Pain Coach
Skeptical About Psychology for Chronic Pain? This Episode Will Change Your Mind | Sophie O'Dwyer
Got a sore back and rolling your eyes at the idea of "seeing a psychologist for it"? You're not alone and this episode is for you. Lachlan puts that exact skepticism to pain psychologist Sophie and what follows is a masterclass in the real, physiological role psychology plays in persistent pain. They unpack the "window of tolerance," why the nervous system can become overprotective, how adverse life experiences shape our pain response and why phantom limb pain proves pain is never just about tissue damage. From practical tools - progressive muscle relaxation, the stress bucket analogy, graded exposure, CBT, ACT and pain reprocessing therapy - to the bigger picture of why multidisciplinary care changes outcomes, this conversation bridges the physical and psychological divide that so many pain patients get stuck in. Lachlan and Sophie also share the story behind Paced Health, their new multidisciplinary telehealth pain clinic - why they built it, what the name means, and how they're trying to fix the fragmented, confusing experience so many people with chronic pain describe. RESOURCES: - Pain Coach: Clinical software helping clinicians turn complex chronic pain into simple habit targets. Sign-up here: https://paincoach.co - Paced Health website: https://www.pacedhealth.com - Paced Health Instagram: https://www.instagram.com/pacedhealth/ KEY TOPICS: 00:00 – Cold open: "Can psychology really help my back pain?" 01:00 – Meet Sophie, pain psychologist at Managing Pain 01:36 – Why a psych referral for pain feels invalidating — and how to start 03:17 – Noticing patterns: what pain psychologists actually look for 04:34 – What is nervous system regulation? The "window of tolerance" 06:35 – Signs you're in hyperarousal (fight-or-flight) 07:48 – Signs you're in hypoarousal (shutdown/freeze) 10:13 – How adverse childhood experiences shape your nervous system 12:46 – Complex trauma vs. single-event trauma 16:20 – Why do some people develop PTSD (and pain) — and others don't? 18:43 – How to actually widen your window of tolerance 20:33 – Allostatic load and the "stress bucket" analogy 22:00 – Doing hard things on purpose: habituation and control 27:11 – Phantom limb pain: proof pain isn't just physical 28:31 – Practical tools: breathing, PMR, mindfulness 30:31 – Cognitive functional therapy & movement experiments 33:29 – CBT and Acceptance and Commitment Therapy for pain 35:13 – What is Pain Reprocessing Therapy? 37:17 – Why multidisciplinary teams change outcomes 39:17 – The Paced Health origin story 42:05 – The idea: multiple clinicians, one room, one hour 44:12 – Why the name "Paced Health"? 47:09 – The Tour de France analogy for pacing 49:13 – Why build this business at all? 51:07 – How to get involved (clients + clinicians) 52:13 – Advice for someone at their lowest point with pain 54:27 – Closing thoughts: autonomy, hope, and community Disclaimer: This podcast is not personalised medical advice. Please consult a health professional before acting on anything discussed.
