This presentation will explore how medicine can think differently about the treatment of chronic stress through a “backdoor approach.” A case is presented in which a young man sought medical treatment for his chronic back pain for over 4 years with no result. Finally, a nerve ablation was suggested and fearing the worse he entered neuro-psychoanalytic treatment with the hope of avoiding the nerve ablation. Exploring his history and current situation, it became clear that he had struggled with chronic stress (C-PTSD) for much of his life. The author notes the connection between chronic stress and sleep disturbances, and between poor sleep patterns and chronic pain. These connections interrupted his natural healing mechanisms through normal sleep and dream patterns. Through the use of an Apple Watch the patient was able to track his nightly sleep patterns and bring them into his treatment. Working with this awareness and the data, he was able to change his sleep and dream patterns, record continuous healthy sleep/dreaming cycles and the chronic pain subsided.

Leighton J Reynolds, PhD is a certified psychoanalyst. He is the author of “The complex architecture and healing of a traumatic brain injury: Listening to the brain” (to be published by Cambridge Scholars Publishing 2023) and a chapter “The complex architecture of a traumatic brain injury” in “Topics in surgical trauma” published through Open Access Press (March 2023).