Saul Rosenthal, PhD


Chronic pain and medical conditions are complex syndromes that can completely debilitate the sufferer. Migraine, Irritable Bowel Syndrome, Chronic Regional Pain Syndrome, cardiovascular disease, diabetes and other chronic conditions are often resistant to traditional medical treatment, leaving people in constant distress, frustrated, distrustful of the health system or angry that nothing seems to help. Billions of dollars a year are lost to chronic health conditions, reflecting an even more costly loss in quality of life for millions of people.

A healthy outside starts from the inside. Set your mind first and the body will follow.


Chronic health conditions are more than a collection of physical symptoms. Mental, behavioral and emotional issues are also significant features of health. I take a multimodal approach to treatment, focusing on my individual client with the goal of improving their quality of life.

Integration for health

All medical conditions start with physical issues. For chronic conditions, bioeedback, neurofeedback, breath training or imagery are examples of interventions that improve physiologic self-regulation and reactivity.

  • Tension headaches often respond to reducing muscle reactivity in the head, neck and shoulders
  • Hypertension can be improved by learning how to increase blood flow

Cognitive factors are also important because our beliefs and understanding about health can directly affect our health. Many people with chronic medical conditions come to see themselves as inherently flawed – even their bodies are out of control! CBT, acceptance and mindfulness therapies can help modify underlying thought patterns to reflect healthier perceptions. In turn, health – physical and mental – improves.

  • A diabetic who believes that a changing to a healthier diet is impossible might learn that, while difficult, changing habits is not only possible but leads to many benefits.
  • A person with chronic pain may benefit from monitoring their pain levels and adjusting their activity levels so that they can remain active without triggering a flareup.

Healthy behavior is always beneficial. Chronic conditions can be affected by behavior patterns, for better or worse. Learning new behaviors is often a challenge, but can have significant impact on health.

  • Obese children can learn to take more responsibility for their own food choices and preparation.
  • A person with chronic headaches can learn to minimize the stress and reactivity that often trigger a flareup.

There is clearly a connection between emotion and debilitation due to a chronic condition. We know that people with chronic pain are more likely to feel anxious and depressed, in part because of shared neurology. We also know that people experiencing more positive emotion tend not to notice pain and discomfort. Much of my work helps clients with their feelings of anger, anxiety, depression, guilt and loss.

Working with clients to understand the impact of the chronic condition and how they can maintain a quality of life typically requires approaches that integrate all these factors. Moreover, I work in conjunction with physicians, psychologists, other health care workers, schools and family members.

Complex conditions demand complex approaches. I find that most people’s lives improve when treatment incorporates all aspects of their experience.