Get The Article
- Article PDF
- ScienceDirect Article
Cite This Work
- APA
- MLA
- Bibtex
Schoeller, F., Horowitz, A. H., Jain, A., Maes, P., Reggente, N., Christov-Moore, L., . . . Friston, K. J. (2024). Interoceptive technologies for psychiatric interventions: From diagnosis to clinical applications. Neuroscience & Biobehavioral Reviews, 156, 105478. https://doi.org/10.1016/j.neubiorev.2023.105478
Schoeller, Félix, Adam Haar Horowitz, et al. “Interoceptive Technologies for Psychiatric Interventions: From Diagnosis to Clinical Applications.” Neuroscience & Biobehavioral Reviews, vol. 156, Jan. 2024, p. 105478. https://doi.org/10.1016/j.neubiorev.2023.105478.
@article{Schoeller_Horowitz_Jain_Maes_Reggente_Christov-Moore_Pezzulo_Barca_Allen_Salomon_et al._2024, title={Interoceptive technologies for psychiatric interventions: From diagnosis to clinical applications}, volume={156}, url={https://doi.org/10.1016/j.neubiorev.2023.105478}, DOI={10.1016/j.neubiorev.2023.105478}, journal={Neuroscience & Biobehavioral Reviews}, author={Schoeller, Félix and Horowitz, Adam Haar and Jain, Abhinandan and Maes, Pattie and Reggente, Nicco and Christov-Moore, Leonardo and Pezzulo, Giovanni and Barca, Laura and Allen, Micah and Salomon, Roy and Miller, Mark and Di Lernia, Daniele and Riva, Giuseppe and Tsakiris, Manos and Chalah, Moussa A. and Klein, Arno and Zhang, Ben and Garcia, Teresa and Pollack, Ursula and Trousselard, Marion and Verdonk, Charles and Dumas, Guillaume and Adrien, Vladimir and Friston, Karl J.}, year={2024}, month=jan, pages={105478} }
What Is Interoception?
Interoception refers to our awareness of internal bodily signals like heartbeat, breathing, and digestion. While often overlooked, emerging research is revealing interoception as a fundamental process underlying emotion, cognition, and mental health. A new multidisciplinary review led by IACS senior research scientist Felix Schoeller and published in Neuroscience & Biobehavioral Reviews explores the profound significance of interoception and its potential applications in psychiatric diagnosis and treatment.
Directly manipulating interoceptive signals in experiments has proven challenging due to the highly invasive techniques currently used, like esophageal balloon distension. There is also a lack of standardized, validated measures of interoceptive function across research disciplines as “the lack of correlation across unimodal tests underscores the need for multimodal approaches that assess integration of interoceptive information across bodily systems.” Drawing from fields like psychology, physiology, psychiatry, engineering, and neuroscience, the article provides a detailed account of the neurobiology of interoception, describing it as a hierarchical predictive processing system in the brain, and emphasizing the key role of dysfunctional interoceptive processing in disorders like anxiety, depression, and eating disorders.
What are Interoceptive Technologies?
The review also explores in details existing paradigms for modulating interoception, like interoceptive conditioning. This involves pairing internal bodily sensations with aversive stimuli to reshape emotional and physiological responses through a form of classical conditioning. The authors discuss clinical applications of these approaches, such as interoceptive exposure therapy for anxiety disorders. They also propose a new classification system for interoceptive technologies, dividing them into three categories: artificial sensations that induce novel bodily perceptions, interoceptive illusions that manipulate the precision of predictions, and emotional augmentation systems that facilitate beneficial changes in beliefs or behaviors.
Figure 1. Overview of interoceptive technologies: A) the breath-holding test as an artificial sensation, whereby some bodily signal is directly manipulated, B) false heart feedback as an interoceptive illusion, where contextual cues generate a perceptual drift (here the illusion that the heart beats faster at a faster-than-expected rate), C) the therapeutic alliance as entrainment, where the patient’s heart rate slows down as the therapist’s is increasing, leading both to tend towards some average value, D) augmented exposure therapy as emotional augmentation, similar to B but with additional exteroceptive cues having personal significance to the individual (e.g. eliciting the trauma-related memory) favoring an emotional explanation for the interoceptive drift.
Such technologies could have powerful implications. Artificially inducing bodily sensations could help diagnose psychiatric conditions by testing patients’ susceptibility to developing skewed predictions about their internal state. More advanced emotional augmentation systems could precisely modulate predictive processes to reshape maladaptive cognitions and behaviors. While acknowledging that much remains unknown, the review shows the vast potential for interoceptive interventions to improve diagnosis and treatment of mental health disorders. Developing standardized measures and new technologies to precisely manipulate interoceptive signaling may open transformative frontiers in biological psychiatry and psychology.
