# Somatic Tracking: A Step-by-Step Guide to the Practice

_Somatic tracking is the core technique of Pain Reprocessing Therapy. Learn how to practice it step by step, why it calms pain, and the science behind it._

_Published 2026-05-28 · updated 2026-06-08 · 15 min read_

## Answer summary

Somatic tracking is a technique for chronic pain where you observe pain sensations with curiosity instead of fear, while reminding your nervous system that you're safe. It's the core practice in Pain Reprocessing Therapy, the treatment that left 66% of patients pain-free or nearly pain-free in a 2022 JAMA Psychiatry trial.

## What Is Somatic Tracking?

Somatic tracking is a way of paying attention to pain that helps your brain learn the pain is safe. You observe the sensation with curiosity instead of fear, and while you watch it, you gently remind your nervous system that you're not in danger. That's the whole move. Attention, plus safety.

Your pain is real. Let's be clear about that up front. Somatic tracking isn't about pretending the sensation isn't there, or deciding it's 'all in your head.' The sensation is real, and your brain is producing it for a reason. The catch is that for many people with chronic pain, the brain has learned to treat safe signals from the body as dangerous ones. Somatic tracking is how you teach it the difference.

The technique has three parts. First, mindful attention: you notice the sensation and describe it, the way a curious scientist would. Is it burning, tight, buzzing, dull? Second, safety reappraisal: while you observe, you remind yourself the sensation is safe, that your body isn't being damaged. Third, a light touch: you try to bring a little ease, even mild humor, to the moment. Alan Gordon, the therapist who named the technique, describes it as watching the sensation the way a snorkeler watches a fish. Curious. Unhurried. Not trying to chase it or fix it.

If you already understand that chronic pain can be [neuroplastic](/neuroplastic-pain), brain-generated rather than a sign of ongoing damage, you're exactly who this guide is for. You don't need convincing. You need the steps, and you'll have all of them by the time you finish reading.

## Somatic Tracking vs. Mindfulness (and Why the Difference Matters)

If you've tried meditation for pain and it didn't help, this part matters.

Plain mindfulness, like a body scan, asks you to notice sensations without judgment and without trying to change anything. You observe, you accept, you let it be. That's useful for a lot of things. But on its own, it often doesn't reduce chronic pain. Why not? Because acceptance alone doesn't tell your brain the one thing it needs to hear. It doesn't deliver the safety signal.

Somatic tracking adds that signal. You still observe with curiosity, but you also actively update the meaning of the sensation: this is safe, my body isn't in danger, my brain is being overprotective. That second step is the difference between watching the pain and changing your brain's prediction about it.

Think of it like this. Mindfulness says, 'Notice the alarm without reacting.' Somatic tracking says, 'Notice the alarm, and remind yourself it's a false alarm.' Same attention. Different message. The message is what does the work.

## Why It Works: Fear Is the Fuel

Here's the core idea, in one line: pain equals sensation plus fear. Reduce the fear, and you reduce the pain. Not just the worry about the pain. The pain itself.

That sounds too simple, so let's look at why it holds up. Modern pain neuroscience describes the brain as a prediction machine. It's constantly guessing what's happening in your body and bracing for what's next. In chronic pain, those predictions get stuck on 'danger.' The brain expects threat, so it amplifies ordinary signals into pain, and fear makes the prediction louder. Johan Vlaeyen and Steven Linton mapped this years ago in their fear-avoidance model (Vlaeyen & Linton, Pain, 2000): fear of pain, not tissue damage, is what keeps so many people stuck.

Somatic tracking works on each piece of that loop. When you turn calm attention toward a sensation, you change how the brain processes it. Irene Tracey's team showed with brain imaging that attention alone shifts pain signaling through the brainstem's own pain-control network (Tracey et al., Journal of Neuroscience, 2002). When you name the sensation ('burning, about the size of a fist, pulsing'), you quiet the brain's threat center. Matthew Lieberman's research found that simply putting feelings into words reduces activity in the amygdala (Lieberman et al., Psychological Science, 2007). And when you add the safety message, you're running something close to exposure therapy for a phobia: you face the feared thing in a safe context, again and again, until the fear response fades.

That's the mechanism. You're not fighting the sensation. You're changing what your brain thinks it means.

