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Self-transcendence Predicts Better Pre- and Postoperative Outcomes in Two Randomized Clinical Trials of Brief Mindfulness-Based Interventions

Mindfulness volume 13, pages 1532–1543 (2022)Cite this article

Abstract

Objectives

Self-transcendent experiences have been infrequently examined by modern psychological science, despite their purported healing potential. The two studies reported here were designed to test whether surgical patients could achieve self-transcendent states and whether those states predicted better clinical outcomes.

Methods

Two, single-site, parallel-group randomized clinical trials (RCTs) involving knee and hip replacement patients were conducted. In Study 1 (N = 196), patients were randomized to a preoperative, 15-min mindfulness of breath or cognitive-behavioral pain psychoeducation intervention. In Study 2 (N = 118), patients were randomized to a preoperative, 20-min mindfulness of breath, mindfulness of pain, or cognitive-behavioral pain psychoeducation intervention. Self-transcendent state and acute clinical symptomology were assessed immediately before and after the preoperative interventions. Postoperative outcomes were also assessed.

Results

A brief MBI induced self-transcendent states in a general sample of knee and hip replacement patients (Study 1: F = 36.79, p < .001; Study 2: F = 7.25, p = .001). MBI-induced self-transcendent states were associated with decreases in pain intensity (Study 1: β =  − .26, p = .001; Study 2: β =  − .30, p = .004), pain unpleasantness (β =  − .21, p = .008), and anxiety (β =  − .36, p < .001) immediately after the preoperative intervention. The depth of self-transcendent states achieved during meditation before surgery predicted better postoperative physical function (β = .21, p = .033) in Study 1 and less postoperative pain intensity (β =  − .35, p = .016) and pain interference (β =  − .32, p = .019) in Study 2.

Conclusions

These two studies suggest self-transcendence is a therapeutic mechanism of mindfulness that is accessible to a general sample of surgical patients and can improve clinical outcomes. Clinical Trial Registration for Study 1: ClinicalTrials.gov = NCT03665727. Clinical Trial Registration for Study 2: ClinicalTrials.gov = NCT04520958.

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Fig. 1
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Data Availability

Data will be made available to qualified individuals following written request.

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Funding

AWH was supported by a seed grant from the University of Utah College of Social Work during the preparation of this manuscript. ELG was supported by the grant number R01DA042033 from the National Institutes of Health during the preparation of this manuscript. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Center On Mindfulness and Integrative Health Intervention Development (C-MIIND), University of Utah, Salt Lake City, USA

    Adam W. Hanley & Eric L. Garland

  2. College of Social Work, University of Utah, 395 South, 1500 East, Salt Lake City, UT, 84112, USA

    Adam W. Hanley & Eric L. Garland

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  1. Adam W. Hanley
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Contributions

Dr. Hanley had full access to all the data and takes full responsibility for the completeness and integrity of the data. Study concept and design: Hanley, Garland. Acquisition of data: Hanley. Analysis and interpretation of data: Hanley, Garland. Drafting of the manuscript: Hanley. Critical revision of the manuscript for important intellectual content: Garland. Statistical analysis: Hanley, Garland. Obtained funding: Hanley, Garland. Administrative, technical, and material support: Hanley, Garland. Study supervision: Hanley, Garland.

Corresponding author

Correspondence to Adam W. Hanley.

Ethics declarations

Ethics Approval

The University of Utah’s Institutional Review Board approved all study procedures: IRB_00085446 and IRB_00123611.

Consent to Participate

This study was performed in accordance with the ethical standards stipulated by the 1964 Declaration of Helsinki.

Conflict of Interest

Eric Garland, PhD, LCSW, is the Director of the Center on Mindfulness and Integrative Health Intervention Development. The Center provides Mindfulness-Oriented Recovery Enhancement (MORE), mindfulness-based therapy, and cognitive-behavioral therapy in the context of research trials for no cost to research participants; however, Dr. Garland has received honoraria and payment for delivering seminars, lectures, and teaching engagements (related to training clinicians in MORE), including those sponsored by institutions of higher education, government agencies, academic teaching hospitals, and medical centers. Dr. Garland also receives royalties from the sale of books related to MORE. Dr. Garland has also been a consultant and is a licensor to BehaVR, LLC.

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Hanley, A.W., Garland, E.L. Self-transcendence Predicts Better Pre- and Postoperative Outcomes in Two Randomized Clinical Trials of Brief Mindfulness-Based Interventions. Mindfulness 13, 1532–1543 (2022). https://doi.org/10.1007/s12671-022-01896-6

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Keywords

  • Mindfulness
  • Mindfulness-based intervention
  • Self-transcendence
  • Nondual
  • Oneness
  • Pain
  • Surgical pain
  • Knee replacement
  • Hip replacement