Full Title
Pointing beyond the pain perception box: Treating chronic pain by modulating phenomenological and psychophysiological indices of self-transcendence
Background
Our goal is to help chronic pain (CP) patients deconstruct their pain perception boxes by achieving self-transcendent states during meditation. Our five randomized controlled trials in journals including Science Advances and Neuropsychopharmacology (N=196, N=165, N=118, N=95, N=62) suggest self-transcendent experiences elicited during meditation result in immediate and long-term benefits for CMP patients. Yet, science does not yet know how best to reliably induce self-transcendent phenomena through meditation or the psychophysiological signature of self-transcendence. With our validated psychometric instruments, we are now well equipped to address both unknowns. The proposed project’s central hypothesis is that direct pointing instruction - an ancient technique for encouraging self-transcendence that remains underutilized in modern mindfulness-based interventions (MBIs) - will enable CMP patients to get out of their pain perception boxes and, thereby, decouple their self-schemas from pain, disrupting chronification of pain experience. If expected outcomes are observed, then direct pointing instruction should be added to MBIs for CMP patients to facilitate the deconstruction of pain perception boxes. We will also better understand psychophysiological mechanisms implicated in the deconstruction of pain perception boxes that can be 1) measured with relatively low cost, accessible equipment and 2) targets to develop targeted, neurofeedback protocols to accelerate healing.
Aims
- AIM 1: Identify the best mindfulness practice for increasing self-reported and psychophysiological indices of self-transcendence from resting state before treatment begins to during participants’ fourth, and final, 30-minute training session. Hypothesis: Relative to mindful breathing alone, mindful breathing + direct pointing will increase (1a) self-reported self-transcendence, (1b) increase frontal midline theta power as measured by EEG, and (1c) decrease connectivity in a fronto-temporal-parietal cortical index of DMN activity as measured by functional near-infrared spectroscopy (fNIRS).
- AIM 2: Determine whether self-reported self-transcendent states are associated with psychophysiological indices of self-transcendence. Hypotheses: Regardless of treatment condition, self-reported self-transcendent state will be associated with (2a) increased frontal midline theta power and (2b) decreased connectivity in a fronto-temporal-parietal cortical index of DMN activity DMN.
- AIM 3: Investigate the extent to which changes in self-reported and psychophysiological indices of self-transcendence mediate the relationship between experimental condition and pain symptoms at two time scales. Hypotheses: Relative to mindful breathing alone, direct pointing-related increases in self-reported and psychophysiological indices of self-transcendence will predict less (3a) pain intensity immediately after the final training session, and (3b) pain-related functional interference at one-month follow-up.
- EXPLORATORY AIM: Explore which index of self-transcendence (i.e., self-report, theta activity, DMN activity) is most predictive of clinical improvement.
Partnerships
Publications
This work is ongoing.
Funding source: $900,000
Tiny Blue Dot Foundation
Interested in participating?
We are currently enrolling individuals with doctor-diagnosed chronic musculoskeletal pain. Check out these information sheets for a study overview and participation requirements.