Neuroplastic Pain and Dr. Schubiner's Unlearn Your Pain model
- colinliggett
- 5 days ago
- 7 min read
Here is a sentence that has changed thousands of lives: most chronic pain is real, but it is not always coming from damaged tissue. Often it is coming from the brain itself - from nerve pathways that have learned to produce pain and keep firing long after any injury has healed.
That idea is the heart of Dr. Howard Schubiner's book Unlearn Your Pain. Dr. Schubiner is an internal medicine physician who was himself a patient and student of the late Dr. John Sarno, the pioneer who first argued that unresolved emotional stress can show up as physical symptoms. Schubiner took Sarno's clinical insights and rebuilt them on top of modern neuroscience. The result is a model he calls Mind Body Syndrome (MBS), or neuroplastic pain - and, crucially, a step-by-step program to reverse it.
I've followed this work for years because it lines up so closely with what I see every day in clinical practice through SensoriMotor Repatterning (SMR). Below is what the book teaches, in plain language, and how it fits with the way I work.
Key Points:
Much chronic pain is driven by learned neural pathways in the brain, not ongoing tissue damage.
The brain produces pain as a danger signal - and it can be triggered by stress, not just physical injury.
Because these pathways are learned, they can be unlearned. The brain's neuroplasticity is the whole reason recovery is possible.
All pain is real. "Neuroplastic" does not mean imaginary - it means the nervous system, not the tissue, is generating the signal.
Fear amplifies pain. Shifting out of fear and into a sense of safety is central to turning the volume down.
SMR works on the same nervous system from the motor-control side - finding and resolving the protective patterns the brain holds onto, so the body learns it is safe again.
What is "Mind Body Syndrome," and what does "learned pain" actually mean?
Think about how the brain learns anything - a language, a golf swing, an anxious reaction to a certain location. Repetition wires it in. Schubiner's argument is that pain can be learned the same way. After an injury, illness, or period of high stress, the brain can build a pain circuit. Then, like any well-practised habit, that circuit can keep firing on its own, even once the original cause is long gone.
This is why so many people are told their scans look "normal" and yet they still hurt. The problem isn't always in the hardware (the tissue) - it's often in the software (the nervous system's learned patterns). MBS isn't a fringe label for a handful of cases either; Schubiner connects it to a wide range of conditions, including back and neck pain, migraines and tension headaches, fibromyalgia, irritable bowel syndrome, pelvic pain, chronic fatigue, anxiety and depression.
Hold on - if it's coming from my brain, is the pain "all in my head"?
No. This is the single most important reframe in the book, so I want to be clear about it. All pain is real. Pain is always produced by the brain — that's true of a stubbed toe and a broken leg just as much as it's true of neuroplastic pain. The brain being involved doesn't make your suffering less valid. In fact, it's the hopeful part: if pain is a structural problem, you're often stuck waiting on surgery or medication. If pain is a learned problem, it can be unlearned. That's not dismissal. That's a door opening.
Why would my brain learn to produce pain in the first place?
Because pain is fundamentally a danger alarm, not a damage meter. Its job is to protect you. The brain is constantly scanning - through your senses, but also through memories, past injuries, and emotions - asking one question: am I safe right now? When it decides the answer is "no," it can sound the alarm, and that alarm is often felt as physical pain.
Here's the key move in Schubiner's model: the brain doesn't distinguish very well between a physical threat and an emotional one. Stress, fear, anger, grief, and unresolved conflict can all register as "danger" and switch on the same circuits. And then a vicious loop sets in - pain creates fear, fear tells the brain there's danger, and danger produces more pain. This fear-pain cycle is a big part of why chronic pain digs in and stays.
What feeds this process?
Schubiner points to the accumulated load a nervous system carries. Some of the common contributors:
Unresolved emotions: anger, fear, anxiety, sadness, guilt, and the stress of conflicts we never fully worked through.
Childhood adversity: difficult or unsafe early experiences can sensitize the nervous system, setting a lower threshold for the danger alarm later in life.
Ongoing life pressure: work, relationships, caregiving, finances; the everyday stress that quietly stacks up.
Personality traits: and this one surprises people. Being highly self-critical, perfectionistic, deeply conscientious, or a chronic people-pleaser tends to keep the nervous system in a state of pressure and self-generated stress. The very traits we're often praised for can keep the alarm primed.
None of this is a character flaw. It's simply the raw material a nervous system can draw on when it learns to produce symptoms.
How do I know if my pain is neuroplastic rather than structural?
This is where Schubiner is genuinely useful and practical - he gives you criteria instead of guesswork. He uses the shorthand F.I.T.:
F - Functional: there's no clear structural cause that fully explains the pain (x-rays, MRI's are normal for your age, or the findings don't match the severity).
I - Inconsistent: the pain behaves in ways real tissue damage wouldn't - it moves around, changes with your mood or the time of day, or varies with activity in ways that don't fit the anatomy.
