Dr. David Clarke, president of the
Psychophysiologic Disorders Association, details the link between stress and chronic pain and the scope of brain-generated symptoms. Clarke says many patients have symptoms not explained by disease or injury, estimating about 20% of U.S. adults (about 50 million) live with chronic pain, with costs estimated at $650 billion, and notes clinicians are often not trained to evaluate psychosocial stressors. He describes clues that pain is brain-generated (e.g., multiple long-lasting or shifting symptoms, lack of objective nerve damage) and a broad symptom spectrum from migraines and IBS to pelvic pain and rashes. Clarke discusses adverse childhood experiences, triggers, personality traits, and repressed emotions, cites randomized trials showing “pain relief psychology” can reduce pain and change MRI findings, and shares resources including a clinician directory, self-assessment quiz, and the Curable app.