When the Brain Stays on Alert
Remember that The Office scene where Michael Scott yells, “EVERYBODY STAY CALM!” while chaos unfolds around him?
When the brain thinks something’s wrong and perceives a threat in the environment, the nervous system can jump into full-on alarm mode — even when there is no danger, or when the threat is far less intense than the brain believes.
“Sometimes the most productive thing you can do is relax.” — Mark Black
Now, Michael Scott may have the right idea — to communicate safety when everyone is in panic mode. However, his energy is clearly off, and the safety message comes across as inauthentic.
It’s the same with pain recovery. Learning to communicate safety is essential, especially when you’re in a state of full panic about your symptoms. But even more important is finding genuine messages and communicating them with the right energy.
For some people, saying “I am safe” works. For others, it feels hollow — like flooding themselves with repetitive, inauthentic messages that don’t land or move the needle toward felt safety at all.
Since the primary goal of pain reprocessing therapy is to move toward a felt sense of safety, finding the right safety messaging is a critical part of the work.
How Safety Reappraisal Works
When the brain believes danger is near — or that there’s a threat to the body — pain gets louder. It’s our built-in alarm system.
Pain isn’t all bad. Pain is a protector. It shows up when the brain believes you are unsafe. But when your system overestimates threat, it keeps you on high alert for far too long. Sometimes, the alarm keeps ringing long after the fire is out.
Safety reappraisal is the process of helping the brain realize, “Hey, the fire drill is over.”
This isn’t about ignoring pain or “thinking positive.” It’s about creating small, believable experiences of safety so your brain can update its story. It’s about learning to give yourself what you need when you’re feeling unsafe — and communicating messages your primitive brain can actually hear.
By teaching the brain that specific sensations are safe, and by focusing on what you need during moments of fear, danger signals begin to soften. Over time, you can even start to use pain as information — guiding your thoughts and behaviors toward greater safety.
How great does that sound?
How to Communicate Safety Correctly
This all sounds promising — but how do you choose messages of safety?
PRT is grounded in scientific data and evidence. When creating safety messages, it helps to anchor them in proof that your pain is neuroplastic and that your body is not in genuine danger.
Ask yourself:
- Does your pain come and go? Does it ebb and flow, change intensity, or move around your body?
- Does your pain worsen when you’re stressed and improve when you’re calm or engaged in something enjoyable?
- Do you experience multiple chronic symptoms or co-occurring mental health challenges?
- Do you identify with traits like perfectionism, people-pleasing, anxiousness, or conscientiousness?
- Are your symptoms triggered by things unrelated to physical damage (weather, light, smell, sound, stress, etc.)?
Use your answers to tailor messages that feel believable to you.
For example:
- “The sensations are unpleasant right now, but I know they will decrease soon. This feeling is temporary.”
- “My symptoms are stronger right now because of my brain’s perception — I have a very opinionated brain.”
- “I’ve survived this before, and I know I can get through it again.”
- “I can take a break. I can step away and take care of myself.”
Over time, these messages land because they’re authentic. The more you respond to symptoms without fear, the less fuel pain has. Less fuel means less pain — and more evidence that your pain truly is neuroplastic.
As your brain collects believable experiences of safety, it no longer needs to keep sounding the siren.
Research
The Impact of Language in Pain Rehabilitation
Words have the power to heal — or to harm.
Living with chronic pain often leads to ongoing worry and a constant search for answers. Research increasingly shows that psychological factors are stronger predictors of pain and disability than structural findings.
Medical terms that sound neutral to clinicians — like “degenerative discs” or “wear and tear” — can feel terrifying to patients. Chronic pain becomes more likely when vulnerability, distress, and misunderstood language amplify fear.
How a diagnosis is communicated can matter as much as — or more than — imaging results. “Scary” language can lead to unnecessary disability and contribute to conditions becoming chronic.
By choosing language carefully, using safety-oriented messaging, and listening with empathy, clinicians have enormous influence over a patient’s recovery journey. Language can reduce fear, build trust, and help people regain a sense of control.
Reference:
Stewart, M., & Loftus, S. (2018). Sticks and stones: The impact of language in musculoskeletal rehabilitation.
Journal of Orthopaedic & Sports Physical Therapy,