When asked “How many senses do you have?,” you’d probably answer: smell, taste, sight, touch, and sound. And you would be right… to sense our external environment.
But, we also have interoception to sense internal phenomena like experiencing hunger, pain, fever, heart palpitations, stomach butterflies,…
What is interoception?
Interoception is the process by which the nervous system senses, interprets, and integrates internal signals coming from inside the body. It can happen on a conscious level such as feeling the heart thump when giving a speech. Conversely, it can also happen on an unconscious level such as when the body keeps blood sugar levels in check.
Interoception can be broken down into various aspects. These include interoceptive accuracy and interoceptive awareness. Interoceptive accuracy is how accurately one notices internal sensations. Interoceptive awareness is the ability to identify, access, understand and respond appropriately to internal signals in the body. When someone has problems with interoceptive awareness, they may confuse bodily signals, over-feel these signals or under-feel these signals.
The insular cortex is crucial for the body’s registration of interoceptive awareness. As a result, it has been called the “interoceptive center of the brain.” It is responsible for various activities including pain perception; primary emotions such as happiness, disgust, joy and anger; awareness of bodily states such as feeling your heartbeat or changes in temperature. The insular cortex also allows us to perceive our sense of self.
The most common method for measuring interoception is through heartbeat detection tests. Individuals with good interoceptive awareness can detect their heartbeat with a high degree of accuracy. Conversely, individuals with poor interoceptive awareness have difficulty doing so.
Ways to improve interoception
Interestingly, research shows that we can improve our interoceptive awareness. Some ways to improve interoceptive awareness include mindfulness practices.
Mindfulness practices are recognized as some of the most effective, evidence-based methods for improving interoceptive awareness. Research shows that mindfulness activates the insula, which may explain why those who meditate often have superior levels of interoception.
Some mindfulness practices that are beneficial include:
Mindful Framing
This popular practice focuses on how to be mindful of the present moment and frame your mind and body in 5 visualization steps to: 1) Get rid of ANXIETY by riding an imaginary bus; 2) Get input of your SIX SENSES; 3) Connect with NATURE; 4) Embrace your EMOTIONS; and 5) Dive into your ORGANISM, being aware of your nervous, immune, endocrine, digestive, musculoskeletal and cardiorespiratory systems.
Body Scan Practices
Body scan mindfulness typically involves sequentially focusing attention on various parts of the body and observing the resultant sensations and feelings. Body scan practices have been shown to increase interoceptive awareness.
Rhythmic Breathing
Many studies have shown that focusing on the breath activates the interoceptive network. Rhythmic breathing involves breathing at a regular, controlled pace. This technique usually includes a set pattern of inhaling, holding the breath, exhaling, and sometimes pausing before the next inhalation. Common forms of rhythmic breathing include 4-7-8 breathing and box breathing. Of note, 4-7-8 breathing is contraindicated in those who have chronic lung disease.
Yoga
Research shows that insular gray matter volume in yogis correlates positively with the amount of yoga experience. Thus, it is likely that these neuroplastic changes improve interoceptive awareness.
Mindfulness-based interoceptive exposure therapy
Research also shows that addressing body mistrust may improve body image in patients with eating disorders by disrupting the interoceptive awareness-eating disorder network. Recently, researchers have started exploring the effectiveness of eating disorder-specific interoceptive exposures such as rapidly drinking water to simulate fullness and bloating to intentionally provoke body image concerns. Preliminary research shows that interoceptive exposure can help improve eating disorder symptoms and reduce the tendency to interpret body signals as dangerous. This suggests a potential method for addressing body mistrust.
Additionally, mindfulness interventions that emphasize non-judgmentally observing noticing uncomfortable body sensations without reacting or distracting (e.g. noticing fullness and the urge to purge without acting on it) may be beneficial. Mindfulness may also enhance awareness of hunger and fullness sensations.
Interoception and Mental Illness
Dysfunctional interoceptive processing has been linked to a variety of mental health conditions such as depression, anxiety, panic disorder, and eating disorders.
Eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder pose a global burden. They are common psychiatric disorders that affect about 1 in 10 individuals and have a peak of onset in adolescence.
What’s more, anorexia nervosa has the highest mortality rate of any psychiatric disorder. Tragically, many of these deaths aren’t from starvation-related health effects, but from suicide. Why might this be?
Disturbance in the interoceptive system has recently been proposed as a central mechanism in the pathology of anorexia nervosa. This disturbance in the interoceptive system not only affects hunger and satiety, but also emotional awareness and body dysmorphia. Individuals with body dysmorphia (such as occurs in anorexia nervosa) often experience negative thoughts and emotions about their appearance.
Untreated body dysmorphia significantly increases the risk of self-harm or suicide. Up to 80% of people with body dysmorphia experience suicidal thoughts, and 1 in 4 attempts suicide. And those with body dysmorphia are 45 times more likely to die by suicide than those without it.
By fostering a better understanding of interoception and incorporating mindfulness practices into our lifestyle, we can help ourselves and others develop healthier relationships with internal bodily signals, ultimately improving overall mental and physical health.
