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Why do some teens continue to experience chronic pain long after an injury has healed? And what if the brain—not damaged tissue—is keeping the pain alive?
In this episode of Thoughts on Record, Dr. Pete Kelly speaks with Dr. Penina Zilberberg and Paulina Soble, LCSW, co-authors of The Pain Reprocessing Therapy Workbook for Teens. Together, they explore the emerging science of neuroplastic pain and explain how chronic pain can become a learned pattern of threat signaling within the nervous system—one that is real, debilitating, and, importantly, reversible.
The conversation examines how predictive processing, fear conditioning, anxiety, perfectionism, and family dynamics interact to amplify pain during adolescence. Dr. Zilberberg and Ms. Soble discuss how Pain Reprocessing Therapy helps teens reinterpret pain signals, gradually return to meaningful activities, and retrain the brain away from danger and toward safety. They also explore common misconceptions about neuroplastic pain, the role of schools and parents in recovery, and why adolescence represents a uniquely powerful window for intervention.
Whether you're a clinician, educator, parent, or someone living with persistent pain, this episode offers a practical, evidence-informed framework for understanding chronic pain through the lens of contemporary neuroscience—and for helping young people reclaim their lives.
Guests: Dr. Penina Zilberberg, PhD, Clinical Psychologist, and Paulina Soble, LCSW, Licensed Clinical Social Worker and co-authors of The Pain Reprocessing Therapy Workbook for Teens.
