Exploring the mind-body connection to end chronic pain

On a large screen, a YouTube video plays of a guided visualization aimed at healing trauma caused by an unhealthy parent-child relationship.

As Diane Tunney watches, her eyes well up with tears. Tunney is part of an eight-week program focused on tapping into the mind-body connection to treat chronic pain, which affects more than 20 percent of the population—more than heart disease, cancer, and diabetes combined.

“Be curious about whatever comes up,” says Stephanie Carpizo, a group co-facilitator and doctoral student at the Warner School of Education and Human Development.

For 66-year-old Tunney, who has struggled with muscle spasms and insomnia, what is coming up are feelings of nausea and fear. In her mind, she recounts later, she is a little girl again, growing up with a narcissistic, manipulative father who made her feel unworthy and unloveable.

Ten adults are part of this program to “unlearn their pain by looking nonjudgmentally at it, being curious about it,” says Doug Guiffrida, professor of counseling and human development and director of the advanced certificate program in mind/body healing and wellness. “Pain is useful when it alerts us to some injury that needs attention—a break, an infection, or cancer—but it becomes unhelpful when it lodges into a chronic condition. And research is showing pretty conclusively that emotions are tied to physical pain.”

The participants struggling with chronic back pain, pelvic pain, fibromyalgia, heel spurs, insomnia, and other conditions have committed to attending the weekly sessions, which offer small- and large-group support, as well as reading book chapters, watching videos, writing reflections, and practicing mindfulness—all to learn how to express uncomfortable emotions in healthy ways.

The program is a collaboration between Guiffrida at the Warner School and Sachiko Kaizuka, MD, a physician based at Highland Family Medicine, whose presence lends a sense of credibility, he says: “There’s a big difference when a physician suggests you might consider a mind-body connection when treating chronic pain compared to that same suggestion coming from someone in behavioral health.”

Also involved are Stephanie Carprizo and Aubry Ball, two Warner School advanced doctoral student interns—both licensed mental health clinicians—who serve as co-facilitators of the group, and another Warner School student, Madeline Truman, who will be evaluating the program for her dissertation research.

According to Guiffrida, for too long, the field of medicine has seen the mind and body as separate, with patients getting passed from one specialist to another rather than being treated with an integrative approach. Research has shown that integrating mindfulness with emotion-focused work, such as the visualization video, can help alleviate chronic pain.

In fact, several intervention studies have shown that many forms of chronic pain are the result of repressed emotions—most notably, pain turned inward—rather than injuries or structural abnormalities.

In early 2024, Guiffrida led a small, qualitative study, published in the Journal of Psychotherapy Integration, to explore the relationship between chronic pain and emotions, mindfulness meditation, and an experiential approach to emotion-focused work called Emotional Awareness and Expression Therapy. In his study, 11 participants had suffered for years with their conditions, failing to find relief from mainstream approaches, including surgery. After 10 weeks, nine of the 11 participants reported the intervention to be helpful, and four of them were nearly or completely pain-free. Those who experienced significant improvement expressed strong belief in the process from the beginning and never wavered, even when symptoms flared up while becoming aware of repressed emotions.

Guiffrida has some personal experience with the topic. Two decades ago, he had surgery scheduled for chronic back pain, but canceled the procedure after reading a book titled Healing Back Pain: The Mind-Body Connection, written by John E. Sarno, MD. He later studied with Dr. Howard Schubiner, who co-developed an experiential approach to emotion-focused work called Emotional Awareness and Expression Therapy, and other leaders in the field—eventually centering his professional work on mind/body healing and wellness.

Guiffrida is quick to point out that approaching chronic pain this way can be very difficult.

“It’s much easier to get a surgery or take a pill to heal something than it is to do deep-rooted psychology retraining and emotional work,” he notes.

The program brings in guest speakers at times. Shortly before the guided visualization video, Dr. Bryan Guzski, a physical therapist, talked about how the body “wants to feel safe and survive” and suggested being strategic about getting exercise by breaking activities into digestible chunks he called “movement snacks.”

“Stress plus recovery equals adaptation—small, consistent changes lead to big changes,” explained Guzski, who then led the group in a short series of chair yoga poses.

Stress can come from repressing normal, healthy emotions such as anger or grief. That repression is often necessary in childhood, when systems are unable to handle those emotions, but it becomes problematic later. 

One major goal of the group is to assist in identifying, experiencing, and expressing repressed emotions. Says Guiffrida: “It’s time to say, ‘I’ve got this now.’”

With roots in Internal Family Systems—a psychotherapy model that teaches people are made up of a family of inner parts rather than a single personality—the program also helps increase the capacity for compassion, curiosity, confidence, and other qualities that ultimately lead to a sense of peace and safety.

As a way to help notice and explore those inner parts, the group asks questions of each of their internal parts, such as “How are you trying to help me?” “How long have you been doing this?” “What are you afraid would happen if you stopped doing what you do?”

Carpizo adds that self-compassion is “a gateway that gets blocked so much of the time” because of repressed emotions.

Because those who volunteered for the program are motivated to do what is asked of them, Kaizuka has noticed positive changes happening more quickly with the group than with individual patients seen in her clinic. “They’re more engaged in putting in the work,” she says. “A lot times in the clinic, patients leave and go back to their regular lives without the accountability.”

Group members fill out pain and emotional assessments at the beginning, middle, and end of the program, and will complete in-depth interviews about their experiences in the group. Results of the study will be available in several weeks, but preliminary data suggests many of the members already are seeing stark improvements.

A second group—date to be determined—already has a waitlist.

“From a holistic viewpoint, this is really doing a lot more for me than Western medicine, and I’m grateful,” says Tunney. “I’ve reframed: This isn’t pain, it’s discomfort. It’s sensation. It’s not harmful.”