> **Evidence**
> 
> **66% pain-free in 4 weeks**
> 
> Two-thirds of chronic back pain patients became pain-free or nearly pain-free with Pain Reprocessing Therapy, the protocol built around somatic tracking. Results held at five years.
> 
> *Source: Ashar et al., JAMA Psychiatry, 2022 (n=151 randomized controlled trial, University of Colorado Boulder)*
> 
> Somatic tracking was the central technique participants practiced. Effect sizes of Hedges' g = -1.14 vs placebo and -1.74 vs usual care were, in the words of lead author Yoni Ashar, 'very rarely observed in chronic pain treatment trials.'

## Does Somatic Tracking Actually Work? The Honest Evidence

Let's be honest about what the research does and doesn't show.

The strongest evidence comes from the Boulder Back Pain Study (Ashar et al., JAMA Psychiatry, 2022). In that randomized trial of 151 people who'd had back pain for about a decade, 66% became pain-free or nearly pain-free after four weeks of Pain Reprocessing Therapy, with somatic tracking at its center. Brain scans showed the changes weren't imaginary: pain-processing regions quieted down. A five-year follow-up found the results held. A separate analysis (Ashar et al., JAMA Network Open, 2023) found the people who shifted most toward seeing their pain as brain-generated got the biggest relief. The belief did a lot of the work.

There are real limits, though, and you deserve to know them. That trial used two highly experienced therapists, including the person who developed the method, so some of the effect may come from skilled coaching that's hard to reproduce alone. No study has tested somatic tracking by itself, separate from the full therapy. And digital delivery looks weaker than the real thing: the only published randomized trial of a consumer neuroplastic-pain app found a moderate effect on pain severity (d = 0.43) over six weeks (Thomson et al., Canadian Journal of Pain, 2024). That study tested an entire multi-feature app, not somatic tracking on its own, and a moderate effect sits well below the very large effect (g of about 1.74) seen with in-person therapy.

None of that means the technique doesn't help. It means the realistic picture is a powerful tool that works best paired with understanding, patience, and ideally some guidance. One more honest note: the technique needs genuine belief. Done mechanically, while you're secretly waiting for it to 'work,' it tends not to. And if your pain is new, changing, or severe, see a doctor first to rule out a medical cause. Somatic tracking is for pain that's already been checked out.

## How to Do Somatic Tracking: A Step-by-Step Guide

Here's the practice. Set aside five to fifteen minutes when your pain is at a manageable level, below about a 5 out of 10. (More on why that matters in a moment.) Sit or lie somewhere comfortable. You're not trying to fix anything. You're just going to observe.

**Step 1: Notice.** Bring your attention to the area where you feel the sensation. Don't analyze it yet. Just let yourself feel that it's there. What's the raw quality of it right now? Sharp, dull, burning, aching, tingling, tight?

**Step 2: Get curious.** Explore it like something interesting rather than something threatening. Where exactly is it? Does it have edges, or does it blur outward? Is it steady, or does it flicker and change moment to moment? Many people are surprised to find the sensation shifts the instant they study it with curiosity instead of dread.

**Step 3: Add safety.** While you keep observing, gently offer your nervous system a different message: 'This sensation is safe. My body isn't damaged. My brain is generating this as a protective signal, but there's nothing here to protect against.' You don't have to fully believe it. Just hold it as possible.

**Step 4: Lighten up.** This is the hardest part, and the most important. See if you can bring a little ease, even mild humor, to the moment. Gordon suggests watching the sensation the way you'd watch waves roll in at the beach. Interesting. Not threatening. If the sensation flares, that's fine. Shift your attention to a comfortable part of your body for a few breaths, then come back when you're ready. (That shifting move has a name: pendulation. It's your volume knob.)

**Step 5: Release.** When you're done, widen your attention to your whole body. Notice the parts that feel fine. Take a breath. That's it. You're finished.

Start with shorter sessions and do them often. Frequency matters more than length. A calm two minutes, several times a day, teaches your brain more than one tense thirty-minute marathon.

## You Just Did It. Here's What Makes It Stick

Notice what just happened. You turned toward a sensation, offered it a little safety, and watched. That's somatic tracking. The whole skill, in one rep.

