Skip to main content
SpringerLink
Log in

The Effects of Acceptance of Thoughts, Mindful Awareness of Breathing, and Spontaneous Coping on an Experimentally Induced Pain Task

  • ORIGINAL ARTICLE
  • Published:
The Psychological Record Aims and scope Submit manuscript

Abstract

The current study examined the effects of acceptance of thoughts, mindful awareness of breathing, and spontaneous coping on both pain tolerance and pain threshold during a cold pressor task. Eligible participants (N = 58), 16 males and 42 females (M age = 29.31, SD = 11.21), were randomized into three groups and completed two cold pressor trials. The first cold pressor trial formed a baseline for all three groups. The acceptance of thoughts and mindfulness of breathing groups listened to recorded instructions and then completed a second administration of the cold pressor task. The spontaneous coping group completed the cold pressor task twice with instructions to select their own coping style. Multilevel linear modeling showed significant group differences in pain tolerance. The acceptance of thoughts and mindfulness of breathing conditions resulted in significantly higher pain tolerance in post hoc analysis than spontaneous coping. Results were interpreted to be consistent with Acceptance and Commitment Therapy. Further examination of the effects of ACT processes on experimentally induced pain tolerance is needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143. doi:10.1093/clipsy/bpg015.

    Google Scholar 

  • Berkley, K. J. (1997). Sex differences in pain. Behavioral and Brain Sciences, 20, 371–380.

    PubMed  Google Scholar 

  • Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011). Preliminary psychometric properties of the acceptance and action questionnaire-II: a revised measure of psychological flexibility and acceptance. Behavior Therapy, 42(4), 676–688.

    Article  PubMed  Google Scholar 

  • Edens, J. L., & Gil, K. M. (1995). Experimental induction of pain: Utility in the study of clinical pain. Behavior Therapy, 26(2), 197–216.

    Article  Google Scholar 

  • Edwards, R. R., Haythornthwaite, J. A., Sullivan, M. J., & Fillingim, R. B. (2004). Catastrophizing as a mediator of sex differences in pain: differential effects for daily pain versus laboratory-induced pain. Pain, 111, 335–341. doi:10.1016/j.pain.2004.07.012.

    Article  PubMed  Google Scholar 

  • Field, A. (2009). Discovering statistics using SPSS (3rd ed.). London: Sage.

    Google Scholar 

  • Fletcher, L., & Hayes, S. C. (2005). Relational frame theory, acceptance and commitment therapy, and a functional analytic definition of mindfulness. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 23(4), 315–336. doi:10.1007/s10942-005-0017-7.

    Article  Google Scholar 

  • Geisser, M. E., Robinson, M. E., & Pickren, W. E. (1992). Differences in cognitive coping strategies among pain-sensitive and pain-tolerant individuals on the cold-pressor test. Behavior Therapy, 23, 31–41.

    Article  Google Scholar 

  • Graven-Nielsen, T., Sergerdahl, M., Svensson, P., & Arendt-Nielsen, L. (2001). Methods for induction and assessment of pain in humans with clinical and pharmacological examples. In L. Kruger (Ed.), Methods in pain research (pp. 263–304). Boca Raton: CRC Press.

    Google Scholar 

  • Gutierrez, O., Luciano, C., Rodriguez, M., & Fink, B. C. (2004). Comparison between an acceptance-based and a cognitive-control-based protocol for coping with pain. Behavior Therapy, 35, 767–783.

    Article  Google Scholar 

  • Harris, R. (2009). ACT made simple: An easy to read primer on acceptance and commitment therapy. Oakland: New Harbinger Publications.

    Google Scholar 

  • Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35, 639–665.

    Article  Google Scholar 

  • Hayes, S. C., Bissett, R. T., Korn, Z., Zettle, R. D., Rosenfarb, I. S., Cooper, L. D., & Grundt, A. M. (1999). The impact of acceptance versus control rationales on pain tolerance. The Psychological Record, 49, 33–47.

    Google Scholar 

  • Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: model, processes and outcomes. Behaviour Research and Therapy, 44, 1–25. doi:10.1016/j.brat.2005.06.006.

  • Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., & McCurry, S. M. (2004). Measuring experiential avoidance: a preliminary test of a working model. The Psychological Record, 54, 553–578.

    Google Scholar 

  • Hayes, S. C., Strosahl, K., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). New York: The Guildford Press.

