How Can Pain Reprocessing Therapy Help Your Transgender & Gender Diverse Patients

Feb 26, 2024

Over several years, I’ve utilized so many treatments to alleviate chronic daily migraine pain. Some of those treatments are evidenced-based (preventative and abortive medication, acupuncture) and some methods are decidedly... NOT. After a lot of trial and error, I tried Pain Reprocessing Therapy, the most effective current, evidence-based treatment for chronic pain, and then I got certified as a practitioner.


Here's how this works and who can benefit. Pain Reprocessing Therapy works for neuroplastic pain, which happens when the brain misinterprets safe signals from the body as if they were dangerous and creates pain. Pain is a danger signal created by the brain. For example, if you injure yourself, the body sends signals to the brain to inform you of the danger, and you feel pain to let you know there’s damage to your body and that something needs attention. Sometimes the brain makes a mistake and sends out false alarms (pain) to indicate danger when there is none. 


In this case, the pain can be addressed psychologically and somatically, which does not mean that the pain isn’t real. It’s not “all in your patient’s head”. The pain is totally real, and brain imaging corroborates this fact, but the treatment for neuroplastic pain is psychological and somatic. The centerpiece of PRT is mindfulness, reducing fear of the pain, and rewiring the brain for more safety.


I do this work in the context of identity and oppression. The stress of historical trauma and on-going identity-based persecution is correlated with chronic pain and illness, so reducing fear and increasing safety in response to those pain signals in the body is challenging for folks who feel unsafe in the world but a necessary pathway to healing chronic pain.


For a deeper discussion on how chronic pain intersects with the oppression experienced by your transgender and gender diverse patients specifically and how I utilize PRT, check out my guest episode on the QueerCME podcast.


Here are my upcoming offerings, both groups and one-on-one Somatic coaching and Pain Reprocessing Therapy.


Building Connection and Setting healthy Boundaries, a Somatic Practice group

Wednesdays, Feb 21-May 1, 5:30-7pm PT


  • Weekly 10 session group covers topics including building our capacity for mutual connection, setting grounded boundaries, moving from reactivity to skillful response in challenging situations



Somatic Transformation Group for People Experiencing Chronic Illness and/or Pain
Thursdays, April 11-June 13, 5-6:30pm PT

  • Weekly 10 session group covers topics including navigating relationships, finding aliveness and purpose in midst of illness, working with fear, and compassion


Pain Reprocessing Therapy and Somatic Coaching Sessions

  • I work with each client to identify what is most important to you, support you to take new actions aligned with your values and goals, build resilience, and transform triggers

Kristina Armenakis (they/she) is a certified Somatic Coach who works with people experiencing chronic illness and/or chronic pain. Kristina offers a somatic support group to people experiencing chronic illness and works one-on-one with clients in a process of embodied transformation: accessing all levels of intelligence in the body – intellectual, emotional, and physical, healing trauma and creating safety in the body, and building resilience in the face of stress and challenge. Prior to their work as a Somatic Coach, Kristina managed leadership and community building programs for queer and TGD youth for over a decade, provided counseling for queer and TGD survivors of domestic and sexual violence, and most recently, co-created and led an intensive support, education, and leadership program for TGD young people. They hold Master of Social Work and Master of Public Administration degrees from the University of Washington. Kristina has been trained in the Somatic Coaching methodology of the Strozzi Institute and is certified in Pain Reprocessing Therapy, an evidence-based modality used to treat chronic pain. Visit Kristina's practice at her website. Alternatively, clinicians can experience a taste of somatic coaching at a MeetUp Kristina hosts. 



  1. Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(1):13–23. doi:10.1001/jamapsychiatry.2021.2669



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