Interoception refers to the process by which the nervous system receives and processes afferent and efferent visceral information through receptors in the body, both internally and externally, and then carries that information to the brain, where it is translated. The brain then decides how to respond, taking effective action. The decision, or response, is then sent back to the body, where the action is carried out. This process happens along the autonomic and central nervous system. The brain interprets information across multiple systems simultaneously, often outside of the realm of consciousness. The multiple bodily systems involved include receptors, the spinal cord, brain stem, thalamus, hypothalamus, hippocampus, amygdala, insula, somatosensory regions, anterior insula, anterior cingulate, as well as many others.
One example of this happening internally might be if a person breathes in too much dust, the cell receptors in the lungs discover the dust and then send this information back to the brain, where the brain responds by sending a signal back to the body to start coughing. Externally, this may happen by the receptors in the skin picking up on a cool temperature, sending that information to the brain, where the brain responds by creating goosebumps or cold chills.
Interoception is integral to human survival, as this process is involved in maintaining homeostasis, making decisions, emotional experiences, self-regulation, a sense of self, and consciousness. In fact, the experiences of emotion and pain are integral to maintaining homeostasis in the body. But what if this process has been eroded, or even erased?
Research has found that dysfunctions in the interoceptive process can play a role in mood and anxiety disorders, eating disorders, drug addiction, PTSD, and somatic system disorders (Paulus MP and Stein MB, 2010, Goldstein et al. 2009; Naqvi et al. 2009; Paulus et al. 2013; Avery et al. 2017; Khalsa and Lapidus, 2016). Even conditions that have a psychiatric component, such as fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, physical conditions such as noncardiac chest pain, acid reflux, and asthma have been linked to interoceptive dysfunctions playing a role in these conditions.
A person who has eroded or erased interoceptive processes presents interpersonal difficulties, hypersensitivity to touch, analgesia, difficulties localising skin contact, somatisation, difficulty describing feelings and internal experience, problems knowing and describing internal states, difficulty communicating wishes and desires, disturbances of body image, lack of a continuous, predictable sense of self, a poor sense of separateness, difficulty attuning to others’ emotional states, and sleep disturbances. This is the same list of symptoms that children who have experienced relational trauma present. These manifestations cluster together to create psychiatric conditions such as eating disorders, “borderline” personality disorder, dissociative identity disorder, negative symptoms of schizophrenia, self-injurious behavior, addictions - either to feel something or to numb out something you don’t want to feel ( which is related to the phenomenon of self-injurious behaviour), body dysmorphia, alexithymia, and autism/adhd/aspergers.
The hypothesis is that a significant amount (not all) of psychiatric conditions may be the result of having experienced trauma. A high percentage of people receiving psychiatric services have histories of trauma. Interoception is completely turned off in people who have experienced extreme cases of certain types of chronic relational trauma. The areas of the brain involved in interpreting information received by the body have been damaged and/or shut down. The brain did what it had to do to survive. It just stopped feeling. It decided to become nobody.
The good news is that these areas of the brain have been shown to have increased activity after a person has practiced certain types of mindfulness-based practices. The plasticity and malleability of the brain allows for interoceptive processes to become active again.
This is where yoga, mindfulness-based stress reduction, and other meditation/movement based treatments come in. These practices are aimed at improving metacognitive awareness of mind-body relationships by attuning to the sensations of breathing, cognitions, and/or other modulated body states, such as stretching (Daubenmier et al. 2015). Repetition and long-term practices that restore homeostasis can influence not only present moment experiences, but future physiological and psychological states as well. Since interoception helps us to recognize how things are going in the present moment using information from the experienced past to help anticipate the future. The more we practice mindfulness based practices, the more we train our brains and bodies to pay attention to what we are experiencing, and, how we should respond to those experiences. Think of it like a skill. Practice makes… well, in this case... better practice.
This is something that always can be improved upon. There is no end goal, however, there is a considerable amount of research that shows substantial improvements in the symptomatology of key psychiatric and physical conditions, improvements of both current mental and bodily states, and future emotional and physiological states as well. Especially important is that these practices have been shown to reduce symptoms in participants who were unresponsive to other treatments.
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