Brief Self-Compassion Training Alters Neural Responses to Evoked Pain for Chronic Low Back Pain: A Pilot Study.
Michael P Berry, Jacqueline Lutz, Zev Schuman-Olivier, Christopher Germer, Susan Pollak, Robert R Edwards, Paula Gardiner, Gaelle Desbordes, Vitaly Napadow
Pain Medicine October 1, 2020 DOI: 10.1093/pm/pnaa178 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Longitudinal, exploratory pilot study Peer reviewed |
|---|---|
| Sample size | 20 |
| Population | Participants with chronic low back pain |
| Duration | Two weeks of home practice |
| Measures | Self-Compassion Scale (SCS), Multidimensional Assessment of Interoceptive Awareness (MAIA), clinical pain intensity |
| Topics | Meditation |
| Keywords | Cuff pressure pain Pain anticipation Posterior cingulate cortex Self-compassion Temporo-parietal junction |
| Key findings | Self-compassion training reduced clinical pain intensity and disability and altered brain responses to evoked pressure pain and its anticipation in regions involved in self-reference, salience processing, and emotion regulation. |
Abstract
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). 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. 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. 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.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cited by 12
- Mindfulness-based Interventions for Chronic Low Back Pain: A Systematic Review and Meta-analysis. Clinical Journal of Pain February 1, 2024
- Childhood adversity severity modulates the associations between adaptive psychological changes and amygdala volumetric changes in response to behavioral interventions. Journal of Affective Disorders Reports 2024
- Dynamic processes of mindfulness-based alterations in pain perception. Frontiers in Neuroscience 2023
- fMRI-based explanations for how meditation could modulate pain processing. Frontiers in Neuroscience 2025
- Interoception-Based Yoga for Chronic Pain: A Pilot Feasibility Study. Global Advances in Integrative Medicine and Health 2025
and 7 more in the library
Cites 31
- Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology Science and Practice 2003
- How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective Perspectives on Psychological Science October 14, 2011
- Regulation of the Neural Circuitry of Emotion by Compassion Meditation: Effects of Meditative Expertise PLoS One March 25, 2008
- On the relationship between the “default mode network” and the “social brain” Frontiers in Human Neuroscience 2012
- Conceptual and methodological issues in research on mindfulness and meditation. American Psychologist October 1, 2015
and 26 more in the library