Sustained Pain Reduction Through Affective Self-awareness in Fibromyalgia: A Randomized Controlled Trial
Journal of General Internal Medicine, Exclusive Author Commentary

Hsu MC et al. – Affect and how it is regulated plays a role in pain perception, maintenance of pain, and its resolution...The affective self–awareness intervention improved pain, tenderness, and self–reported physical function for at least 6 months in women with fibromyalgia compared to wait–list control. This study suggests the value of interventions targeting emotional processes in fibromyalgia, although further studies should evaluate the efficacy of this intervention relative to active controls.

This is the first article to demonstrate that a therapeutic approach to fibromyalgia (and associated conditions) that emphasizes the primary role of emotions in the initiation and persistence of pain and other symptoms is effective. We showed that a brief intervention in which patients participate in therapeutic writing, mindfulness meditation, and positive affirmations can result in significant and sustained reductions in pain. Participants also showed significant changes in locus of control, in that they were more likely to view their disorder as being under their control. Even though this is a small study and the control group did not receive an active intervention, the effect sizes were quite large and a quarter of the participants had pain levels below 3 at the end of the study. We view these results as an important step towards finding more effective therapeutic interventions for this disorder that has been difficult to understand and treat. We are planning a larger study with a more intensive intervention and active control groups. Feel free to contact me if you would like more information on the study or the intervention model we used.

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