Sixteen years. Two extruded discs. Two doctors who recoiled at an MRI.
That is where this story starts — not in a lab coat or a textbook, but on an old basketball court at Columbia, and in the spine of a psychologist who would later use her own wrecked back to rewrite the rules of pain medicine. She could barely walk.
The discs were pressing on her sciatic nerve. The standard medical playbook — surgery, injections, more specialists — was laid out before her. She did not take it.
Instead, she spent nearly two decades building a different case: that chronic pain is not a broken window, but a blaring alarm system long after the window is fixed. The numbers tell the story.
Tens of millions of Americans live with persistent pain. That is the scale of the problem. And the core mechanism, as she sees it, is not tissue damage.
It is a hypersensitive threat signal produced by the brain. The original injury heals. The alarm keeps ringing.
Her approach breaks down into two main techniques: pain neuroscience education and cognitive behavioral therapy. Patients learn to identify the thoughts, emotions, and behaviors that keep the threat system on high alert.
Fear of movement. Catastrophizing about the future. Avoidance of activity.
Each one feeds the cycle. Each one can be interrupted.
She has seen patients who spent years bouncing between specialists, getting injections, undergoing surgeries. One patient had been told by multiple surgeons that nothing more could be done. Through what she calls “brain-based” approaches, they found relief.
Not because the body was fixed. Because the brain was retrained. The analogy is blunt: acute pain is a broken window.
Chronic pain is a hypersensitive alarm. The window is repaired.
The alarm still screams. The problem is no longer the window. The problem is the alarm system itself.
This is not a theory cooked up in a quiet office. It is lived.
She has been living with that reminder for 16 years. The old basketball injury flared up. The discs extruded.
The doctors recoiled. And she set out on a path that reshaped how she — and eventually her patients — understand what pain actually is. Pain is not a message from damaged tissue.
It is a threat signal produced by the brain. The brain can learn to turn up that signal even when the original injury has healed.
That is the core argument. It is built on years of clinical work and personal experience. It flies in the face of a medical system that still treats pain as a simple mechanical problem.
The practical upshot is this: the brain can be retrained. The techniques are not experimental.
They are drawn from established fields — pain neuroscience education and cognitive behavioral therapy. Patients learn to spot the thoughts that keep the alarm blaring. They learn to move without fear.
They learn to stop catastrophizing about the future. The cycle can be broken. The alarm can be turned down.
The numbers — tens of millions of Americans — suggest there is a lot of work to do. The psychologist has been at it for nearly two decades.
She started with her own spine. She kept going.
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