Here's the honest part. One rep rarely changes much. What changes chronic pain is practicing this regularly, with enough understanding behind it that the safety message is something you actually believe, not words you recite. That's the gap most people fall into. They read about the technique, try it a few times while half-doubting it, and decide it doesn't work for them.

The people who recover usually have one thing in common. They really get why their pain is safe. The conviction does the heavy lifting, which is why the researchers found that the patients who shifted most toward seeing their pain as brain-generated got the biggest relief (Ashar et al., JAMA Network Open, 2023). That shift is learnable. It's the part PainApp is built to teach, in short pain neuroscience lessons that make the science click, so when you tell your nervous system the sensation is safe, you mean it.

## The Two Rules You Can't Skip

Two rules make the difference between somatic tracking that helps and somatic tracking that backfires.

**Rule one: don't track high pain.** Only practice when your pain is below roughly a 5 out of 10. Trying to calmly observe an 8 out of 10 isn't brave, it's retraumatizing, and it teaches your nervous system the opposite of safety. When pain is high, this isn't the moment for tracking. Switch to comfort instead: rest, warmth, slow breathing, gentle distraction, whatever truly soothes you. Come back to tracking when things settle.

**Rule two: let go of the outcome.** This one's a paradox, and it trips up almost everyone. If you do somatic tracking in order to make the pain go away, you're sending your brain a quiet message that the pain is still an emergency that must be fixed. That's pressure, and pressure is fear wearing a calmer outfit. Gordon calls the goal 'outcome independence.' You track with curiosity, not with hope. You're allowed to want relief. You just can't make this minute's session depend on getting it. Strange as it sounds, wanting it to work too badly is part of what keeps it from working.

So how do you hold both? You show up, you observe with real curiosity, and you let whatever happens happen. The relief, when it comes, tends to arrive sideways, once you've stopped chasing it.

## What People Often Notice Over Time

People often want a timeline, and the honest answer is that it varies a lot from person to person. There are some patterns many people notice, offered here as what's common, not what's promised.

In the first session, most people feel nothing dramatic. That's normal. Some notice a small shift. A few find the sensation briefly intensifies, which can happen as the brain's alarm protests a new approach. None of those reactions means you're doing it wrong.

Early on, many people find the first thing that changes isn't the pain. It's the fear. You start to feel a little less braced, a little less afraid of the next flare. Research on Pain Reprocessing Therapy suggests that shift in how you relate to the sensation is doing real work, even before the pain itself moves.

With regular practice over weeks, some people report that moments of relief during tracking become more frequent, and that the calmer response starts to show up outside of practice too. Many describe the pain slowly forgetting to show up at certain times, or activities that used to feel risky becoming less scary. It tends to be a slope, not a switch. Some weeks are better than others. Progress that wanders is still progress.

If weeks go by with no change at all, that's worth paying attention to, and the next section covers the usual reasons why.

*How somatic tracking differs from other approaches to pain*

| Approach | What it does | How somatic tracking differs |
| --- | --- | --- |
| Mindfulness meditation | Non-judgmental awareness and acceptance | Adds a safety message and a light tone to actively change the brain's threat appraisal |
| Body scanning | Systematic attention to each body region | Focuses on the pain area on purpose, with the goal of teaching safety, not just observing |
| Distraction | Shifts attention away from pain | Shifts attention toward the sensation, but with safety. Distraction avoids; tracking engages |
| Relaxation and breathing | Lowers physical arousal | Doesn't require you to relax. You can track while tense, because the mechanism is about meaning |
| CBT for pain | Challenges catastrophic thoughts with logic | Works through direct experience, not argument. You feel the sensation differently, not just think about it |
| Graded exposure | Gradually approaches feared movements | The internal version: gradually approaches feared sensations. The two often work well together |

## When Somatic Tracking Isn't Working

If you've been practicing and it doesn't seem to be helping, you're not broken, and you're probably not doing it 'wrong' in some deep way. Usually it's one of a few common snags.

You're trying too hard to make the pain stop. This is the big one. It breaks outcome independence, and the effort itself reads to your brain as fear. Ease off the goal.

You're tracking when the pain is too high. Above a 5 out of 10, observing pain mostly rehearses the threat. Wait for a calmer moment.

You're skipping the safety message. Pure awareness, with no 'this is safe,' is mindfulness, not somatic tracking. The safety reappraisal is the active ingredient. Don't leave it out.

