That chronic pain is not all in your head, but the solution may not be in your body, expert says

CNN

11-04-2025

Summary
Psychotherapist Nicole Sachs advocates a solution for chronic pain rooted in mind-body medicine.
Sachs contends that physical symptoms can result from nervous system responses to stored trauma and repressed emotions.
Her treatment approach includes education about brain science, a writing practice called JournalSpeak, and self-compassion.
JournalSpeak involves 20 minutes of unfiltered emotional writing that releases raw emotions.
Sachs says to approach your body with compassion, listen to its signals and remember that healing is possible.
Although often invisible, chronic pain is everywhere. More than one-quarter of Americans have pain lasting more than three months.
With medical treatment and lost productivity costs of up to $635 billion annually in the United States, pain is expensive as well as debilitating. The fact that traditional Western and alternative medicine have yet to confirm either a cause or a solution doesn't help.
Psychotherapist Nicole Sachs is determined to interrupt this bleak narrative with a cure rooted in evidence-based brain science and mind-body medicine.
In her new book, 'Mind Your Body: A Revolutionary Program to Release Chronic Pain and Anxiety,' the author, podcaster and public speaker shares her method for eliminating not just chronic pain but also long Covid-19, migraines, irritable bowel syndrome, fibromyalgia, chronic fatigue and many other conditions. Where medication, physical therapy, supplements, procedures and treatments have failed, her approach, using a targeted writing practice called JournalSpeak, offers a possible cure.
This conversation has been edited and condensed for clarity.
CNN: What is mind-body medicine, and what role does it play in chronic pain?
Nicole Sachs: Mind-body medicine is a paradigm that recognizes the influence of stored trauma and repressed emotions on physical health. My mentor, Dr. John Sarno, was a pioneering practitioner who challenged the Western assumption that pain or discomfort always correlates directly with the affected body part. His scientific work uncovered that, while real, some physical symptoms are not always tied to pathology in the body.
Dr. Sarno called this condition Tension Myoneural Syndrome, or TMS, which is an umbrella term for the epidemic of chronic conditions that do not resolve by treating the symptomatic area of the body. Instead, chronic pain and other conditions can result from nervous system dysregulation that creates physical symptoms in response to stored trauma and an overflow of repressed emotions.
CNN: How can emotional stress cause physical symptoms?
Sachs: First, it helps to remember that all humans have unconscious processes that are essential to living, like circulating our blood, breathing or making our heart beat. In a sense, the unconscious nervous system signaling that causes chronic pain is equally reflexive. Beneath consciousness, each of us has an emotional reservoir that holds the extent of our grief, rage, terror, despair and shame. The extremity of these feelings is kept below the surface, under the cover of darkness, because feeling the pain of these emotions all the time would make it impossible to live our lives.
Humans are a social species, and our need for connection is as imperative as food and water. If we were constantly aware of the depth of our emotional pain, we'd be too shut down to connect with others. So, our nervous system tries to keep that pain under wraps.
But everyone reaches a point in life when this reservoir starts to bubble over. Too much stress, trauma or some devastating life event and all the emotions that have been stuffed down start to knock at the door of consciousness. That's when our nervous system steps in.
CNN: Why would the nervous system intentionally cause pain?
Sachs: Our nervous system has evolved to protect us against threats. Your brain perceives your repressed emotional world and stored trauma as predators, seeing them as far more dangerous problems than the physical manifestations of pain — because they're not easy to solve. And so, alarm bells go off. The nervous system switches into fight, flight, freeze or fawn mode. When your emotional 'reservoir' becomes overwhelmed, your brain sends pain signals as a protective strategy.
If you are someone who struggles with back pain, for instance, that's likely your nervous system triggering symptoms to keep you safe — I call this 'safe in the un-safest way.'
Back pain might trigger you to take a pill, get into bed and cancel your plans for the day. This restores to the brain a sense of control and familiarity. However unwanted consciously, illness and injury are protective. They require us to slow down and allow us to ask for help, draw boundaries, say no and stay home. And just as you don't have a choice about whether to pull your hand off a hot stove, you don't get to decide not to have back pain right now if your reservoir is overflowing.
CNN: Does this mean the pain isn't real?
Sachs: The pain is very real; it just originates from emotional rather than physical stressors. Here's the fascinating part — all pain signals get fired by the brain and nervous system, landing in different bodily systems and muscles. All pain is felt from the brain. So, when you burn your finger, the nerves in your finger tell the brain that the sensory environment has changed. Then the brain, in a flash, interprets the level of danger and sends pain signals back to the finger. Pain's No. 1 objective is to protect you. With TMS, the brain sends these same pain signals as a protective mechanism, even without physical injury.
