Interoception, contemplative practice, and health

Farb, Norman A. S.; Daubenmier, Jennifer; Price, Cynthia; Gard, Tim; Kerr, Catherine E.; Dunn, Barnaby D.; Klein, Anne; Paulus, Martin P.; Mehling, Wolf

doi:10.3389/fpsyg.2015.00763

Cited by 403 publications

(473 citation statements)

References 226 publications

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“…Interestingly, both alexithymia and depression are linked to diminished interoceptive awareness (e.g. [28,156]), which itself has recently been characterized as an inability to calibrate precision estimates for interoceptive prediction errors [11].…”

Section: The Theory Of Constructed Emotionmentioning

confidence: 99%

An active inference theory of allostasis and interoception in depression

Barrett

Quigley

Hamilton

2016

Phil. Trans. R. Soc. B

372

376

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In this paper, we integrate recent theoretical and empirical developments in predictive coding and active inference accounts of interoception (including the Embodied Predictive Interoception Coding model) with working hypotheses from the theory of constructed emotion to propose a biologically plausible unified theory of the mind that places metabolism and energy regulation (i.e. allostasis), as well as the sensory consequences of that regulation (i.e. interoception), at its core. We then consider the implications of this approach for understanding depression. We speculate that depression is a disorder of allostasis, whose myriad symptoms result from a ‘locked in’ brain that is relatively insensitive to its sensory context. We conclude with a brief discussion of the ways our approach might reveal new insights for the treatment of depression. This article is part of the themed issue ‘Interoception beyond homeostasis: affect, cognition and mental health’.

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Section: The Theory Of Constructed Emotionmentioning

confidence: 99%

An active inference theory of allostasis and interoception in depression

Barrett

Quigley

Hamilton

2016

Phil. Trans. R. Soc. B

372

376

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“…This process is therefore also a perceptual inference . Alternatively, the brain can initiate sensory states that are in line with the prediction, in the sense that the sensory input fits with the prediction (Seth, 2013; Farb et al, 2015). This process is the already mentioned active inference .…”

Section: Interoceptive Predictive Codingmentioning

confidence: 99%

Why Harmless Sensations Might Hurt in Individuals with Chronic Pain: About Heightened Prediction and Perception of Pain in the Mind

2016

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In individuals with chronic pain harmless bodily sensations can elicit anticipatory fear of pain resulting in maladaptive responses such as taking pain medication. Here, we aim to broaden the perspective taking into account recent evidence that suggests that interoceptive perception is largely a construction of beliefs, which are based on past experience and that are kept in check by the actual state of the body. Taking a Bayesian perspective, we propose that individuals with chronic pain display a heightened prediction of pain [prior probability p(pain)], which results in heightened pain perception [posterior probability p(pain|sensation)] due to an assumed link between pain and a harmless bodily sensation [p(sensation|pain)]. This pain perception emerges because their mind infers pain as the most likely cause for the sensation. When confronted with a mismatch between predicted pain and a (harmless bodily) sensation, individuals with chronic pain try to minimize the mismatch most likely by active inference of pain or alternatively by an attentional shift away from the sensation. The active inference results in activities that produce a stronger sensation that will match with the prediction, allowing subsequent perceptual inference of pain. Here, we depict heightened pain perception in individuals with chronic pain by reformulating and extending the assumptions of the interoceptive predictive coding model from a Bayesian perspective. The review concludes with a research agenda and clinical considerations.

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“…(36) Mindfulness-based approaches involve some degree of interoceptive training, as interoceptive awareness is integral to mindfulness strategies (e.g. attention to sensation of the breath; body scans), and have been used to address substance use.…”

Section: Interoceptive Awareness and Self-regulation In Mindfulness-bmentioning

confidence: 99%

Respiratory sinus arrhythmia as a potential measure in substance use treatment–outcome studies

Price

Crowell

2016

Addiction

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Background and Aims Dysfunction of physiological regulation systems may underlie the disrupted emotional and self-regulatory processes among people with substance use disorder (SUD). This paper reviews evidence as to whether respiratory sinus arrhythmia (RSA), as a psychophysiological index of emotional regulation, could provide useful information in treatment-outcome research to provide insights into recovery processes. Methods We reviewed use of RSA in clinical research and studies on SUD treatment. Search terms for the review of RSA in clinical research included respiratory sinus arrhythmia, heart rate variability, vagal, cardiac vagal control, psychophysiology, intervention, treatment, mindfulness, mind-body, mental health, substance use, chemical dependence, regulation, emotion regulation. For the review of RSA in intervention studies, we included only those that provided adequate description of psychophysiological methods, and examined RSA in the context of an intervention study. Results RSA appears to be able to provide an index of self-regulatory capacity; however it has been little used in either intervention or treatment research. Of the four intervention studies included in this review, all were mindfulness-based interventions. Two studies were with substance using samples and both showed pre-post increases in RSA and related improved substance use outcomes. Two of the three studies were RCTs and both showed significant increases in RSA in the experimental compared to comparison condition. Conclusion Respiratory sinus arrhythmia may be a useful index of emotional regulation in people with substance use disorder, and a potential measure of underlying mechanisms for SUD treatment studies, particularly mindfulness-based interventions.

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Interoception, contemplative practice, and health

Cited by 403 publications

References 226 publications

An active inference theory of allostasis and interoception in depression

An active inference theory of allostasis and interoception in depression

Why Harmless Sensations Might Hurt in Individuals with Chronic Pain: About Heightened Prediction and Perception of Pain in the Mind

Respiratory sinus arrhythmia as a potential measure in substance use treatment–outcome studies

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