Rewiring Chronic Pain

This study examines the effectiveness of a brief psychological intervention for chronic pain treatment, as well as the psychological and neurophysiological mechanisms associated with changes in pain intensity. Participants with chronic pain will be randomly assigned to one of three groups: two types of brief psychological interventions and a treatment-as-usual control group. Throughout the study, participants will attend a series of therapeutic sessions, complete questionnaires, undergo brain measurements (EEG and MRI), and participate in physiological monitoring using a smartwatch. The study aims to investigate which cognitive and physiological changes occur during the intervention, and whether early markers can be identified that may predict improvement in pain following this type of treatment. In addition, differences between cognitive and somatic components of the intervention will be examined to better understand which elements contribute to clinical change, and to determine whether knowledge alone is sufficient or whether participants must undergo a bodily experience in order to produce changes in pain levels. The goal of the study is to improve understanding of the mechanisms underlying chronic pain and responses to psychological treatments, and to contribute to the development of more personalized, effective treatments with minimal side effects in the future.

Inclusion Criteria: * Age 20-70 years * Chronic pain lasting over 3 months, including chronic pain conditions such as fibromyalgia and complex regional pain syndrome (CRPS) * Average pain intensity ≥4 on a 0-10 scale * Stable medication regimen for at least 4 weeks prior to treatment initiation * Hebrew language fluency * Provision of informed consent, including consent for video recordings Exclusion Criteria: * Current participation in other pain-related psychotherapy * Pregnancy * Substance abuse, including deviations from prescribed medication use * Change in medication or dosage in the 4 weeks preceding treatment * Diagnosed active cancer * Dementia * Severe depression (BDI-II score \> 29) * Moderate cognitive impairment based on the Montreal Cognitive Assessment (MoCA) * Current or past diagnosis of schizophrenia, psychosis, bipolar disorder, multiple personality disorder, or dissociative identity disorder * Inability to undergo MRI as determined by MRI safety screening (e.g., claustrophobia, metal in body such as vascular clips, pacemakers, or certain cochlear implants)