Today's brain imaging technology even reveals that whether someone is experiencing emotional heartbreak or just broke their ankle the same part of the brain lights up.
CNN: What's the cure?
Sachs: Treatment has three key components. The first part of my prescription is knowledge. I need to teach you about the brain science and provide enough human examples to help you believe and not dismiss that this is what's happening in your human body.
The second component of treatment is JournalSpeak — a specific writing practice I developed to release emotions. The third is practicing patience and kindness for yourself — self-compassion is a verb!
CNN: What is JournalSpeak, and how is it different from other forms of writing?
Sachs: JournalSpeak is a 20-minute, unfiltered writing practice, informed by your understanding of the nervous-system science, where you express your most unreasonable, raw emotions. This practice is like putting a ladle into the reservoir and dumping it out systematically, one day at a time. Once the level drops below maximum capacity, the pain signals stop firing, because your nervous system no longer feels the urgency to protect you from conscious awareness. After the 20 minutes, you destroy the writing. It's about releasing, not analyzing. Like blowing your nose into a tissue, you don't need to look at it again.
CNN: How could complaining on paper heal pain?
Sachs: JournalSpeak is like a venting apparatus for a closed system. Energy is neither created nor destroyed; it shifts from one form to another. The energy of grief and rage and shame and fear gets transformed into physical pain in the closed system of the human body. Writing the most unbridled, impolite, unreasonable, pathetic rant that gives voice to unseen, unheard parts of you opens a relief valve that transfers emotional pain onto the page. Once that energy is vented, the nervous system stops sending physical pain signals.
CNN: Is this approach limited to pain?
Sachs: Not at all. One person's fatigue is another's back pain, is another's migraine or irritable bowel, or long Covid, and so on. The theory at the center of this approach is that there is one genesis for all these symptoms. The same principles can apply to autoimmune conditions, digestive issues and other chronic symptoms. The underlying mechanism is always the same: the nervous system sending signals as a protective response.
When people realize that the sensations we feel in our body, no matter what they are, are controlled by the brain and the nervous system, they can understand why it really doesn't matter how the symptoms are showing up. The central nervous system is the control room for everything in the human experience.
CNN: Do scientific studies back this up?
Sachs: More and more scientific literature documents remission of pain and other chronic symptoms through mind-body practices. Recently, a randomized controlled trial by Dr. Michael Donnino, a professor of medicine and emergency medicine at Harvard Medical School, compared three treatment approaches for chronic back pain.
The first group continued their existing treatment regimens, while the second took an eight-week mindfulness stress reduction course. Participants in the third group received a 12-week psychophysiological intervention based on Dr. Sarno's work where they explored their emotional history using mind-body techniques. This group reported significantly less pain than participants in the other groups. About six months later, nearly 64% of people from the mind-body group reported being pain-free.
Donnino's findings from a similar study on long Covid showed that symptoms previously attributed to physical causes resolved with mind-body medicine.
CNN: How can someone tell if their symptoms are TMS-related?
Sachs: First, consult a doctor to ensure that medically treatable diagnoses are not the root cause of your pain. But if you've had multiple medical tests with no clear explanation, if your pain moves around, or if it seems triggered by stress, these are potential TMS indicators. The key is understanding that pain can be a messenger, not just a malfunction. Once you receive a clean bill of health or you're diagnosed with chronic symptoms deemed incurable, nervous system dysregulation is a likely cause, and it's time to consider my three-part treatment approach.
CNN: Do I need to change my life to heal my symptoms?
Sachs: The goal is to recognize and process your emotions, not necessarily remove every source of stress. You don't have to blow up your life, quit your job or put your kids up for adoption. You don't need to change your life; you just need to know how you feel about it.
CNN: What's the first step toward mind-body healing?
Sachs: Start with curiosity. Approach your body with compassion, listen to its signals and remember that healing is possible. The beauty of this approach is its fundamental message of hope: Your body is not broken, and you have the power to heal. It's about understanding the intricate connection between your emotions and physical experience, and learning to work with your nervous system, not against it. Your body is trying to protect you. By understanding this, you can start a profound healing journey.
You have so much more power than you realize to affect your physical and emotional health.