EP #1248: Psychophysiologic Disorder (PPD) - The Trauma and Chronic Pain Connection with Dr. David Clarke

Most people assume that pain and illness are the straightforward result of injury and disease. However, one in six adults suffers from chronic pain or illness that is either “medically unexplained” or unresponsive to virtually any treatment. These patients often live with a psychophysiologic disorder (PPD), the increasingly common clinical term for very real stress-related and brain-generated medical conditions. Such chronic symptoms manifest themselves as everything from fibromyalgia to irritable bowel syndrome, and their incompatibility with conventional diagnosis leaves most PPD patients feeling neglected by the medical profession and hopeless about their future.


Lisa is joined by Dr. David Clarke, the President of the Psychophysiologic Disorders Association (PPDA), a 501(c)(3) nonprofit dedicated to ending the chronic pain epidemic. Dr. Clarke graduated from Williams College with a bachelor’s degree in psychology, and he holds an MD from the University of Connecticut School of Medicine. He is Board-certified in Internal Medicine and Gastroenterology. His organization’s mission is to advance the awareness, diagnosis, and treatment of stress-related and brain-generated medical conditions. The PPDA supports an evidence-based, biopsychosocial approach that is safer, more affordable, and more effective than traditional treatments of chronic pain. With a focus on uncovering stress and identifying trauma, the PPDA encourages patients to take control of their symptoms without drugs, surgery, or expensive treatments. Dr. Clarke is the organization’s president, a renowned gastroenterologist, author of three books, producer of three films, and an international lecturer on psychophysiologic disorders. Learn more at EndChronicPain.org.


The Psychophysiologic Disorders Association (PPDA) is a 501(c)(3) nonprofit dedicated to ending the chronic pain epidemic by promoting awareness of PPD diagnosis and treatment. Educating medical professionals is the first step in creating a healthcare system that is more compassionate toward PPD and more capable of serving every patient. In 2021, opioids accounted for over 80,000 of the drug overdose deaths reported in the United States. The opioid crisis is a plague on modern health care, and much of its strength originates from those patients unable to find understanding and relief — like those suffering from brain-generated symptoms.

SummaryDr. David Clarke discusses psycho-physiologic disorders, a condition where symptoms are generated by the brain and not explained by disease or injury. He shares personal experiences and explains how stress and trauma can impact the body. Dr. Clarke emphasizes the importance of diagnosing and treating the underlying stressors to alleviate symptoms. He highlights the success of pain relief psychotherapy and the role of self-treatment techniques. Resources such as the Curable app and books are recommended for further support. Dr. Clarke's work offers hope and solutions for individuals with chronic unexplained symptoms.
Chapters00:00Introduction and Personal Experiences
01:05Understanding Psycho-Physiologic Disorders
03:10Discovering the Connection between Stress and Symptoms
05:24The Role of the Brain in Psycho-Physiologic Disorders
06:19The Impact of Trauma and Stress on the Body
07:53Diagnosing and Treating Psycho-Physiologic Disorders
10:06The Success of Pain Relief Psychotherapy
12:19Case Studies and Success Stories
14:43The Work of Dr. John Sarno
17:09Resources for Treatment and Support
18:47Differentiating Evidence-Based Approaches
23:29The Impact of Pain Relief Psychotherapy
25:52Techniques for Self-Treatment
28:07Finding Help and Support
29:11Closing Remarks and Resources