T - Triggered: flares line up with stress, emotions, or life events rather than with mechanical load.
When pain checks all three boxes, the likelihood that it's neuroplastic is high. (Important caveat, and Schubiner stresses this too: structural problems are real and some pain genuinely needs medical or surgical care. The goal is to rule those out first, not to skip them.)
So how do you actually "unlearn" pain?
This is what sets Unlearn Your Pain apart from books that only explain the problem - it hands you a structured research driven program to do something about it. I don't warnt to go into the details here, because the book is such a great read. But, the thread running through all of it is neuroplasticity - the brain's lifelong ability to rewire. The same plasticity that learned the pain is what lets you unlearn it.
How does this fit with SensoriMotor Repatterning (SMR)?
Beautifully, in my experience - because SMR and Schubiner's model are describing the same nervous system from two different doors.
Schubiner works primarily through the emotional and cognitive door: retraining the brain's sense of danger from past events. SMR works through the motor-control door. Long-time readers know I talk about hardware versus software. A pain problem often isn't a hardware fault in the tissue - it's a software issue, a faulty pattern the brain is running. When the unconscious nervous system perceives threat, it produces protective responses - muscle inhibition, pain, guarding, compensation patterns - that were useful during an injury but become maladaptive when the brain stays stuck in that loop long after healing.
That's the same loop Schubiner is describing. He calls it a learned neural circuit; in SMR I'm looking for the learned motor pattern. "Unlearning" pain and "repatterning" the nervous system are two ways of saying the same thing: helping the brain update an out-of-date map and recognize that the body is safe again.
Can SMR help?
Yes - when the nervous system is holding onto faulty or protective movement patterns, those patterns can be found and resolved. SMR bridges the older, survival-focused part of the brain (which clings to protective patterns) and the newer, function-focused part (which wants to move freely). Using manual muscle testing, neuro-functional assessment, and acupoint stimulation via Somato–Autonomic Reflexes, my job is to show the brain that the threat has passed and that efficient, pain-free movement is now possible. When the software is corrected, the hardware tends to return to its healthy state and stay there.
Where does Dr. Sarno fit in all this?
He's the foundation. Sarno was decades ahead of his time in insisting that stress and repressed emotion could drive real physical pain. Schubiner - cured by Sarno, then mentored by him - kept Sarno's central insight and upgraded the mechanism to match modern neuroscience and neuroplasticity research, then added something Sarno never fully provided: a concrete, do-it-yourself recovery program. If Sarno opened the door, Schubiner built the staircase.
Is there research behind this?
Yes, and it keeps growing. Schubiner has published clinical research on this approach, and randomized trials have shown meaningful pain reduction compared with control groups. In one notable trial in fibromyalgia, an emotion-focused approach in this family (Emotional Awareness and Expression Therapy) outperformed standard cognitive behavioural therapy (Lumley et al., PAIN, 2017). The broader evidence that early stress and trauma affect long-term pain and health is now substantial — I've gathered a summary of it here.
A note on my role
I want to be straight about what I do and don't do. I don't "fix" trauma or stress, and SMR is not psychotherapy. What I do is find and resolve the faulty motor-control patterns the nervous system holds onto - the software side of the problem that's generating pain. For the emotional work, I'm a strong believer in pairing SMR with the right support. Unlearn Your Pain is one of the best self-guided tools I can point clients toward, and for deeper work I keep a list of excellent Registered Clinical Counsellors and psychologists I'm happy to recommend (I think Internal Family Systems (IFS) is a great therapy). The two approaches work hand in hand: SMR helps the body feel safe through movement, while Schubiner's program helps the brain feel safe through emotional processing.
Nobody chooses chronic pain at a conscious level. But because so much of it is learned, much of it can also be unlearned. That's a genuinely hopeful message - and it's why I do this work.
If you'd like to find out whether SMR could help you, Read some client success stories or book a session here.
Resources / References
Unlearn Your Pain - Dr. Howard Schubiner https://unlearnyourpain-shan0ed.gamma.site/
Free mind-body videos from Dr. Schubiner https://unlearnyourpain.com/mind-body-videos/
Free video series, "The role the brain plays in pain" https://www.youtube.com/playlist?list=PLsJVYZbo6uWrKc57MDUL1vGciEGnPYrV9
My evidence summary on trauma, stress, and chronic pain https://www.vansmr.ca/post/evidence-resource-on-trauma-causing-pain-and-other-health-issues
Healing Back Pain and The Divided Mind - Dr. John Sarno (the foundational work) https://www.chapters.indigo.ca/en-ca/books/healing-back-pain-the-mind/9781538712610-item.html
The Body Keeps the Score - Dr. Bessel van der Kolk
When the Body Says No: The Cost of Hidden Stress - Dr. Gabor Maté
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