How Trauma & Neuroplasticity Create Chronic Conditions
Let’s suspend disbelief for a moment and imagine haunted houses are real. Let’s further imagine you bought a long-abandoned one for an incredible bargain, and you hope to turn it into something special.
You bring truckloads of treated wood and full pallets of paint. Many months and thousands of dollars later, you have transformed the town’s eyesore into a thing of beauty. Unfortunately, it’s still haunted. It’s not a peaceful place to live, and no one in town wants to buy it back from you. The problems of this house come from phantoms that live in the lowest parts of the foundation, and your remodeling only succeeded in healing the wounds at the surface.
The Chronic Pain Problem
The story of chronic pain — and, by extension, the story of migraines — is very similar.
Over 20% of the U.S. population suffers from chronic pain, and one in ten Americans report experiencing migraines on a regular basis. Until recently, the response from the medical community was heavily dependent on opioids and, for migraines, acute or preventive medications. Opioids for chronic pain show very little evidence of resolving anything in the long term. They are new wooden boards. They are a new coat of paint. They are temporary solutions to a much deeper problem.
Our understanding of chronic pain is always evolving. In 2019, a review of 25 clinical trials of invasive treatments for chronic pain (comprising 2000 subjects with seven different conditions, including migraine) found little evidence for benefit when compared to sham procedures. What we are now recognizing is that the foundations of chronic non-structural pain sit at the very bottom. We know that effectively addressing chronic pain is similar to exorcising a haunted house of its demons. It has to do with phantoms behind the scenes and finding the deepest roots of the problem.
June is Migraine Awareness Month, which is a time to share our latest understanding of migraines and how they might be treated. What follows is a brief exploration and explanation of the mind-body connection with an emphasis on the origins of migraines and proven holistic treatments.
What’s Hidden in the Foundation?
Neuroplasticity is a term that vividly captures the brain’s tendency to reshape itself in response to its surroundings. The term was first introduced to the scientific community in the 1940s, and its impacts on pain and injury started to gain traction with seminal studies in the 1970s and 1980s. Today, neuroplasticity is a cornerstone of chronic pain research and even recognizable in mainstream culture, thanks in part to Norman Doidge’s “The Brain That Changes Itself.”
This plasticity is what gives rise to neuroplastic symptoms, which are chronic conditions that come about not due to physical damage but in response to altered brain pathways. Chronic migraines. Long COVID. Fibromyalgia. These conditions are often the result of prolonged stress or trauma, forcing the brain to lock itself into patterns that sustain pain even in the absence of structural injury. In fact, neuroimaging methods consistently reveal forms of neuroplasticity associated with chronic pain and recurring headaches.
One extra takeaway: Our understanding of “brain flexibility” is still in its infancy. Most recently, scientists proposed creating distinct categories of “upward” (synaptic construction) and “downward” (synaptic deconstruction) neuroplasticity.
Neuroplasticity: The Wiring & Rewiring of Your Brain
How does this happen? Neuroplastic psychology is built on the idea of the mind-body connection. In this sense, adverse childhood experiences (ACEs) and post-traumatic stress disorder (PTSD) aren’t temporary “flare-ups” in the brain’s chemistry. Instead, they are foundational events that create a different reality for the brain altogether.
More specifically, the amygdala becomes swollen and hyperactive, creating a heightened fear response and the inability to reasonably perceive threats. What’s more, chronic conditions like these shrink the hippocampus, which is responsible for memory processing and maintaining a clear distinction between the past and the present.
Essentially, they turn a regular house into a haunted house, and it’s not something that goes away easily or simply “in time.” This new reality demands treatment that acknowledges the impact of trauma, most especially when that trauma takes place at such a young age.
The Connection to Childhood Trauma
Childhood trauma is one of the most critical components to understanding neuroplastic symptoms like migraines and fibromyalgia. Survivors of childhood trauma are particularly susceptible to the wiring and rewiring that takes place as a result of neuroplasticity. The effects on the amygdala and hippocampus are pronounced. Consequently, ACE survivors are at much greater risk for developing chronic pain as they become adults.
Studies show that post-traumatic stress symptoms (PTSS) in young people have a direct correlation with heightened reactivity via the autonomic nervous system (ANS). Simply put, ACEs can keep the body stuck in a constant state of chronic stress. This makes the body more sensitive to physical symptoms, which in turn exacerbates the problem further. For many, healing requires more than medication — it means a deeper confrontation with the trauma itself through neuroplastic therapies and targeted lifestyle changes.
Treatments That Exorcise Everything
These deeper treatments are rooted in a more comprehensive understanding of chronic pain. Approaches include neuroscience education, mindfulness and meditation, and neuroplastic recovery therapies, such as Pain Reprocessing Therapy (PRT) and Emotional Awareness and Expression Therapy. These trauma-informed techniques begin with the recognition that the brain decides whether, where (in the body), and how intensely to generate a pain perception. The techniques then teach patients to view non-structural pain as safe. This rewires how the brain interprets pain. As the brain’s response changes, pain is reduced, which builds resilience.
Cognitive Behavioral Therapy (CBT) has shown modest benefits when addressing chronic pain and migraines. However, PRT takes things one step further. By helping patients shift focus from physical sensations to underlying stressors — and pairing that with practiced self-soothing — PRT produces significantly better outcomes for chronic pain than standard care or placebo. Why? Because it exorcises the phantoms behind it all.
One extra takeaway: But wait, there’s more! A recent study of seniors suffering from chronic musculoskeletal conditions reported that two-thirds achieved at least a 30% reduction in pain by employing a new neuroplastic treatment known as Emotional Awareness and Expression Therapy (EAET). Only one in six patients achieved that level of improvement with the older Cognitive Behavioral Therapy.
Why Traditional Medicine Misses the Mark
Carl Jung once wrote, “Science… obscures our insight only when it holds that the understanding given by it is the only kind there is.”
The medical community has become stuck in a similar rut. For decades, doctors and researchers have focused on organ disease and structural pain. Of course, this focus has produced a number of worthwhile results, but it is ultimately failing to solve the problems for millions of people with chronic non-structural conditions. As traditional diagnostics come up short, the medical community as a whole needs to embrace the idea of deeply exploring the mind-body connection for long-lasting answers.
The biopsychosocial model, pioneered by George Engel, is the perfect starting point for building better medicine. It isn’t about discarding skepticism but rather about expanding the toolbox available to the medical community. This way, when they come across a truly haunted house, they’ll have more options than a hammer and some nails.
One extra takeaway: This sort of thinking isn’t new. Interdisciplinary work and research have long been associated with some of the greatest ideas and breakthroughs in history.
The Way Forward
Much like a haunted house, chronic pain can’t be resolved purely through methods focused on organ disease or structural injury. It takes courage and self-education to confront what lies underneath it all — unresolved trauma, misfiring neural pathways, and deep emotional echoes. Fortunately, we discover better tools for each task every single day. By embracing neuroplastic treatments and the mind-body connection, we’re not just masking symptoms. Finally, we’re beginning to exorcise the phantoms for good.
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