You're being hard on yourself when it doesn't work. Self-criticism is itself a threat signal to your nervous system, and the harshness can keep the pain loop running.

You're going through the motions. Done mechanically, with no real curiosity, the technique is just sitting still. The engagement is the point.

There's also a deeper kind of stuck, where you understand all of this, you're practicing sincerely, and the pain still won't shift. That plateau has its own causes and fixes, and it's common enough that we wrote a whole guide to it: [why brain-based treatment stalls and what to do](/tension-myositis-syndrome/not-working).

> **You've got the technique. Now make it stick.**
>
> PainApp teaches the brain-based science behind somatic tracking in short daily lessons, so your safety message carries real weight.
>
> [See how PainApp works](https://painapp.health/pain-management-app?utm_source=seo&utm_content=somatic-tracking&utm_position=mid)
>
> *7-day free trial. 30-day money-back guarantee. Cancel anytime.*

## Composite case

*Mark · age 41 · chronic back pain · 6 years*

Mark, 41, had lived with low back pain for six years. He'd done the rounds: two stints of physical therapy, a couple of steroid injections, an MRI that showed two bulging discs. His doctor mentioned surgery, and Mark was starting to think he had no choice.

A friend sent him an article about brain-generated pain. He read it, rolled his eyes, and closed the tab. It sounded like someone telling him the pain wasn't real, and the pain was extremely real. But a few things nagged at him. His back was always worse the week before a big work deadline, and oddly fine on the second day of a holiday. His MRI hadn't changed in years, yet the pain kept getting worse. Discs don't have moods. Something else was going on.

He read more, and the concept finally clicked. The trouble was, knowing the concept didn't fix anything. He'd lie down to 'do somatic tracking' and basically grit his teeth at his back, waiting for it to stop hurting. Nothing happened. What changed things was understanding the parts he'd been getting wrong. He worked through the pain neuroscience lessons in PainApp until the method made sense, and two things landed: he'd been tracking when his pain was way too high, and he'd been doing the whole thing as a desperate attempt to make it stop. Once he only practiced in calmer moments, and once he let go of the agenda, the sessions felt completely different.

It wasn't instant. Over about three months, his daily pain dropped from a steady 6 to a 2 or 3. He went on a long hike that fall, the kind of thing he'd written off years earlier. He still gets a flare before stressful deadlines. The difference is he recognizes it now, doesn't panic, and it passes in a day instead of camping out for a month. His MRI still shows the same two discs. His back mostly doesn't bother him anymore.

(Mark is a composite, drawn from common recovery patterns, not one real person.)

## Somatic Tracking Is a Skill You Can Learn

Somatic tracking is a skill, which means it's something you get better at with practice, not a talent you either have or don't. The early sessions can feel awkward and pointless. That's normal. You're learning to do something completely new: to meet a sensation your body has been sounding an alarm about for years with curiosity instead of fear.

If you want the fuller picture, the technique sits inside a larger approach. Somatic tracking is the core practice of [Pain Reprocessing Therapy](/pain-reprocessing-therapy), it targets the [central sensitization](/central-sensitization) that amplifies chronic pain, and it rests on the science of [neuroplastic pain](/neuroplastic-pain), the idea that pain learned by the brain can be unlearned. It's the modern, specific version of what Dr. John Sarno was pointing at when he told patients to 'think psychological.' Here's the actual thing to do.

You've already done one rep. The question now is whether you do it tomorrow, and the day after. Your brain learned this pain over months and years. With patience, and the right kind of attention, it can learn its way back out, one calm, curious minute at a time.

## Learn the method that makes somatic tracking work

PainApp is an education-first program that teaches the neuroscience of neuroplastic pain in short daily lessons, so the safety message at the heart of somatic tracking is something you actually believe. Get it on your phone and start today.

## Next step

**Prefer to start in your browser?**

You don't need the app store to begin. Open PainApp on the web, start the free trial, and work through the pain neuroscience lessons that make somatic tracking click.

[Try PainApp Free on Web](https://painapp.healthhttps://app.painapp.health/?utm_source=seo&utm_content=somatic-tracking&utm_position=end)

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## Frequently asked questions

### What is somatic tracking?

Somatic tracking is a technique for chronic pain where you observe pain sensations with curiosity instead of fear, while reminding your nervous system that you're safe. It's the core practice of Pain Reprocessing Therapy, which left 66% of patients pain-free or nearly pain-free in a 2022 JAMA Psychiatry trial (Ashar et al.).

