Interoception and Proprioception

Interoception

Qigong practice consists of quieting the mind through mindfulness, thus enabling an enhanced interoception, proprioception, vestibular system, awareness of present moment experience, and emotional regulation. Learning to have present moment awareness of and attention to the body without distractions such as thoughts is a mindfulness skill. Interoception is the underlying neurological mechanism of mindfulness-based approaches to meditation. Clinical research describes mindfulness as the attentional focus necessary and fundamental for gaining interoceptive skills (Gibson 2019). The refined ability to sustain awareness characterizes what in Qigong is called cultivating the skill of self-observation and regulating emotional responses to bodily sensation.

Interoception refers collectively to the processing of internal bodily stimuli by the nervous system and includes physical responses in body and brain representation such that the sensing of stimuli is available for reflection, insight, conscious awareness, and action. This characteristic training of awareness makes Qigong an “interoceptive awareness practice.” Interoception is such a new field of psychophysiological study that its first international conference was held in 2016. The National Center for Complementary and Integrative Health (NCCIH) is focusing on the multidisciplinary study of interoception science as a way to research "mind-body" practices, including Qigong.

Interoception, a key component of Qigong practice, is a representation of the body's internal state and bodily signals based on proprioception, the senses, and biofeedback pathways which include bi-directional communication between the limbic system (thoughts and emotions), the frontal cortex, the neuroendocrine system, and the autonomic nervous system. Interoception is essential for physiological homeostasis, cognition, and emotional regulation. Interoceptive awareness is a pre-requisite for emotional regulation.

The Emerging Science of Interoception: Sensing, Integrating, Interpreting, and Regulating Signals within the Self [Chen...Langevin 2021]. Interoception refers to the representation of an organism’s internal states, and includes the processes by which it senses, interprets, integrates, and regulates signals from within itself. This review article presents a unified research framework and attempts to offer definitions for key terms to describe the processes involved in interoception [PMCID: PMC7780231].

Unravelling the Neurobiology of Interoceptive Inference [Allen 2020]. What is the function of the insular cortex? Two recent studies (by Gehrlach et al. and Livneh et al.) offer new insight into how this enigmatic brain region integrates interoception and exteroception in the service of emotion. The findings provide much needed causal evidence for the nascent theory of interoceptive inference [PMID: 32160563].

Mindfulness, Interoception, and the Body: A Contemporary Perspective [Gibson 2019]. The purposes of this article are to (1) highlight that it may be more accurate to link many of the identified benefits in the mindfulness literature to interoception and its neurological correlates and (2) propose attentional style as a means to clarify some of the confusion surrounding mindfulness, interoception, and meditation. Different meditations require different attentional styles. Some of the confusion surrounding mindfulness is believed to stem from an undifferentiated use of the term mindfulness and meditation. There is no universally accepted technical definition of “mindfulness” nor is there a consensus on various aspects underlying the concept to which it refers [PMCID: PMC6753170].

Longitudinal effects of interoceptive awareness training through mindful awareness in body-oriented therapy (MABT) as an adjunct to women's substance use disorder treatment: A randomized controlled trial [Price 2019]. Both MABT and Qigong train interoceptive awareness over time. MABT and Qigong teach interoceptive awareness skills to promote self-care and emotion regulation [PMCID: PMC6467707].

Interoception and Social Connection [Arnold 2019]. Meditation practices that include mindfulness (e.g. Qigong) are important for alleviating loneliness and improving social connection [PMCID: PMC6901918].

A Positive Emotional-Based Meditation but Not Mindfulness-Based Meditation Improves Emotion Regulation [Valim 2019]. This research confirms a fundamental feature of Qigong practice. Qigong meditation begins with mindfulness to focus on present awareness, but what happens next is more important. Unlike mindfulness alone, Qigong practice trains interoception which is intricately related to emotional processing.  Of particular interest is the Multidimensional Assessment of Interoceptive Awareness Version (MAIA). Qigong and Tai Chi practice increase interoceptive awareness which in turn contributes to enhanced health and wellness [PMCID: PMC6448484].

