My Approach

Chronic pain and stress-related symptoms are not purely physical or purely psychological, they live at the intersection of nervous system learning, emotional experience, and relational history. Research increasingly shows that many persistent pain conditions involve a sensitized central nervous system that has learned to produce pain in the absence of ongoing tissue damage. This is not imagined pain, it is real pain with a neurological explanation, and it is treatable.

My approach integrates three evidence-based frameworks, each addressing a different dimension of how symptoms develop and persist.

Emotion Awareness and Expression Therapy (EAET)

Emotion Awareness and Expression Therapy is an evidence-based treatment developed by Mark Lumley, PhD, and Howard Schubiner, MD, grounded in the understanding that unprocessed emotional experience, particularly conflict, grief, and anger, can manifest as physical symptoms. EAET helps clients identify the emotional drivers of their symptoms, move through avoided feelings, and resolve the internal conflicts that keep the nervous system in a state of chronic activation.

In a randomized controlled trial published in Pain (Lumley et al., 2017), EAET produced significantly greater reductions in pain severity and physical functioning compared to both education-only and cognitive-behavioral therapy conditions among fibromyalgia patients. A subsequent trial (Yarns et al., 2020) demonstrated significant reductions in chronic musculoskeletal pain in older veterans, with gains maintained at follow-up.

EAET is particularly well-suited for individuals whose symptoms intensify during stress, relationship conflict, or emotional suppression. These patterns are common among high-achieving people who have learned to override internal signals in favor of performance and productivity.

Pain Reprocessing Therapy (PRT)

Pain Reprocessing Therapy is a structured psychological treatment developed by Alan Gordon and Alon Ziv, grounded in the neuroscience of neuroplastic pain, which is pain that originates in the brain and nervous system rather than from ongoing tissue damage. Rather than managing pain, PRT targets the neural pathways maintaining it. Clients learn to approach physical sensations with safety and curiosity rather than fear and bracing, systematically retraining the brain's threat-detection system.

In a landmark randomized controlled trial published in JAMA Psychiatry (Ashar et al., 2022), 66% of participants receiving PRT were pain-free or nearly pain-free after four weeks of treatment, compared to 20% in the placebo condition. Neuroimaging data from the same study demonstrated measurable changes in brain regions associated with pain processing, including the anterior insula and anterior midcingulate cortex. This is evidence that psychological treatment produces structural neurological change.

PRT is most effective for clients whose pain has persisted beyond expected tissue healing time, fluctuates with stress or emotional state, or has spread beyond the original site of injury. These are all indicators of central sensitization rather than ongoing structural damage.

Attachment-Oriented Depth Work

Chronic pain and somatic symptoms rarely exist in isolation. For many clients, persistent physical symptoms are inseparable from longstanding patterns in how they relate to themselves and others, patterns shaped by early relational experience and reinforced over a lifetime of high achievement, self-reliance, and emotional override.

Drawing on psychodynamic and relational frameworks influenced by the work of John Bowlby and Harry Stack Sullivan, this dimension of treatment attends to the deeper emotional and relational context in which symptoms developed. This includes exploring the role of self-criticism and perfectionism in nervous system dysregulation, the relationship between unmet attachment needs and chronic activation, and the ways in which identity, particularly for high-achieving individuals — can become organized around endurance, performance, and the suppression of vulnerability.

This is not a separate treatment module but an ongoing thread woven through all clinical work. The therapeutic relationship itself becomes a context for new relational experience, one in which it is safe to be uncertain, unproductive, and human.

What Treatment Looks Like

Sessions are held virtually via a secure, HIPAA-compliant platform, making treatment accessible across Washington state and 42 additional PSYPACT-participating jurisdictions.

Treatment typically begins with an Initial Consultation, a 75-minute appointment to review your symptom history, previous treatment, and the emotional and relational context in which your symptoms developed. From there, we collaboratively develop a treatment plan tailored to your presentation.

Ongoing sessions are 45 minutes, structured and focused. Most clients find this a more effective container than a traditional therapy hour. Extended 75-minute sessions are available for clients who benefit from additional depth within a single appointment.

Treatment length varies by presentation and goals. Some clients achieve significant relief in 8–12 sessions; others engage in longer-term work addressing the relational and personality patterns underlying their symptoms. We will revisit goals and progress regularly so treatment remains purposeful and efficient.

If what you've read resonates, I'd welcome a discovery call to see if we're a good fit.