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Feeling the Body in Process: Interoceptive Awareness

Our body is constantly active. The heart beats, the lungs expand and contract, the stomach digests, and countless physiological processes unfold without deliberate control. Most of these visceral activities operate automatically. Yet automatic does not mean inaccessible. Humans are capable of sensing signals generated within their own bodies. Interoceptive awareness refers to the ability to perceive and interpret these internal bodily signals.

Interoception has become an increasingly central concept across multiple domains of psychology. A substantial body of research links maladaptive interoceptive processing to negative mood states, suggesting that not only the presence of bodily signals, but the way they are interpreted, matters for psychological functioning. This insight has even contributed to the integration of interoceptive training components into certain therapeutic approaches.

James–Lange Theory of Emotion

The theoretical relationship between emotion and interoception can be understood through the James–Lange theory of emotion. According to this framework, emotions arise from the interpretation of physiological arousal. First, autonomic and somatic responses occur. Only afterward does the individual interpret these bodily changes as a specific emotional state.

As a classic illustration of this theory: when you see a big bear in the forest, your heart starts beating rapidly, you begin to sweat and tremble and the emotion of fear follows from the interpretation of these physiological changes.

From this perspective, greater sensitivity to bodily signals may be associated with stronger emotional intensity. However, clinical findings complicate this picture. For example, in anorexia nervosa, reduced interoceptive awareness is often linked to impaired recognition of hunger signals. In contrast, anxiety-related disorders, particularly panic disorder, are characterized by heightened attention to bodily sensations combined with catastrophic interpretations.

This distinction has led researchers to differentiate between attention to interoceptive signals and accurate interoceptive perception (1). Because paying attention to bodily signals does not necessarily imply perceiving them accurately. Anxiety may involve hypervigilance rather than enhanced perceptual precision.

In this article, we will focus on how these mechanisms are studied and which kinds of tasks, measurements, and techniques are used to map the neural mechanisms underlying interoception, particularly in light of the significant experiment conducted by Critchley and colleagues (2004).

Heartbeat Detection Task

Do you feel your heart beating when you pay attention to it?

One commonly used method to assess an individual’s level of interoceptive awareness involves tasks that measure sensitivity to cardiovascular signals. There are different approaches, and one of the most widely used is the heartbeat detection task.

In this task, an external stimulus is presented, usually a tone that is triggered by the participant’s own ECG or pulse rhythm. Participants are asked to decide whether the tone is synchronized with their heartbeat or not.

Critchley and colleagues also included a control task that required attention to an external cue. In this condition, participants were asked to determine whether the tones differed in pitch or were all the same. This control task allowed researchers to compare brain activity associated with attention to internal bodily signals versus external auditory stimuli, and to ensure that performance was specifically related to interoceptive awareness rather than general attentional ability.

What else?

In addition to the heartbeat detection task, the researchers administered clinical questionnaires measuring symptoms of anxiety and depression. They also used scales assessing how participants felt at the moment (state affect) and how they generally tend to feel (trait affect).

These measures were included to examine the relationship between interoceptive awareness and emotional experience, as well as the brain regions associated with this relationship.

A link between bodily signals and emotions: rAI

Functional imaging data revealed what happens in the brain while participants perform heartbeat detection tasks. The findings showed that the insula and certain forebrain regions were associated with attention directed toward internal bodily states.

In addition, there was a particularly striking result. One specific region showed differences in both activity and structural size depending on the accuracy of internal signal detection. This region was the right anterior insula (rAI).

fMRI data revealed a positive correlation between activity in the right anterior insula (rAI) and interoceptive accuracy. In addition, the rAI showed sensitivity to the timing of tones relative to the heartbeat. When tones were delayed rather than synchronized, rAI activity increased. This finding suggests that the rAI plays a role in distinguishing interoceptive signals from external stimuli (2).

Furthermore, interoceptive accuracy was positively associated with negative affectivity and elaveted self-reported anxiety symptoms. These results indicate that activity in the rAI may help explain individual differences in emotional experience.

These findings were further supported by MRI morphometry analyses conducted with a group of participants who completed the Body Perception Questionnaire. Gray matter volume in the rAI correlated with scores on the awareness of bodily process sub-test of the Body Perception Questionnaire, linking anatomical variation to subjective bodily awareness.

To sum up, the study aimed to identify neural mechanisms underlying interoceptive awareness and to explore whether individual differences in bodily accuracy relate to emotional traits. The findings position the right anterior insula as a key structure in representing visceral information and transforming it into reportable feeling state (3).

Taken together, these results provide neural support for the theoretical link between interoceptive processing and emotional intensity. Sensitivity to bodily signals has also been shown to be closely related to how emotions are experienced and regulated.

As a final note, for those who find this topic interesting and would like to explore it further, I recommend watching Hugo Critchley’s 2015 presentation on interoception. The link is provided below.

REFERENCES

(1)  Critchley, H. D., Wiens, S., Rotshtein, P., Öhman, A., & Dolan, R. J. (2004). Neural systems supporting interoceptive awareness. Nature Neuroscience, 7(2), 189–195. https://www.overcominghateportal.org/uploads/5/4/1/5/5415260/nature_neurosi_interoception_neural_systems.pdf

(2)  Craig, A. D. (2004). Human feelings: Why are some more aware than others? Trends in Cognitive Sciences, 8(6), 239–241. https://doi.org/10.1016/j.tics.2004.04.004

(3)  Rotman Institute of Philosophy. (2015, December 7). Hugo Critchley: Interoception, Emotion, and Self: How the Heart Gates Feelings and Perceptions [Video]. YouTube. https://www.youtube.com/watch?v=xGqr5buHsXc

Picture (1) by KALZ📸🇺🇬 from Pexels

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