How to Stop Fixating on Pain

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Mar 13, 2025

In this engaging discussion, expert therapist Callie Klebanoff—formerly the executive director of the Pain Psychology Center—teams up with John Gasienica to tackle chronic pain and the mental strain it brings, especially for new mothers. They explore how rumination exacerbates pain by keeping the nervous system in hyper-alert mode. Practical strategies to break the cycle of overthinking are emphasized, along with a real-time therapy session that showcases methods to calm the mind and foster self-compassion in managing discomfort.

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ANECDOTE

New Mom's Pain Rumination Cycle

Leslie, a new mom, constantly monitors her pelvic pain symptoms which worsens her anxiety.
She cycles between hope and despair daily, making her recovery challenging.

INSIGHT

Brain's Survival Bias in Pain

The brain has a negative bias oriented toward survival, making it fixate on discomfort as danger.
Chronic pain can trigger trauma-like responses, leading to anxiety and preoccupation.

ADVICE

Accept Uncertainty to Stop Rumination

Resist the urge to solve problems during rumination and admit intolerance of uncertainty.
Accept uncertainty without compulsively seeking answers to break the rumination cycle.

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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

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