### How do you do somatic tracking for pain?

Practice when your pain is below about a 5 out of 10. Notice the sensation, get curious about its qualities, gently remind yourself it's safe, and bring a light, easy attention to it. Short sessions done often tend to work better than long, effortful ones.

### Does somatic tracking actually work?

In the Boulder Back Pain Study (Ashar et al., JAMA Psychiatry, 2022), Pain Reprocessing Therapy built around somatic tracking made 66% of patients pain-free or nearly pain-free, with results holding at five years. No trial has tested somatic tracking entirely on its own, and digital approaches show smaller effects, so results vary from person to person.

### How long does somatic tracking take to work?

It varies widely. Many people find the first thing to change is their fear of the pain, often within a few weeks, while reductions in the pain itself tend to come gradually after that. It's usually a slope rather than a switch, with better and worse weeks along the way.

### What's the difference between somatic tracking and mindfulness?

Mindfulness asks you to notice sensations without judgment and without trying to change them. Somatic tracking adds an active safety message, reminding your brain the sensation isn't dangerous. That safety signal is what helps update the brain's threat prediction, which plain awareness alone usually doesn't do.

## Related pages

- [The Way Out by Alan Gordon: somatic tracking when it stalls](https://painapp.health/books/the-way-out)
- [Pain Reprocessing Therapy: the method somatic tracking belongs to](https://painapp.health/pain-reprocessing-therapy)
- [What is neuroplastic pain?](https://painapp.health/neuroplastic-pain)
- [Central sensitization: the mechanism somatic tracking targets](https://painapp.health/central-sensitization)
- [When brain-based treatment isn't working](https://painapp.health/tension-myositis-syndrome/not-working)
- [Does brain-based treatment work? The clinical evidence](https://painapp.health/scientific-research)

## References

1. Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(1):13-23. [link](https://pubmed.ncbi.nlm.nih.gov/34586357/)
2. Ashar YK, Gordon A, Schubiner H, et al. Reattribution to Mind-Brain Processes as a Key Mechanism of Pain Reprocessing Therapy: A Secondary Analysis of a Randomized Clinical Trial. JAMA Network Open. 2023;6(1):e2252353. [link](https://pubmed.ncbi.nlm.nih.gov/36602797/)
3. Ashar YK, Gordon A, Wager TD, Schubiner H. Long-Term Durability of Pain Reprocessing Therapy for Chronic Back Pain: A Five-Year Follow-Up. JAMA Psychiatry. 2025.
4. Tracey I, Ploghaus A, Gati JS, et al. Imaging Attentional Modulation of Pain in the Periaqueductal Gray in Humans. Journal of Neuroscience. 2002;22(7):2748-2752. [link](https://pubmed.ncbi.nlm.nih.gov/11923440/)
5. Lieberman MD, Eisenberger NI, Crockett MJ, et al. Putting Feelings Into Words: Affect Labeling Disrupts Amygdala Activity in Response to Affective Stimuli. Psychological Science. 2007;18(5):421-428. [link](https://pubmed.ncbi.nlm.nih.gov/17576282/)
6. Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317-332. (doi: 10.1016/S0304-3959(99)00242-0)
7. Louw A, Zimney K, Puentedura EJ, Diener I. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiotherapy Theory and Practice. 2016;32(5):332-355. [link](https://pubmed.ncbi.nlm.nih.gov/26645023/)
8. Thomson CJ, Pahl H, Giles LV. Randomized controlled trial investigating the effectiveness of a multimodal mobile application for the treatment of chronic pain. Canadian Journal of Pain. 2024;8(1):2352399. [link](https://pubmed.ncbi.nlm.nih.gov/39175941/)

## About the author

**[Tauri Urbanik](https://painapp.health/authors/tauri-urbanik)** — Pain Science Researcher

Researching neuroplastic pain science and recovery methods for 3+ years.

Canonical URL: https://painapp.health/somatic-tracking

## Medical disclaimer

This page is for educational purposes and is not medical advice. Pain is real. Neuroplastic pain is not imaginary. If you are dealing with chronic pain, please work with a qualified clinician who can evaluate your specific situation.