Self-Compassion for Chronic Pain Healing | Dr. John Stracks & Leah Samaha
Video: Watch the full session here → https://www.youtube.com/watch?v=CbKZ6jS12lI
Dr. John Stracks: Welcome. I'm Dr. John Stracks, a physician in Chicago focused on the reduction and elimination of physical symptoms using mind-body medicine. You can learn more about working with us at cormendihealth.com.
I'm joined today by Leah Samaha, an educator who got her first migraine at age 28, which developed into debilitating daily headaches and migraines. She has worked with me and a number of other practitioners — individually, in classes, and in groups — and has significantly reduced her symptoms. Along the way, she's learned so much about self-compassion and mindfulness meditation that she's now teaching a course on self-compassion with us. Today we're talking about what self-compassion is and how it supports the healing of physical symptoms. Leah, welcome.
Leah Samaha: Hey, Dr. Stracks. Thanks for having me.
Leah's Chronic Pain Story
Dr. Stracks: Can you give people a brief sense of what happened, where you've been, and where you are now?
Leah: When I was 28 — no history of headaches — I had my first migraine. It lasted 24 hours, went away, and then came back a week later and didn't really leave for roughly five years. At the start, I had truly debilitating headaches. I was noise sensitive, in excruciating pain, and that led to muscle tightness and pain throughout my body.
I spent the first couple of years bouncing between headache specialists and neurologists, working within a very Western medical framework — a lot of medications, a lot of different treatments. Around year three, I had a major flare-up and found myself in a chronic pain clinic for the second time. That was a turning point.
They had me try biofeedback therapy. I was in a recliner, hooked up to monitors tracking temperature, cortisol, and heart rate — all displayed on a screen. The clinician gently prompted me to take deeper breaths to see if I could lower my stress response. And that's when I noticed something: there was a constant critical voice in my mind saying this will never work, you will never get better, don't trust yourself. And I could literally watch my cortisol spike on the screen as it spoke. I had this aha moment — my physical symptoms were real, but the critical chatter in my head was actively making them worse.
Dr. Stracks: And that was actually before you and I had met. You've now been working together for about four years, and the headaches have mostly gone away at this point — not completely absent, but dramatically reduced.
Leah: Yes. It's been almost a year and a half now without regular headaches. When they do come, they come and pass. Honestly, telling the story of what my pain used to be like feels a little like reading a chapter from someone else's life.
Discovering Self-Compassion
Dr. Stracks: So you had this moment of recognition in the biofeedback session. What happened from there?
Leah: I became fascinated. The psychologist at the chronic pain clinic recommended Kristin Neff's book Self-Compassion, and that was my first real entry point. Kristin Neff is a researcher who has done tremendous work compiling an understanding of what self-compassion actually is and what practices help cultivate it. From there I started exploring what else could help — I shifted to a therapy focused on compassion, deepened my mindfulness meditation practice, and started really approaching this as something I could deliberately build.
Dr. Stracks: How did that change you day to day? How do you go from being very self-critical to something different?
Leah: The first step for me was just awareness — recognizing that there was this relentlessly critical voice that I hadn't fully noticed before. The things it was saying were things I would never say to a friend, and yet it ran constantly in the background. Just noticing that was a revelation.
From there, it was actually too hard at first to direct compassion toward myself. So I started by imagining compassionate figures in my life — what would they say to me right now? What would that voice sound like? I surrounded myself with that — podcasts, writing from a compassionate perspective — and let it work its way inward over time.
Dr. Stracks: I can relate to this. Self-compassion was a completely new concept to me when I became a physician. I remember being in a training in Minneapolis and realizing my schedule was double-booked the day I was supposed to be there. My first instinct was to blame my staff, then to turn it on myself — professionals don't do this, you're never going to be successful if you can't even manage your calendar. But I'd learned enough by then that a part of me said: we don't talk like that around here anymore. And the moment I shut that voice down, it was easy to figure out what to do. Before that, I was just at the mercy of it.
Leah: That's exactly the experience. And I want to name what you said at the end — it's a practice. I didn't suddenly learn about self-compassion and transform overnight. I had a very entrenched critical habit of mind, built over a lifetime, and it took real intentional effort to build something different. But the research on neuroplasticity shows we actually can change the internal monologue — the brain is capable of that. That's what makes this so hopeful.
What Is Self-Compassion?
Dr. Stracks: For people who are new to this — what is self-compassion, and how would you explain self-criticism to someone who doesn't think they have it?
Leah: Let me try something. Think right now of someone in your life who embodies compassion — someone who's on your side, supportive, who can give you honest feedback but from a place of care, not criticism. Does someone come to mind?
Dr. Stracks: My wife, Lisa.
Leah: Exactly. Most of us can easily identify that quality in someone else. Self-compassion is turning that inward — being sensitive to our own suffering and being on our own side. Kristin Neff describes both a tender side and a fierce side of self-compassion: the warmth we offer to our own pain, and the Mama Bear capacity to stand up for ourselves. Both matter.