Self-control is linked to interoceptive inference: Craving regulation and the prediction of aversive interoceptive states induced with inspiratory breathing load [Kruschwitz 2019]. The interoceptive inference framework suggests that our brain continuously anticipates future states of our body and aims to avoid events that might counteract homeostasis by minimizing prediction errors through active inference; e.g. appropriate actions. If predicted interoceptive models are inaccurate, behavior inconsistent with our long-term homeostatic goals may result; e.g. in failures in self-control and emotional regulation [PMID: 31330380]. 

The neurobiology of interoception in health and disease [Quadt, Critchley, Garfinkel 2018]. Interoception is the sensing of internal bodily sensations. Interoception is an umbrella term that encompasses (1) the afferent (body-to-brain) signaling through distinct neural and humoral (including immune and endocrine) channels; (2) the neural encoding, representation, and integration of this information concerning internal bodily state; (3) the influence of such information on other perceptions, cognitions, and behaviors; (4) and the psychological expression of these representations as consciously accessible physical sensations and feelings. Interoceptive mechanisms ensure physiological health through the cerebral coordination of homeostatic reflexes and allostatic responses that include motivational behaviors and associated affective and emotional feelings [PMID: 29974959]. 

Interoception and Mental Health: A Roadmap [Khalsa 2018]. This is a summary of the first international conference on Interoception, the Interoception Summit 2016]. Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body's internal landscape across conscious and unconscious levels. Interoceptive signaling has been considered a component process of reflexes, urges, feelings, drives, adaptive responses, and cognitive and emotional experiences, highlighting its contributions to the maintenance of homeostatic functioning, body regulation, and survival. Dysfunction of interoception is increasingly recognized as an important component of different mental health conditions, including anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders. Recent years have witnessed a surge of interest on the topic of interoception due in part to findings highlighting its integral role in emotional experience, self-regulation, decision making, and consciousness [PMCID: PMC6054486]

Interoceptive Inference: From Computational Neuroscience to Clinic [Owens...Friston 2018]. The central and autonomic nervous systems can be defined by their anatomical, functional and neurochemical characteristics, but neither functions in isolation. For example, fundamental components of autonomically mediated homeostatic processes are afferent interoceptive signals reporting the internal state of the body and efferent signals acting on interoceptive feedback assimilated by the brain. Recent predictive coding (interoceptive inference) models formulate interoception in terms of embodied predictive processes that support emotion and selfhood. We propose interoception may serve as a way to investigate holistic nervous system function and dysfunction in disorders of brain, body and behaviour. We appeal to predictive coding and (active) interoceptive inference, to describe the homeostatic functions of the central and autonomic nervous systems [PMID: 29694845].

Multidimensional Assessment of Interoceptive Awareness Version 2 (MAIA-2) [Mehling 2018]. [PMCID: PMC6279042].

Interoceptive Awareness Skills for Emotion Regulation: Theory and Approach of Mindful Awareness in Body-Oriented Therapy (MABT) [Price 2018]. Emotion regulation involves a coherent relationship with the self, specifically effective communication between body, mind, and feelings. Effective emotion regulation involves the ability to accurately detect and evaluate cues related to physiological reactions to stressful events, accompanied by appropriate regulation strategies that temper and influence the emotional response. There is compelling evidence demonstrating links between poor or disrupted awareness of sensory information, or interoceptive awareness, and difficulties with emotion regulation. This paper presents a framework, based on psychological and neurobiological research, for understanding how interoceptive awareness facilitates regulation and an integrated sense of self, and thus contributes to health and well-being [PMCID: PMC5985305].

Increasing Our Insular World View: Interoception and Psychopathology for Psychotherapists [Duquette 2017]. Interoception has been determined to be an elemental aspect of the neural foundations of physiological homeostasis, subjective experience, and motivated behavior. This paper reviews current neuroscience research regarding interoception and forms of interoceptive dysfunction that may result in psychopathology, focusing on depression, and anxiety, in a manner conducive to psychotherapists engaging with it to consider clinical applications [PMCID: PMC5359279].

