger, compassion, and play can unlock recovery. You’ll also hear a real coaching segment with “Sarah,” navigating vulvodynia, fear, and uncertainty with step-by-step emotional work and somatic tracking.

What you’ll learn

Why certainty isn’t required for recovery—and how to “negotiate” with the brain’s demand for it.

A gentle, repeatable way to sit with fear and sadness so safety messages can finally land.

How practicing anger expression (safely) restores agency after medical gaslighting.

Somatic tracking: Relaxing bracing and signaling “nothing to protect”.

Re-introducing play and joy as evidence to your brain that you’re safe—even while symptoms are present.

Rough timeline

0:00 Intro — symptoms fade when we feel safer, not when we solve everything

2:00 Disclaimer & PRT training mention

3:00 Meet Dr. Becca Kennedy; path to neuroplastic care

6:00 Vulvodynia labels: validation vs. harm

7:00 Sarah’s story: yeast infection → persistent pelvic pain, despair, isolation

14:00 Processing the emotions of being in pain (not just past trauma)

20:00 Guided exercise: feeling fear/helplessness with compassion in the “life raft”

29:00 Accessing frustration/anger and why it’s protective to express it

37:00 Living with uncertainty; safety in the now vs. promises about later

43:00 Safety visualization and re-introducing play

50:00 Fun as medicine; nature, joy, and daily moments of ease

51:00 Parting encouragement & hope

Guest
Dr. Becca Kennedy — Resilience Healthcare (neuroplastic conditions, long COVID, chronic pain)

Mentioned/Concepts
Pain Reprocessing Therapy (PRT), somatic tracking, Emotional Awareness & Expression Therapy (EAET), nervous system regulation, medical trauma, safety signals.

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]

In this episode of the PRT Podcast, host John Gasienica, LCSW, is joined by Dr. David Clarke, a board-certified physician in internal medicine and gastroenterology and co-founder of the Association for the Treatment of Neuroplastic Symptoms.

John and Dr. Clarke discuss how trauma and adverse childhood experiences (ACEs) can shape chronic pain and stress, and why traditional tools don’t always work for those with PTSD. Together, they guide patient Rachel through techniques to face emotions of grief, fear, and anger, while learning to see physical symptoms as expressions of emotions rather than signs of damage.

Key topics include:

Understanding trauma as a driver of chronic pain

The three major consequences of childhood trauma (triggers, suppressed emotions, and people-pleasing)

Why stillness and compassion can feel unsafe for trauma survivors

How to use the physiological sigh and mindfulness tools for regulation

Steps to build self-esteem, self-compassion, and sustainable healing

Featured Guests:

Dr. David Clarke – Physician, author of They Can’t Find Anything Wrong, expert in neuroplastic pain, co-author of Psychophysiological Disorders

Rachel – Patient guest sharing her journey with trauma, PTSD, and recovery

Click here to access the free meditations mentioned by John in the podcast!

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]

Perfectionism, pressure, and the belief that we’re never “enough” are some of the most overlooked drivers of chronic pain and today’s episode digs deep into how to break that cycle.

Therapist John Gasienica and special guest Vanessa Blackstone explore the emotional patterns behind nervous system dysregulation through the story of Jaycie, a nurse and mom dealing with chronic pain and burnout. They uncover how early life messages, people-pleasing, and emotional suppression (especially around anger and rest) keep us stuck and how to begin softening those patterns with real, grounded self-compassion.

Vanessa also shares personal reflections on grief and healing, and the episode walks listeners through somatic and visualization tools to begin shifting pain from the inside out.

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]

In this episode, we continue our deep dive with Daniel Lyman as we analyze a session with June, a filmmaker who’s made major strides in her chronic pain recovery but finds herself stuck. Together, we unpack the fear, anger, and sadness that have been underlying her migraines—and how reframing these emotions as protective allies can create powerful breakthroughs.

Daniel shares insights from his OCD and pain reprocessing background, and John uses emotional exposure and paradoxical agenda setting to help June see emotions as mature, trustworthy parts of herself.

🔹 How to make journaling more effective
🔹 What to do when recovery plateaus
🔹 Why fear of emotions keeps the nervous system stuck
🔹 How to turn fear and anger into strengths
🔹 Why feeling emotions in the moment creates change

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]

This is part two of our experimental two-part series following David, a patient living with chronic foot pain. In Episode 4, David received a neuroplastic pain diagnosis. In Episode 5, we go a step further—showing what happens when that diagnosis is explored through therapy.

What you’ll hear in this episode:
– A live, unscripted therapy session combining Pain Reprocessing Therapy (PRT), somatic tracking, and Emotional Awareness and Expression Therapy (EAET)
– Real-time reduction in pain as David rewires his brain’s fear response
– Exploration of childhood emotional patterns, perfectionism, and self-directed anger
– A somatic shift that helps David reclaim movement, safety, and strength
– Dr. Howard Schubiner’s expert commentary on the science behind each moment

This episode is about more than pain—it’s about the emotional undercurrents that shape how we experience our bodies, and the incredible transformation that can occur when we meet our pain with curiosity, compassion, and courage.

