Interoception Technologies

Can we work it? A practical guide to working with interoception for therapists and clinicians.

Amitabha, the Buddha of the Western Pure Land (Sukhavati), Central Tibet. Public domain.

Interoception is our most neglected somatic sense. It is the 6th sense - our sense of internal bodily signals. Today, interoception is thought to play a central role in emotion, cognition, decision making, mental states and in mental health.

But if interoception has a key role in emotion and mental states more generally, what can we do to intervene on these bodily signals? This piece is a deep dive into how and whether we should work it.

In this post I will:

• Recap on definitions and interoception’s principal sensory channels and receptors

• Describe three different interoception components

• Look into whether more interoception is always better

• Give you a list of interventions for modulating interoception

• Share a selected state-of-the-art references

I wrote this with clinicians in mind, but it could be useful for almost anyone interested in the inner workings of the mind. I talk C-tactile afferents, interoceptive illusions, interoceptive exposure, relationship between trauma presentations and interoception and more.

My Interoception piece is not a required but is recommended: I delve into the definitions, basic notions, neural underpinnings and the role interoception is thought to play in allostasis and emotion.

Interoception of What?

OK, so interoception is sensing of the internal bodily states. Hunger, fatigue, tension, discomfort, arousal etc.

But is it one sense, or it is senses? Interoception, indeed comes through several different channels:

• respiratory

• cardiovascular

• gastrointestinal

• genitourinary

• endocrine

The receptor cells involved in the process of interoception include:

• mechanoreceptors

• chemoreceptors

• thermoreceptors

• osmoreceptors

In fact, there is evidence that accuracy of interoception on one of these channels does not entrain interoceptive accuracy on other channels.

Interoception Dimensions

The research shows that the interoception can be broken down into three components or dimensions:

• interoceptive accuracy

• sensibility

• awareness (metacognition)

Garfinkel SN, Seth AK, Barrett AB, Suzuki K, Critchley HD. Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biol Psychol. 2015 Jan;104:65-74. doi: 10.1016/j.biopsycho.2014

Furthermore, interoception senses are different between different systems- it does not mean that if you sense your breathing well you sense your heartbeat well.

Is More Interoception Always Better?

In therapy - especially when it comes to accessing therapy interventions that don’t fall within the CBT or psychodynamic canon - we are typically encouraged to support the client in tuning into their bodily sensations - in other words, we ask them to turn up their sense of interoception.

But is this something that is universally and indiscriminately beneficial? Or could it be that some clients are tuned in just fine as it is or even tuned in too much as it were.

Are there some therapy presentations where interoception is accentuated and needs to be turned down in some ways, learned to be ignored or even reframed all together?

Let’s have a look.

In Neuroscience & Psychotherapy I publish weekly dispatches from the frontier of neuroscience and psychotherapy, conversations with N&P friends and more, with plenty of practical material to help you work in a neuroscience-informed way.

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