Interoception and stress [Schulz 2015]. Interoception and stress are, therefore, associated via the bi-directional transmission of information on the brain–body axis. It could be argued that excessive and/or enduring activation (e.g., by acute or chronic stress) of neural circuits, which are responsible for successful communication on the brain–body axis, induces malfunction and dysregulation of these information processes. As a consequence, interoceptive signal processing may be altered, resulting in physical symptoms contributing to the development and/or maintenance of body-related mental disorders, which are associated with stress [PMCID: PMC4507149].

Interoception, Contemplative Practice, and Health [Farb, Price, Mehling 2015]. Well-being is deeply rooted in the body, a continuous flow of feelings denoting comfort or distress. Interoception, the representation of the body's internal state, is a growing target of scientific research, buoyed by a growing respect for contemplative traditions relating interoceptive awareness to the cultivation of well-being. An emerging interoception literature cuts across studies of neurophysiology, somatic anthropology, contemplative practice, and mind-body medicine. This paper reviews interdisciplinary perspectives on interoception, with the goal of presenting a unified perspective from diverse fields such as neuroscience, clinical practice, and contemplative studies. It introduces an expanded taxonomy of interoceptive processes, arguing that many of these processes can be understood through an emerging predictive coding model for mind–body integration. The model, which describes the tension between expected and felt body sensation, parallels contemplative theories, and implicates interoception in a variety of affective and psychosomatic disorders. We conclude that maladaptive construal of bodily sensations may lie at the heart of many contemporary maladies, and that contemplative practices may attenuate these interpretative biases, restoring a person’s sense of presence and agency in the world [PMCID: PMC4460802]. 

Mindfulness meditation training alters cortical representations of interoceptive attention [Farb 2013]. One component of mindfulness training is the development of interoceptive attention to visceral bodily sensations, facilitated through daily practices such as breath monitoring. [PMCID: PMC3541492].

The Multidimensional Assessment of Interoceptive Awareness Version (MAIA) [Mehling, Price 2012]. Qigong and Tai Chi practice increase interoceptive awareness which in turn contributes to enhanced health and wellness. This paper gives an excellent background on the processes of interoception which include awareness of body sensations, emotional reaction and attentional response to sensations, capacity to regulate attention, trusting body sensations and beliefs about importance of sensations, and mind-body integration [PMCID: PMC3486814].

How do you feel? Interoception: the sense of the physiological condition of the body [Craig 2002]. The seminal paper on interoception. [PMID: 12154366] [PDF].

Proprioception

Proprioception is the body's ability to sense movement, including alignment, posture, orientation, and balance. Proprioception also involves awareness of body position in space as well as the relationship between muscles and structure. Mechanoreceptors, more precisely proprioceptors, are located in tendons, muscles, ligaments and joint capsules. Proprioception can be defined as the cumulative neural input to the central nervous system from mechanoreceptors. Tai Chi and Qigong are fundamentally proprioceptive practices. There is some debate among researchers as to whether proprioception is separate from interoception because interoception is normally associated with afferent sensory input to the brain from visceral organs and not proprioceptors. However, most researchers agree that all receptor input, except from the senses (which comprise exteroception), can be considered interoception. 

Overview and Classification of Sensory Receptors.wmv

Physiology, Sensory System [Gadhvi 2021]. Humans can perceive various types of sensations, and with this information, our motor movement is determined. We become aware of the world by way of sensation. Sensations can also be protective to the body, by registering environmental cold or warm, and painful needle prick, for example. From the soft touch of the child to the painful punch of a boxer, all the daily activities carry associations with sensations. Broadly, these sensations can classify into two categories. First, general sensations which include touch, pain, temperature, proprioception, and pressure. Vision, hearing, taste, and smell are special senses which convey sensations to the brain through cranial nerves. In this activity, the discussion will be limited to general sensations. All these sensations begin with skin receptors and get conveyed through spinal neurons to the brain. Receptors get classified based on the type of stimulus activating them [PubMed Books NBK547656].

Physiology, Vestibular System [Casale 2020]. The vestibular system is a complex set of structures and neural pathways that serves a wide variety of functions that contribute to our sense of proprioception and equilibrium. These functions include the sensation of orientation and acceleration of the head in any direction with associated compensation in eye movement and posture. The vestibular system also plays a role in consciousness, and dysfunctions of the system can cause cognitive deficits related to spatial memory, learning, and navigation. Qigong and Tai Chi practice help develop our sense of proprioception, and this research gives more insight into that process [PubMed Books NBK532978].