She also describes three core components. First, mindfulness — simply bringing awareness to the fact that the critical response is happening. Second, common humanity — recognizing that what you're experiencing is something all humans go through. We all make mistakes, forget things, say the wrong thing. And third, kindness — practicing being genuinely kind to yourself, whether that means forgiving a mistake or fiercely encouraging yourself toward something you've been afraid to try.
Dr. Stracks: Kristin Neff has a story about this — she's on a plane with her son, who has autism, and he has a meltdown, running up and down the aisle while the pilot threatens to turn the plane around. She finally gets him settled and immediately starts berating herself. And then she catches it — wait, I literally wrote the book on self-compassion — and walks herself through the three steps. She recognizes the suffering, recognizes she isn't the first or last parent this has ever happened to, and starts to regulate. And as she calms down, her son calms down too.
Leah: The common humanity piece is one of the most powerful for me, personally. It's also one of the reasons self-compassion works so well in groups — you look around and hear other people say you too? You also said something harsh to yourself today? You're also still working up the courage to try that thing? And suddenly the weight of it lifts a little. Being human is hard. We're usually doing the best we can with what we have.
How Self-Compassion Supports Physical Healing
Dr. Stracks: For those listening who are here specifically because of physical symptoms — how does self-criticism translate into physical pain, and how does self-compassion help heal it?
Leah: You may have heard the phrase "sticks and stones will break my bones but words will never hurt me." The research suggests that's actually not true — physical pain and emotional pain activate similar regions in the brain and body. When I learned that, it was genuinely revolutionary.
If critical self-talk is a constant soundtrack, the body registers it as a threat. Cortisol spikes. Muscles tense. The system stays on guard. And that physical tension and arousal creates and amplifies pain. What seemed like a soft skill suddenly had a clear physiological mechanism.
Dr. Stracks: And this goes right to the heart of how mind-body medicine understands pain. Pain is fundamentally about the perception of danger versus safety. There are few things more dangerous-feeling, on a nervous system level, than constantly telling yourself you're terrible or broken or never going to get better. That's a massive source of the threat signal. Self-compassion works in part by reducing that signal — creating safety from the inside.
Guided Self-Compassion Practice
Note: Dr. Stracks participated as the example. Those at home can follow along.
Leah: Close your eyes if you're comfortable, or leave them open. Take a moment to settle into your body — feel your feet on the floor, the top of your head, and let your attention fill the space in between. Take a few deeper breaths, extending the exhale, to activate the soothing nervous system.
Now bring to mind a moment from this week where you were harsh with yourself — keep it small, a two or three out of ten. Maybe you made a mistake at work, cut someone off in traffic, or said something to a partner you wished you hadn't. Watch it as if it's playing on a small screen in front of you. Notice the emotions or thoughts that came with it.
Now say your own name to yourself, quietly, and offer these phrases:
This is really hard right now. Suffering is a part of life — this is something everyone experiences. How can I be kind to myself in this moment?
Repeat those phrases again, gently. And then ask: what do I actually need right now? Maybe it's a cup of tea, a breath of fresh air, a simple acknowledgment that it's okay to make mistakes. Whatever comes up, offer it to yourself.
Notice how your body feels as you receive that care. Then take a deep breath in, exhale through the mouth, and open your eyes.
Dr. Stracks: That really slowed things down. My breathing evened out, and the compassion toward myself felt genuinely different from where I can get to when I'm upset — a real softening.
Leah: That's a fairly standard self-compassion break, and it's one of the core practices we'll teach in the class.
About the Self-Compassion Course
Dr. Stracks: You're teaching a five-week class — seven and a half hours total. What can people expect?
Leah: We're going to approach self-compassion from multiple angles — as a concept, but also as it relates to the body, emotions, thoughts, and actions. Each session will have a short teaching, some storytelling, experiential practices like the one we just did, and group debriefs. We'll also do journaling, creative exercises like developing a character for your inner critic as a way to relate to it differently, and various meditations and reflective practices.
The goal is to offer many different tools. If meditation sticks for you, great. If expressive writing is more powerful, great. We want people to find what resonates and take that forward.
Dr. Stracks: I've had patients who took a self-compassion course a decade ago who still talk about what it meant to them. There's something about doing this in community, over time, that goes much deeper than a single exercise.
Leah: A series of classes lets you actually watch the skill develop — from week one to week five you can feel the change. It's like learning piano. You can't just show up once and expect fluency. The group accountability helps too. And the common humanity piece really comes alive when you're in a room with other people doing the same work.
A Few Things Worth Knowing
Leah: Two things I want to say for anyone on the fence. First — self-compassion is not soft or mushy. It can be genuinely fierce and strong. Developing it takes real effort and courage. Skeptics are welcome. Second — we're going to bring humor. This work is important, but it doesn't have to be heavy. I want it to feel enjoyable.
Dr. John Stracks practices mind-body medicine via telehealth nationally and internationally, focused on the reduction and elimination of chronic pain and physical symptoms. Leah Samaha is a mindfulness meditation teacher trained with Jack Kornfield and Tara Brach, and teaches self-compassion and meditation through Cormendi Health. For information about Leah's self-compassion course or working with Cormendi, visit cormendihealth.com.