    Google Scholar 

  • Kabat-Zinn, J. (1990). Full catastrophe living: The program of the stress reduction clinic at the University of Massachusetts Medical Center. New York: Dell Publishing.

    Google Scholar 

  • Keogh, E., Bond, F. W., Hanmer, R., & Tilston, J. (2005). Comparing acceptance and control-based coping instructions on the cold-pressor pain experiences of healthy men and women. European Journal of Pain, 9, 591–598. doi:10.1016/j.ejpain.2004.12.005.

    Article  PubMed  Google Scholar 

  • Kingston, J., Chadwick, P., Meron, D., & Skinner, T. C. (2007). A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity. Journal of Psychosomatic Research, 62, 297–300. doi:10.1016/j.jpsychores.2006.10.007.

    Article  PubMed  Google Scholar 

  • LeResche, L. (2000). Epidemiologic perspective on sex differences in pain. In R. Fillingim (Ed.), Sex, gender, and pain: Progress in pain research and management (pp. 233–249). Seattle: IASP Press.

    Google Scholar 

  • Masedo, A. I., & Esteve, M. R. (2007). Effects of suppression, acceptance and spontaneous coping on pain tolerance, pain intensity and distress. Behaviour Research and Therapy, 45, 199–209. doi:10.1016/j.brat.2006.02.006.

    Article  PubMed  Google Scholar 

  • McCraken, L. M., MacKichan, F., & Eccleston, C. (2007). Contextual cognitive-behavioural therapy for severely disabled chronic pain sufferers: effectiveness and clinically significant change. European Journal of Pain, 11, 314–322. doi:10.1016/j.ejpain.2006-.05.004.

    Google Scholar 

  • McCraken, L. M., Vowles, K. E., & Eccleston, C. (2005). Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour Research and Therapy, 43, 1335–1346. doi:10.1016/j.brat.2004.10.003.

  • Mikulas, W. L. (2011). Mindfulness: significant common confusions. Mindfulness, 2, 1–7. doi:10.1007/s12671-010-0036-z.

    Article  Google Scholar 

  • Morone, N. E., Greco, C. M., & Weiner, D. K. (2008). Mindfulness meditation for the treatment of chronic low back pain in older adults: a randomized controlled pilot study. Pain, 134, 310–319. doi:10.1016/j.pain.2007.04.038.

    Article  PubMed Central  PubMed  Google Scholar 

  • Paez-Blarrina, M., Luciano, C., Gutierrez-Martinez, O., Valdivia, S., Ortega, J., & Rodriguez-Valverde, M. (2008). The role of values with personal examples in altering the functions of pain: comparison between acceptance-based and cognitive-control-based protocols. Behaviour Research and Therapy, 46, 84–97. doi:10.1016/j.brat.2007.10.008.

    Article  PubMed  Google Scholar 

  • Roche, B., Forsyth, J. P., & Maher, E. (2007). The impact of demand characteristics on brief acceptance and control-based interventions for pain tolerance. Cognitive and Behavioural Practice, 14, 381–393.

    Article  Google Scholar 

  • Rosenstiel, A. K., & Keefe, F. J. (1983). The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain, 17, 33–44.

    Article  PubMed  Google Scholar 

  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guildford Press.

    Google Scholar 

  • Takahashi, M., Muto, T., Tada, M., & Sugiyama, M. (2002). Acceptance rationale and increasing pain tolerance: acceptance-based and FEAR-based practice. Japanese Journal of Behavior Therapy, 28(1), 35–46.

    Google Scholar 

  • von Baeyer, C. L., Piira, T., Chambers, C. T., Trapanotto, M., & Zeltzer, L. K. (2005). Guidelines for the cold pressor task as an experimental pain stimulus for use with children. The Journal of Pain, 6(4), 218–227. doi:10.1016/j.jpain.2005.01.349.

    Article  Google Scholar 

  • Wicksell, R. K., Ahlqvist, J., Bring, A., Melin, L., & Olsson, G. L. (2008a). Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (wad)? A randomized controlled trial. Cognitive Behavior Therapy, 37(3), 169–182. doi:10.1080/16506070802078970.