Bonus: Stay tuned to the end to hear Dr. Schubiner’s reflections on the future of healing—blending neuroscience, trauma-informed care, and emotional expression into one powerful therapeutic approach.

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]

This special episode captures part one of an innovative two-part series, following a patient's full neuroplastic pain journey — from diagnosis to treatment.

What you'll hear in this episode:
– A live neuroplastic pain assessment from Dr. Matt McClanahan, DO
– Discussion of "FIT criteria" (Functional, Inconsistent, Triggered symptoms)
– The impact of trauma and historical context on pain
– David’s candid account of how conflicting diagnoses made recovery harder
– A breakdown of why nervous system safety is essential for healing

Part two of this series will feature a treatment session with David and legendary insights on how to begin retraining the brain.

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]

Rumination—constantly monitoring symptoms, worrying about pain, and overanalyzing every sensation—can make chronic pain worse by keeping the nervous system in a state of high alert. In this episode, therapist John Gasienica works with Leslie, a new mom struggling with chronic pelvic pain and obsessive symptom fixation. Alongside expert therapist Callie Klebanoff, they break down the Pain Reprocessing Therapy (PRT) blueprint for stopping rumination and retraining the brain to feel safe.

What You’ll Learn in This Episode:

• Why fixating on symptoms reinforces pain pathways in the brain.
• How symptom monitoring can do more harm than good.
• Practical strategies to break the cycle of overthinking pain.
• A real-time therapy session where Leslie learns to calm her nervous system.

Key Topics & Timestamps:
00:00:00 – Introduction: Why rumination fuels chronic pain
00:01:00 – The cycle of symptom fixation and its impact on daily life
00:02:00 – Meet Callie Klebanoff: Breaking the cycle of rumination
00:03:00 – The mental load of symptom monitoring and anxiety
00:04:00 – How overthinking affects the nervous system
00:06:00 – Leslie’s experience: A new mom stuck in the pain-rumination loop
00:07:00 – Constant symptom monitoring: How it worsens chronic pain
00:09:00 – Why the brain fixates on pain and discomfort
00:12:00 – Understanding intolerance of uncertainty and symptom anxiety
00:18:00 – The PRT approach: Moving from overthinking to feeling safe
00:23:00 – Emotional work: Addressing fear, grief, and self-doubt
00:31:00 – Practical strategies to stop overthinking and retrain the brain
00:39:00 – Final thoughts & next steps for listeners

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]

This episode of the PRT podcast, hosted by John Gasienica, focuses on identifying and addressing hidden emotions that hinder recovery from chronic conditions. Special guest Christie Uipi, an expert clinician and founder of the Better Mind Center, joins John to discuss the importance of emotional awareness in pain reprocessing therapy. The episode features a live session with Ben, a patient who experiences a significant breakthrough in his recovery journey. Listeners will learn about the impact of stress, fear, and self-criticism on chronic pain and explore effective tools to foster emotional healing and achieve sustainable relief.

00:00 Introduction to the PRT Podcast

01:41 Meet the Expert: Christie Uipi

02:40 Christie's Journey and Innovations

03:56 Understanding Pain and Emotions

05:43 Client Session: Ben's Story

10:29 Exploring Stress and Pain Connection

17:17 Emotional Processing Techniques

25:29 Inner Nurturing

28:15 Messages of Safety

29:04 The Complexity of Safety

34:43 The Role of Self-Criticism

36:18 Somatic Tracking and Self-Compassion

43:43 Final Thoughts and Reflections

Transcript

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]

In this episode, we dive into Pain Reprocessing Therapy (PRT) and how it helps break the cycle of chronic pain. Anna, a patient who has struggled with chronic pain for years, shares her experience of healing through techniques such as somatic tracking, emotional awareness, and gratitude exercises.

John Gasienica and Daniella Deutsch explain how PRT works by rewiring the brain’s response to pain, allowing individuals to regain control of their lives. John guides Anna through gratitude practices to help her achieve the emotional awareness necessary to use PRT techniques successfully.

This episode provides valuable insights into how both patients and practitioners can use PRT to transform the experience and perception of pain, offering a hopeful and empowering approach to not only manage, but heal from chronic pain.

Get the Full Transcript

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
• Subscribe for updates, resources, and insights in the world of chronic pain and Pain Reprocessing Therapy.
• Patient Hub
• Practitioner Hub
• Learn about WellBody Psychotherapy and how our certified therapists and coaches can support your healing journey: Visit WellBody
• Email Us: [email protected]