Learn Interoception

The Skill That Can Help You Lose Weight, Reduce Stress, and Improve Your Mood

Do you ever grab a cookie when you aren’t hungry? Do you sometimes yell at a friend or family member, and then later realize you were just tired, not really angry? Do you end up mindlessly browsing social media when you are really avoiding a task you should do?

Learning the skill of interoception can help you deal with all of these common life occurrences in a way that will reduce your waistline by eliminating unnecessary eating, drop your stress levels, and improve your productivity.

Interoception is our ability to feel and identify the sensations from within our body, and it’s a skill that can be improved.

“Interoception is the perception of sensations from inside the body and includes the perception of physical sensations related to internal organ function such as heartbeat, respiration, satiety, as well as the autonomic nervous system activity related to emotions (Vaitl, 1996; Cameron, 2001; Craig, 2002; Barrett et al., 2004). Much of these perceptions remain unconscious; what becomes conscious, i.e., interoceptive awareness, involves the processing of inner sensations so that they become available to conscious awareness (Cameron, 2001).” — Cynthia Price and Carole Hooven. “Interoceptive Awareness Skills for Emotion Regulation.”

How Interoception Works

Our interoceptive ability allows us to sense inside our body and feel both low-level homeostatic control processes that are often managed unconsciously as well as other body systems that are under conscious control. Your brain receives information about these body functions through your nervous system. Your brain may receive this information unconsciously, or you may be partially or fully aware of it, depending on the type of information. Interoception monitors the status of a variety of bodily functions such as:

• Body hunger
• Bladder/bowel fullness
• Nausea
• Heart beat
• Respiration
• Pupil dilation
• Skin flushing
• Gastrointestinal sensations
• Immune system
• Autonomic nervous system
• Sleepiness/tiredness

The body is always working to maintain homeostasis of the energy systems in the body by anticipating the body’s needs and preparing to satisfy those needs before they arise. The brain projects what is going to happen next and uses that information to adjust bodily systems. Then it checks to see where it was wrong to modify it’s plans, using the actual results it detects in the world and your body. Some of the ways your clever brain tries to achieve homeostasis is by directly altering hormone levels in the body. However, sometimes movement or action on your part is needed to regulate the body, and in that case the mind generates emotions to drive action.

Emotions and Feelings Drive Action

How does this work?

• The brain gets data from the body about the state of energy balance and status of internal organs and body processes.
• Based upon past experiences, the brain uses that information to guess what this might mean will happen next, and therefore what the energy balance of the body will be in the future. This is the mental model of the world. This is one place the process can cause problems because the model the brain constructs can be wrong.
• Based upon its projection of what these body sensations might mean in the given context, the brain constructs an emotion, which you feel. If you have a fluttery sensation in your stomach and the context is that you are getting up to speak in front of a group, your brain may interpret that sensation as “nervousness.” On the other hand, if you have a fluttery sensation in your stomach and the context is that you are on a first date with a good-looking person, your brain may interpret that sensation as “attraction.” If you have a fluttery sensation in your stomach after eating strange food, your brain may interpret it as “nausea” or “disgust.”
• You take action based on the emotion or feeling that the brain constructed and your past experiences. For example, if your brain decided that the fluttery sensation was “nervousness,” it might spur you to do a relaxation exercise if that has helped in the past. If the brain thought it was attraction, you might start flirting. If the brain thought it was nausea or disgust, you might stop eating. The problem is that sometimes the brain is wrong about what emotion to construct to level the energy needs of parts of the body. It may misidentify the sensation, or not evaluate the context fully, or decide on an action which doesn’t really help address the true underlying issue.

“Emotion is basically your brain’s way of making sense of the sensory changes that are going on inside your body in relation to what’s going on around you in the world. So, an emotion is your brain making meaning of sensations from the world. It’s not your reaction to the world; it’s your construction of what the world is, what your body is like in the world as it appears to you in that moment.” — Lisa Feldman Barret in an interview for Nautilus.

Numerous scientific studies have shown that poor interoceptive ability is linked to many mental health issues, such as depression, anxiety, eating disorders, and addiction. These and other common issues that humans deal with are partially the result of the mind failing to read or interpret the sensations of the body well, and then predicting the wrong thing to balance the energy needs of the body. Learning to improve our interoception can reduce the occurrence of these kinds of errors.

