Interoception - our sense of the internal state of our body - is not as well known as your “outward facing” senses such as sight, hearing, taste, touch and smell, but it’s turning out to be really important for your mental health.
Our sensitivity to the interoceptive signals coming from the different organs in our body determines our ability to control our emotions. And neuroscience and psychology is developing new techniques that help you “tune in” to your body and alter perception of its interoceptive signals to overcome a host of mental health problems, such as anxiety and depression.
Signals between brain and bodily organs controls our emotions
If you’re sitting in a safe and comfortable position, close your eyes and try to feel your heart beating in your chest. Can you, without moving your hands to take your pulse, feel each movement and count your heart’s rhythm? Or do you struggle to detect anything at all? This simple test is just one way to assess your “interoception” – your brain’s perception of your body’s state, transmitted from receptors on all your internal organs.
Interoception may be less well known than the “outward facing” senses such as sight, hearing, taste, touch and smell, but it has enormous consequences for your wellbeing. Our sensitivity to interoceptive signals can determine our capacity to regulate our emotions, and our subsequent susceptibility to mental health problems such as anxiety and depression.
It is now one of the fastest moving areas in neuroscience and psychology, with a wealth of new research emerging every month. Importantly, these findings include promising new ways for you to “tune in” to the body and alter your perception of its interoceptive signals – techniques that may help treat a host of mental health problems. Just by listening to the heart, it seems, that we can take better care of our brain.
Interoception includes all the signals from your internal organs, including your cardiovascular system, your lungs, your gut, your bladder and your kidneys. There’s a constant communication dialogue between the brain and the viscera.
Most of the processing of these signals takes place below your conscious awareness: you won’t be aware of the automatic feedback between brain and body that helps to keep your blood pressure level, for instance, or the signals that help to stabilise your blood sugar levels. But many of these sensations – such as tension in your muscles, the clenching of your stomach, or the beating of your heart – can be made available to the conscious mind, at least some of the time. And the ways you read and interpret those feelings has important consequences for your wellbeing.
We’re starting to recognise interoception as a key biological mechanism for mental and physical health, where understanding our body’s signals helps us understand and regulate emotional and physical states.
Emotions begin in the body
This idea stems from the pioneering work of Antonio Damasio. He proposed that emotional events begin with non-conscious changes in bodily states, called “somatic markers”: when you see an angry dog, for instance, and your muscles tense or your heart begins to race. This physiological reaction occurs before you are even aware of the emotion, and it is only when the brain detects the alteration to the body’s internal state, through interoception, that we actually experience the feeling and allow it to shape our behaviour. Without the back-and-forth between the brain and the body, the feelings of happiness, sadness or excitement wouldn’t exist.
But many people struggle to tune in to their interoceptive signals, and this can be measured through various exercises. You can ask someone to count their heartbeat over a minute, for example, and then compare that with the actual reading. Or you can play recordings of a regular beat, and ask someone to say whether it is in sync with their own heart or not.
In each case, individuals show a spectrum of responses, which seem to be related to their ability to recognise and regulate their emotions. It makes sense: if you are more adept at accurately detecting your bodily signals, you will be able to form more nuanced interpretations of your feelings about a situation, and this in turn should help you to make wiser choices about the best ways to respond.
Intercoception and mental health
Such processes may play an important role in many mental illnesses. A large subgroup of people with depression, for example, often show poorer interoceptive awarensss on the heartbeat detection tasks and, for these patients, the reduced ability to feel their bodily signals may lie behind their sense of lethargy and emotional numbness – the sense that they can “feel nothing” at all.
People with anxiety, in contrast, do report being attentive to their interoceptive signals – but they don’t necessarily read them accurately. They may misinterpret a small change in heart rate as being much bigger than it really is, for example, which can lead them to “catastrophise” their feelings and amplify their sense of panic.
Poor interoceptive awareness can also lead to the sense of “depersonalisation” and dissociation, which are early symptoms of psychosis and may be a precursor of their delusions. Interoception helps us to form our most basic sense of self– and it seems to be askew in patients with these types of mental illness.
Therapies that aim to address these problems are still in their infancy, but the early signs are promising.
Interoceptive training, for example, can lower the incidence of anxiety and in some cases hep people completely recover from their anxiety disorder. It improves people’s ability to recognise and ‘de-catastrophise’ their bodily feelings and experiences.
Mindfulness can also help to improve your interoceptive awareness. There are many kinds of mindfulness, of course – some of which may place more focus on the mental experience and the appearance of thoughts. For example, a training programme that specifically encourages participants to focus on the internal sensations within sequential body areas has helped people with substance abuse problems.
This condition is often accompanied by poor emotional regulation, which can make it harder to avoid relapse – and, crucially, many people report a sense of disembodiment that might contribute to their problems. The therapy successfully reduces symptoms of depression and cravings, and it significantly increases abstinence.
The new awareness of interoception can help us to understand why certain physical exercises can be so good for our mental health. For one thing, regular workouts may change the nature of the signals that your brain receives. If you’re de-conditioned from a lack of exercise, you’re more likely to experience symptoms that you might associate with anxiety. Your heart will race more when you experience challenges – be it physical or emotional. As you get fitter, however, and organs such as the heart become more adept at dealing with strain, your body will show a more resilient response to changing circumstances – changes that could spill over into your emotional wellbeing.
Doing exercise should lead you to be more attentive to those signals, so that you are also more accurate in reading and interpreting the changes that you detect in your body. This doesn’t mean that all athletes have very high emotion regulation capacities,. But they do have an advantage, precisely because their interoceptive system is better attuned.
It’s not just aerobic exercise that will help; increasing evidence suggests that strength training can be effectively reduce feelings of anxiety. You might expect this to arise from the aesthetic improvements and the ego-boost that comes from looking more toned – but the effects remain even if you control for visible changes in muscle size. One potential explanation is that the training somehow alters the interoceptive signals we’re receiving from the muscles. By engaging with our muscles, we feel physically sturdier and more capable to deal with threats – and this bolsters our sense of self-esteem and mental resilience, too.
Interoceptive feedback from the muscles can tell you something, unconsciously, about what you can achieve in the world. After strength training, your body feels that it can cope, and so, on some level, you feel a bit more in control of life.
Interoception, it seems, is one of our most important senses. And by paying a little bit more attention to the signals it sends you, you may be healthier in body and brain.
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