Neuronal stretch reception - making sense of the mechanosense [Das 2019]. The sensation of mechanical force underlies many of our daily activities. As the sense of touch determines the quality of life, the subconscious sense of proprioception and visceral mechanosensation is indispensible for survival [PMID: 30817929].

The Importance and Role of Proprioception in the Elderly: a Short Review [Ferlinc 2019]. Proprioceptive training is important for maintaining the best possible physical fitness. Aging causes alterations in various body functions, such as motor, sensory, cognitive and psychosocial. One of the factors associated with aging is also the decline in proprioceptive function. Proprioception encompasses exercises for stability and coordination, stimulates motor learning, helps in maintaining proper body posture and balance, and improves body control. Proprioceptive training is fundamental in the rehabilitation and prevention of sports injuries. With the loss of proprioception during aging, the biomechanics of joints and the neuromuscular control of the limbs may change, resulting in impaired balance and a higher possibility of falls. Appropriate and proper physical activity (e.g. Tai Chi and Qigong) can slow the age-related decline in proprioception [PMCID: PMC6853739].

Emotions can alter kinesthetic acuity [Samain-Aupic 2019]Kinesthesia, the perception of our own body movements, relies on the integration of proprioceptive information arising mostly from muscle spindles, which are sensory receptors in skeletal muscles. This research shows that emotion can shape the perception of movements [PMID: 30500394].

Neural Basis of Touch and Proprioception in Primate Cortex [Delhaye 2018]. The sense of proprioception allows us to keep track of our limb posture and movements and the sense of touch provides us with information about objects with which we come into contact. In both senses, mechanoreceptors convert the deformation of tissues-skin, muscles, tendons, ligaments, or joints-into neural signals. Tactile and proprioceptive signals are then relayed by the peripheral nerves to the central nervous system, where they are processed to give rise to percepts of objects and of the state of our body [PMCID: PMC6330897].

NCCIH-funded Study Provides New Information on Mechanisms Involved in Touch Sensation and Self-Perception of Body in Space [Chesler 2016]. The ability to detect and transduce mechanical force, which is known as mechanosensation, provides humans and other animals with important information about the environment, and it is a fundamental component of the practice of Tai Chi. Proprioception is considered to be essential for posture and controlled movement.

The vestibular system: a spatial reference for bodily self-consciousness [Pfeiffer 2014]. Proprioception and interoception fans should enjoy this research finding. In Qigong and Tai Chi practice we're always adjusting our posture. One such adjustment is having the head "dangling from a string" to have it centered, upright, etc. to improve structure and energy flow. This research provides a very interesting view of why this adjustment is so important and has such an impact upon our energy, practice, and consciousness [PMCID: PMC4028995].

Qigong and Energy Medicine Database™


Interoception or Proprioception

How do you feel?

Excellent lecture on the neurobiology of interoception from Bud Craig, the functional neuroanatomist who wrote the seminal paper on interoception in 2002 [PDF].

The Interoceptive Mind

Book Review: The Interoceptive Mind: From Homeostasis to Awareness. To understand the nature of mind, cognitive scientists of all theoretical strands may benefit from considering experimental evidence of cognition (for example, perception, attention, memory) alongside phenomenology of bodily self (or conscious) feelings (proprioceptive, exteroceptive, and interoceptive). Roughly, the former dimension of scientific studies of mind seems to have found its legitimacy; yet, at first glance, the latter could still not be exonerated completely. That is to say, as far as the scientifically evidence-based account of endogenously generated interoceptive feeling is concerned, we will have come a long way toward buttressing its legitimacy. The Interoceptive Mind: From Homeostasis to Awareness can be seen as a guide to scientific studies of interoception in all of the cases so far. In particular, the essays collected in this book shed light on multisensory integration of interoceptive and exteroceptive feelings (and even self-conscious feelings) across widespread disciplines [PMCID: PMC7876277].