“Interoception is our ability to feel and identify sensations from within our body, and it’s a skill that can be improved.”

Managing Your Body Budget

“Our brain is constantly monitoring the energy in various parts of our body — our ‘body budget’” Dr. Lisa Feldman Barrett, University Distinguished Professor of Psychology at Northeastern University and author of the book “How Emotions Work,” notes. When the brain senses an adjustment is needed, it scans the environment and uses our memories and experiences to make a guess about what could fix the gap between where our energy levels are and where they should be. You can help the process of interoception by learning to hear your body more clearly. This results in your mind being better able to to identify the sensation clearly, pull up memories of matching experiences, and better predict what will help the situation, which results in you taking action in a way that makes you better able to deal with what is happening.

“The Somatic Marker Hypothesis proposes that fluctuations in bodily arousal contribute to cognitive processes themselves by feeding back to bias thoughts, judgments and behaviors (Damasio et al., 1991). This process may be particularly relevant for correcting suboptimal behaviors and guiding complex decision making in the face of uncertainty (Bechara et al., 1997). The hypothesis also suggests that individuals with high interoceptive sensitivity may be particularly gifted at utilizing this bodily information to guide cognition as associated behavioral choices. Emerging evidence suggests that individuals with better interoceptive sensitivity have an enhanced implicit memory (Werner et al., 2010) and display improved decision making on the Iowa Gambling Task (Dunn et al., 2010a).” — from “Interoception, emotion and brain: new insights link internal physiology to social behavior.” by Sarah Garfinkel and Hugo D Critchley.

‘You can help the process of interoception by learning to hear your body more clearly.’

Techniques for Learning Interoception

The Mindful Awareness in Body-Oriented Therapy (MABT) approach was developed to increase interoceptive ability in those in therapy. The intent of MABT is to develop the ability to identify, access, and appraise internal body signals. This technique consists of a series of exercises based on touch, mindfulness, and education. I’ve adapted the MABT approach below to be used by individuals at home to increase interoceptive awareness.

(Note: If you have a serious psychiatric illness you are trying to address, please see a professional to implement this approach.)

Step 1: Awareness of Body Sensations and Body Literacy

Learning how to sense what is going on inside the body can be difficult for some people. Some people may have spent their lives avoiding paying attention to their internal landscape, or may deal with dissociation due to high stress or chronic pain or trauma. These people often are not aware that this is something they can learn to sense.

When MABT is used in therapy, body literacy is taught by the therapist or the client applying physical pressure to an area of the client’s body, then the therapist asking the client what they notice. The therapist guides the client by providing possible words if the client has trouble describing the sensation. In addition, the therapist asks follow-up questions to encourage better descriptions.

At home, on your own, you can duplicate this activity. You are encouraged to practice this once or twice a day for two weeks for 10–15 minutes a session:

• Sit or lay down and close your eyes. Apply pressure to a part of your body of your choice, such as your arm or shoulder.
• Spend 60 seconds just feeling the sensations.
• Try to find words to describe what you sense. If you have trouble, refer to the following list of sensation words.
• If the area is tense, take deep breaths and see if that changes the sensations.
• Repeat the exercise with other body areas.

Sensation Words

• Hot, warm, fiery
• Cold, cool, freezing
• Painful, sharp, uncomfortable
• Tense, tight
• Hungry, full, nauseated
• Thirsty
• Tired
• Throbbing, pulsating, twitching, shaky

Step 2: Access — Training Interoceptive Awareness

The next step in the MABT system is to learn to focus attention inside the body. There are a series of steps that can be done at home on your own. Set aside 10–20 minutes to practice this daily for two weeks:

• Sit comfortably or lie down and move your attention to the sensations associated with your breath flowing into and out of your body. Spend 5 minutes simply focusing on the feeling of inhaling and exhaling.
• Direct your attention to areas of muscular tension in your body. Gently encourage them to soften.
• Next, select an area of your internal body (e.g., abdomen, inside chest, thigh muscles, heart, etc.) and direct your attention there. Spend a minute or two just feeling the sensations.
• Try to describe what it feels like. Pay close attention.
• Repeat the process with additional areas of your body.

Step 3: Appraisal — Mindful Body Awareness Practice

The goals of this third step of MABT is to build sustained awareness of internal sensations, and to learn to appraise them properly.