    Article  Google Scholar 

  • Wicksell, R. K., Melin, L., Lekander, M., & Olsson, G. L. (2008b). Evaluating the effectiveness of exposure and acceptance strategies to improve functioning and quality of life in longstanding pediatric pain: a randomized controlled trial. Pain, 141(3), 248–257. doi:10.1016/j.pain.2008.11.006.

    Article  PubMed  Google Scholar 

  • Zeidan, F., Gordon, N. S., Merchant, J., & Goolkasian, P. (2010). The effects of brief mindfulness meditation training on experimentally induced pain. The Journal of Pain, 11(3), 199–209.

    Article  PubMed  Google Scholar 

  • Zettle, R. D., Hocker, T. R., Mick, K. A., Scofield, B. E., Peterson, C. L., Song, H., & Sudarijanto, R. P. (2005). Differential strategies in coping with pain as a function of level of experiential avoidance. The Psychological Record, 55, 511–524.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Social Sciences and Psychology, University of Western Sydney, Sydney, NSW, 2751, Australia

    Loch Forsyth

  2. Orygen Youth Health Research Centre and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia

    Louise L. Hayes

Authors
  1. Loch Forsyth
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Louise L. Hayes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Loch Forsyth.

Appendixes

Appendixes

Appendix 1: Acceptance Rationale

When we are in pain, there are a number of different ways in which we can think about it. One way of thinking about pain is to accept that we are in pain. Here is an example of an “acceptance” way of thinking about pain: I try to accept that I am in pain. I do this by disconnecting my evaluations about the pain from the pain itself. For example, if I have a thought like, “I can’t stand this pain,” I can accept that thought and notice that this is a thought that doesn’t need to prevent me from continuing on. If instead I try and control my thoughts by imagining that the pain isn’t there, I find that I end up thinking about my pain even more. When I accept thoughts, I can notice them, but I don’t allow them to control my behavior. I accept my thoughts and my feelings as they are, without trying to control them or without trying to push them away. I can stop trying to control the pain since this may be unproductive; instead, I try not to ignore my pain, and I don’t try to push thoughts away. I try to accept that the pain doesn’t mean I can’t continue on. What I need to do is accept my thoughts as they are.

Acceptance Instructions for the Pain Task

Thoughts and feelings do not cause you to do things. Therefore, if you have thoughts such as “I can’t stand this pain,” you do not have to let the thought control your actions. So, you are able to feel pain and still keep your hands in the cold water.

Appendix 2: Mindfulness Rationale

This exercise is called “awareness of breathing.” The exercise is brief and is an introduction to mindfulness practice. First, close your eyes, and let your awareness shift to your body in the chair. Now I would like you to focus your attention on your breathing. First of all, allow your attention to notice a deep slow breath, in and out. And again take a deep slow breath in and out, and on your next breath, pay attention to the feeling of the air coming into your body through your nostrils. Just feel the sensation of the air coming in and then going out of your body, and notice if you can, the movement of your belly as you breathe, and notice the movement of your ribs as you inhale and exhale. Notice which parts of your body move as you breathe. So as you sit there, continue to breathe in and out and let your awareness rest on this process of breathing in and breathing out. Keep your awareness on the sensations and feelings of just breathing. And as you continue to notice the breathing, notice any physical sensations in your body. See if you can notice the physical sensations of your body in the chair and your feet on the floor. Now, bringing your awareness again back to your breathing, see if you can follow the air as it goes all the way in through your nostrils down into your lungs. Notice the rise and fall of your stomach, the expanding and collapsing of your ribs, and any other movement in your body as you breathe. And if your mind has anything to say about this process, if it wants to draw you away to thinking about other things, just acknowledge your mind for that and bring your attention back to your breathing. Every time your mind runs away to thinking about other things, just simply bring your attention back to your breathing; there’s no need to force it. Just gently bring your attention back each time to your breathing. Now with mindfulness practice, you can choose to use mindfulness breathing by bringing your awareness to your breathing at any time.

Mindfulness Instructions for the Pain Task

In the cold pressor task that you’ve been doing, you can choose to use mindfulness of your breath to bring your attention to your breathing as you perform the task.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Forsyth, L., Hayes, L.L. The Effects of Acceptance of Thoughts, Mindful Awareness of Breathing, and Spontaneous Coping on an Experimentally Induced Pain Task. Psychol Rec 64, 447–455 (2014). https://doi.org/10.1007/s40732-014-0010-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40732-014-0010-6

Keywords

Search

Navigation