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Immediate and Lasting Chronic Pain Reduction Following a Brief Self-Implemented Mindfulness-Based Interoceptive Exposure Task: a Pilot Study

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Abstract

Recent imaging research shows that approximately 80% of people who transit from acute to chronic pain produce neuroplasticity linking pain pathways to learning areas of the brain, thus showing physiological evidence that chronic pain is largely learned. Mindfulness meditation programs have been used successfully to teach people a way of decreasing pain-related distress and unlearning their unhelpful relationship to pain. However, not all chronic pain patients are amenable to undergo a full mindfulness program and then maintain daily practice. Accordingly, we conducted a pilot study of a task extracted from a second-generation MBI, Mindfulness-integrated Cognitive Behavior Therapy, which consisted of a self-guided 30-s mindfulness-based interoceptive exposure task (MIET) to pain sensations in 15 medically diagnosed chronic pain patients. Participants using the MIET repeatedly over 15 days learned not to identify with pain and focused on four subcomponents of interoception (mass, motion, temperature, and cohesiveness) while remaining equanimous. This led to significant reduction in pain anxiety (p = .001; d = 0.96), pain duration (p = .01; d = 0.86), and pain intensity after each 30-s exposure (p < .001; d = 1.37). These effects were maintained, and some further improved, at 2-month follow-up. Marked decrease in depression, anxiety and stress were also observed (p < .001; d = 0.81). While participants rated the task as highly acceptable and some reduced their use of analgesic medication; no other change in medical or psychological treatment was required. These early results show the potential for the MIET to be use as an adjunct to traditional treatments of chronic pain, although controlled studies are needed to establish the validity of our results. Brain-imaging studies are also needed to assess the possible unlearning effect of the MIET on corticolimbic regions, a process that may be termed “central desensitization.”

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Acknowledgements

We are grateful to Dr. Melissa Farmer for her invaluable comments and associated resources regarding the possible neural correlates of the MIET’s active mechanisms. We are also grateful to the reviewers of the original manuscript.

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Authors and Affiliations

  1. Mindfulness-integrated CBT Institute, Hobart, TAS, Australia

    Bruno Cayoun

  2. University of Technology Sydney, Sydney, Australia

    Akeesha Simmons & Alice Shires

  3. University of Sydney, Sydney, Australia

    Alice Shires

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  1. Bruno Cayoun
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  2. Akeesha Simmons
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  3. Alice Shires
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BAC designed and executed the study, collaborated with the data analysis, and collaborated with the writing of the study. AS provisionally analyzed the data and collaborated with writing of the results. AS collaborated with the design of the study, analysis of data, and writing of the study.

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Correspondence to Bruno Cayoun.

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The study was approved by the Human Research Ethics Committee of the University of Tasmania (Ref. H0012893). All participants were fully informed of the procedure and aims of the study and gave their informed consent.

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Cayoun, B., Simmons, A. & Shires, A. Immediate and Lasting Chronic Pain Reduction Following a Brief Self-Implemented Mindfulness-Based Interoceptive Exposure Task: a Pilot Study. Mindfulness 11, 112–124 (2020). https://doi.org/10.1007/s12671-017-0823-x

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