Set aside 20 minutes once a day for two weeks for this exercise:

• Sit or lie down comfortably. Start with 5 minutes of attention on the sensations of the breath flowing in and out of the body.
• Continue next with a scan of your body, identifying areas with tension. Direct your attention to your feet, ankles, calves, up through every part of your body, and note which areas feel tense, heavy, or uncomfortable.
• Choose one body area that feels tense, heavy, or uncomfortable and direct attention there. Spend 2–3 minutes just feeling the sensations there.
• Describe the sensations to yourself.
• Continue paying attention to the sensations of the body area for another 5 minutes. Notice if they change or shift.
• Do a brief body scan to see what parts of your body feel tense, heavy, or uncomfortable. Have the sensations changed from the original scan?
• Spend a minute to reflect on what changed. Consider writing about it briefly to solidify the experience in your mind.

“In MABT, the therapist coaches the client to attend to the array of possible accessible sensory experiences in order to facilitate appraisal and reappraisal processes. This includes noticing whether shifts in internal experience occur during the session, and noticing the sensory qualities of these shifts. At the end of the session the client is asked to verbally review the session highlights to facilitate cognitive integration of the session material. This review process also facilitates cognitive reappraisal of session experiences in ways that further motivate continued use of interoceptive awareness practices and integration into daily life” — Cynthia Price and Carole Hooven. “Interoceptive Awareness Skills for Emotion Regulation.”

Applying Your Skills In Daily Life

Once you’ve developed stronger interoceptive awareness, how can you use it to change your daily life?

1. Stop. When you experience an emotion, feeling, or urge to act, stop before acting and turn your attention inward.
2. Investigate. What sensations do you feel in your body? Use words to describe what you feel. Note what parts of your body feel tense, heavy, uncomfortable, and which feel light, soft, and pleasant.
3. Explore. Consider what alternate explanations for those sensations might exist. For example, imagine a situation in which you find yourself feeling very annoyed and on the verge of snapping at your partner. If you feel annoyed, you might stop and notice that your head is pounding and your abdomen feels tense. What are alternate explanations for those sensations other than annoyance? Maybe you missed lunch and those sensations actually mean you are hungry. Maybe you didn’t get enough sleep and they indicate you are tired. Maybe you’ve been working continuously and they reveal that you are stressed out. Maybe you’re worried about losing your job and they signal anxiety.
4. Choose. Based on your considered reappraisal of the situation, choose an action that could rebalance your body budget. For example, if you decide the sensations of pounding in your head and a tense abdomen actually are not signs of annoyance, but instead of hunger, you might choose to eat something to see if that balances your body budget.

Continue practicing these techniques to improve your internal awareness in order to get a better handle on where your emotions come from and how they drive you to act. Our lives are composed of the actions we do every day. Allowing our brains to continue to make less than optimal choices based on faulty mental models is a path to dissatisfaction both for us and those in our lives. Learning to better understand what our bodies and brains need and provide them with what will truly nourish them is gaining the power to build a better and happier life.

Check out my follow up article “Reducing Snacking Through Interoception”!

Further Reading:

Garfinkel, Sarah N, and Hugo D Critchley. “Interoception, emotion and brain: new insights link internal physiology to social behaviour. Commentary on:: “Anterior insular cortex mediates bodily sensibility and social anxiety” by Terasawa et al. (2012).” Social cognitive and affective neuroscience vol. 8,3 (2013): 231–4. doi:10.1093/scan/nss140

Interoception Summit 2016 participants 2018, ‘Interoception and Mental Health: A Roadmap’, Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, vol. 3, no. 6, pp. 501–513. https://doi.org/10.1016/j.bpsc.2017.12.004

“Ingenious: Lisa Feldman Barrett — Inside a new theory of emotions that spotlights how the brain works.” by Kevin Berger, Natilus, 2017. http://nautil.us/issue/46/balance/ingenious-lisa-feldman-barrett

Price, Cynthia J, and Carole Hooven. “Interoceptive Awareness Skills for Emotion Regulation: Theory and Approach of Mindful Awareness in Body-Oriented Therapy (MABT).” Frontiers in psychology vol. 9 798. 28 May. 2018, doi:10.3389/fpsyg.2018.00798