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: beta = -.26, p=.001; Study 2: beta = -.30, p= .004), pain unpleasantness (beta = -.21, p = .008), and anxiety (beta = - .36, p < .001) immediately after the preoperative intervention. The depth of self-transcendent states achieved during meditation before surgery predicted better postoperative physical function (beta = .21, p = .033) in Study 1 and less postoperative pain intensity (beta = - .35, p = .016) and pain interference (beta = - .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.