Interventions and Manipulations of Interoception

Neuromodulation can tap into known interoceptive pathways for clinical benefit. Meditation with sustained interoceptive focus on breath sensations increases the neural activation of interoception networks (including insula) and decreases engagement of the default mode network, which supports self-referential processing. While sympatholytic medications often have intolerable side effects, interoceptive interventions may be a safe and well-tolerated modality to improve sympathetic regulation and thereby reduce the risk of hypertension and cardiovascular disease. Recent findings highlight possible underlying mechanisms of improved interoceptive awareness skills and emotion regulation in mindfulness-based interventions for the treatment of physical and mental health conditions. Interoceptive pathways may be manipulated at various levels to develop interventions to improve symptoms in a range of disorders. Primarily through the lens of the respiratory system, we outline various pathways that can be manipulated at neural, behavioral, and psychological levels to change the representation of and attention to interoceptive signals, which can alter interconnected physiological systems and improve functioning and adaptive behavior. Interventions can alter interoception via neuromodulation of the vagus nerve, slow breathing to change respiratory rate and depth, or awareness processes such as mindfulness-based interventions. Aspects of this framework may be applied to other physiological systems and future research may integrate interventions across multiple levels of manipulation or bodily systems. Interoceptive pathways may be manipulated at various levels to develop interventions to improve symptoms in a range of disorders. Primarily through the lens of the respiratory system, we outline various pathways that can be manipulated at neural, behavioral, and psychological levels to change the representation of and attention to interoceptive signals, which can alter interconnected physiological systems and improve functioning and adaptive behavior. Interventions can alter interoception via neuromodulation of the vagus nerve, slow breathing to change respiratory rate and depth, or awareness processes such as mindfulness-based interventions. Aspects of this framework may be applied to other physiological systems and future research may integrate interventions across multiple levels of manipulation or bodily systems. a chemical process that uses oxygen to convert carbohydrates and fats into energy. a part of the peripheral nervous system that regulates involuntary functions of the body such as heart rate, respiratory rate, and digestion. a homeostatic mechanism that helps regulate blood pressure changes through a rapid negative feedback loop. localize sensation to a specific channel or organ system and differentiate it from other sensations. a state of deliberate attention to the contents of conscious thought, serving as an appraisal of consciousness awareness. a group of systems that use monoamine neurotransmitters, such as serotonin, dopamine, norepinephrine, epinephrine, and/or histamine, to influence processes such as emotion, arousal, and memory. another term for a motor neuron, a type of efferent neuron that conveys motor impulses from the brain or spinal cord to a muscle or gland. a schedule of conditioning in which an increase in response is required for the delivery of a reinforcement in successive sessions. above the pons. The pons is part of the brain stem. a type of medication that attenuates the downstream effects of postganglionic functioning in organs innervated by the SNS. a noninvasive form of VNS that uses cutaneous or percutaneous electrodes to electrically stimulate the auricular branch of the vagus nerve at the ear. an invasive (surgical) form of neuromodulation that applies electrical stimulation to interoceptive pathways that direct afference from visceral organs to the brain. a form of interception that is characterized by the awareness of bodily signals originating from the viscera – the heart, lungs, stomach, bladder, and other internal organs in the trunk of the body.