University of Massachusetts Medical School Faculty Publications

Title

Brief Self-Compassion Training Alters Neural Responses to Evoked Pain for Chronic Low Back Pain: A Pilot Study

UMMS Affiliation

Department of Family Medicine and Community Health; Center for Integrated Primary Care

Publication Date

2020-08-12

Document Type

Article

Disciplines

Alternative and Complementary Medicine | Integrative Medicine | Movement and Mind-Body Therapies | Neuroscience and Neurobiology | Pain Management | Psychiatry and Psychology

Abstract

OBJECTIVE: Self-compassion meditation, which involves compassion toward the self in moments of suffering, shows promise for improving pain-related functioning, but its underlying mechanisms are unknown. This longitudinal, exploratory pilot study investigated the effects of a brief (eight contact hours, two weeks of home practice) self-compassion training on pain-related brain processing in chronic low back pain (cLBP).

METHODS: We evaluated functional magnetic resonance imaging (fMRI) response to evoked pressure pain and its anticipation during a self-compassionate state and compared altered brain responses following training with changes on self-reported measures of self-compassion (Self-Compassion Scale [SCS]), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness [MAIA]), and clinical pain intensity.

RESULTS: In a sample of participants with cLBP (N = 20 total, N = 14 with complete longitudinal data) who underwent self-compassion training, we observed reduced clinical pain intensity and disability (P < 0.01) and increased trait self-compassion and interoceptive awareness (all P < 0.05) following training. Evoked pressure pain response in the right temporo-parietal junction (TPJ) was reduced following training, and decreases were associated with reduced clinical pain intensity. Further, increased fMRI responses to pain anticipation were observed in the right dorsolateral prefrontal cortex (dlPFC) and ventral posterior cingulate cortex (vPCC), and these increases were associated with mean post-training changes in SCS scores and scores from the body listening subscale of the MAIA.

DISCUSSION: These findings, though exploratory and lacking comparison with a control condition, suggest that self-compassion training supports regulation of pain through the involvement of self-referential (vPCC), salience-processing (TPJ), and emotion regulatory (dlPFC) brain areas. The results also suggest that self-compassion could be an important target in the psychotherapeutic treatment of cLBP, although further studies using controlled experimental designs are needed to determine the specificity of these effects.

Keywords

Cuff Pressure Pain, Mindfulness, Pain Anticipation, Posterior Cingulate Cortex, Self-Compassion, Temporo-Parietal Junction

DOI of Published Version

10.1093/pm/pnaa178

Source

Berry MP, Lutz J, Schuman-Olivier Z, Germer C, Pollak S, Edwards RR, Gardiner P, Desbordes G, Napadow V. Brief Self-Compassion Training Alters Neural Responses to Evoked Pain for Chronic Low Back Pain: A Pilot Study. Pain Med. 2020 Aug 12:pnaa178. doi: 10.1093/pm/pnaa178. Epub ahead of print. PMID: 32783054. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Pain medicine (Malden, Mass.)

PubMed ID

32783054

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