MiCBT Research (Selected Studies)

MiCBT Research (Selected Studies)

Unlearning chronic pain with equanimity: Immediate and lasting pain reduction following a self-implemented mindfulness-based interoceptive exposure task

Tuesday, June 07, 2016

Presented at the 2nd International Mindfulness Conference in Rome, May 2016

Submitted for publication

Bruno Cayoun (1), Akeesha Simmons (2) and Alice Shires (1,2,3)
1 Mindfulness-integrated CBT Institute, 277 Macquarie Street, Hobart, TAS, Australia
2 Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia
3 School of Psychology, University of Sydney, NSW 2006, Australia


Introduction: Recent neurological research shows that about 80% of people who transit from acute to chronic pain produce neuroplasticity linking pain pathways to learning areas of the brain, showing evidence that chronic pain is largely learned. This pilot study investigated the efficacy of a short self-guided mindfulness-based interoceptive exposure task (MIET) in extinguishing learned aversive responses to pain sensations. The MIET has been used routinely in Mindfulness-integrated Cognitive Behaviour Therapy for over a decade to decrease emotional distress and regulate emotions more generally, but its effects on chronic pain have never been empirically demonstrated.

Method: Fifteen (8 males, 7 females) diagnosed chronic pain patients, aged 26 to 73 (M = 47.33), individually underwent two 30-second exposures to pain sensations (pre-treatment) and were asked to self-implement this method aided by printed instructions each time their pain reached high intensity, for the following two weeks (post-treatment). Following post-treatment interview, participants were asked to continue practising the method on their own for another two months (follow-up).

Results:The results show large reductions in pain-related anxiety from pre- to post-treatment (p=.001; d=0.96) and further reduction at 2-month follow-up (p=.03; d=0.42), and large decrease in pain severity from pre- to post-treatment (p=.01; d=0.86), which was maintained at 2-month follow-up. Averaged dynamic data also show large reductions in pain intensity after each 30-second exposure (p<.001; d=1.37). Large reduction in emotional distress (depression, anxiety and stress) was also observed from pre-treatment to 2-month follow-up (p<.001; d=0.81). Participants rated the task as highly acceptable and some reduced their use of analgesic medication.

Discussion: These early results show the possible benefits of this method as a costless adjunct to traditional treatments of chronic pain and has the potential to change unhelpful habits and moderate the mechanism of brain reorganisation in pain chronification.