Self-transcendence Predicts Better Pre- and Postoperative Outcomes in Two Randomized Clinical Trials of Brief Mindfulness-Based Interventions.

Objectives: Self-transcendent experiences have been infrequently examined by modern psychological science, despite their purported healing potential. The two studies reported here were designed to test whether surgical patients could achieve self-transcendent states and whether those states predicted better clinical outcomes. Methods: Two, single-site, parallel-group randomized clinical trials (RCTs) involving knee and hip replacement patients were conducted. In Study 1 (N = 196), patients were randomized to a preoperative, 15-min mindfulness of breath or cognitive-behavioral pain psychoeducation intervention. In Study 2 (N = 118), patients were randomized to a preoperative, 20-min mindfulness of breath, mindfulness of pain, or cognitive-behavioral pain psychoeducation intervention. Self-transcendent state and acute clinical symptomology were assessed immediately before and after the preoperative interventions. Postoperative outcomes were also assessed. Results: A brief MBI induced self-transcendent states in a general sample of knee and hip replacement patients (Study 1: F = 36.79, p <.001; Study 2: F = 7.25, p =.001). MBI-induced self-transcendent states were associated with decreases in pain intensity (Study 1: β = −.26, p =.001; Study 2: β = −.30, p =.004), pain unpleasantness (β = −.21, p =.008), and anxiety (β = −.36, p <.001) immediately after the preoperative intervention. The depth of self-transcendent states achieved during meditation before surgery predicted better postoperative physical function (β =.21, p =.033) in Study 1 and less postoperative pain intensity (β = −.35, p =.016) and pain interference (β = −.32, p =.019) in Study 2. Conclusions: These two studies suggest self-transcendence is a therapeutic mechanism of mindfulness that is accessible to a general sample of surgical patients and can improve clinical outcomes. Clinical Trial Registration for Study 1: ClinicalTrials.gov = NCT03665727. Clinical Trial Registration for Study 2: ClinicalTrials.gov = NCT04520958. [ABSTRACT FROM AUTHOR]