E11. Rebecca Brewer – Interoception

US_UK_Apple_Podcasts_Listen_Badge_RGB

Today we speak with Dr. Rebecca Brewer, Senior Lecturer in Psychology at Royal Holloway, University of London. Rebecca studies social and emotional abilities across a range of clinical and typical populations, and how interoception (the perception of the internal states of one’s body) is related to these emotional and social abilities.

Interoception is a topic that I’ve been finding fascinating lately. Interoception is important to many processes fundamental to what makes us who we are, from homeostasis to subjective experience itself, from decision making to psychopathology.

In this conversation, we focus particularly on the relation of interoception to psychopathology, an area where Rebecca has done interesting work and proposed big ideas.

Show Notes

1:20 – What is interoception and why study it?

4:25 – On the relevance of interoception to psychopathology.

6:25 – On interoception abnormalities as the p-factor.

9:45 – Does the relationship of interoception abnormalities to psychopathology appear causal?

13:00 – On treatments targeting interoceptive ability.

21:45 – On what Rebecca hopes the next wave of interoception research

26:00 – On the importance of interpretation of interoceptive signals

28:30 – On whether interoception is an area of interest for positive psychology

30:30 – On the focus of upcoming research for Rebecca’s group

39:40 – What Rebecca wishes she new when she was a student.

1:20 – What is interoception and why study it?

Interoception is the perception of signal arising from within the body. Sometimes the definition is widened to include stimuli that share similar neural pathways, such as slow sensuous touch.

Rebecca’s early research focused on ASD and alexythymia (difficulty understanding your own emotions), which led her to interoception.

4:25 – On the relevance of interoception to psychopathology.

Many different clinical populations struggle to understand their own emotions. Additionally, it seems linked to other disorders unrelated to emotional recognition, such as eating disorders and substance use disorders.

6:25 – On interoception abnormalities as the p-factor.

The p-factor is idea that there is a single factor that might underlie susceptibility to psychopathology in general, analogous to the g-factor in intelligence. Rebecca did work with Geoff Bird and Jennifer Murphy suggesting that the p-factor might relate to interoception. They suggested this as interoceptive abnormalities have been seen across a very wide range of psychopathologies (including depression, anxiety, OCD, schizophrenia, eating disorders, substance use disorders).

9:45 – Does the relationship of interoception abnormalities to psychopathology appear causal?

It’s unclear at this point. In some cases interoception abnormalities can lead to psychopathology, but the relationship is likely bidirectional.

13:00 – On treatments targeting interoceptive ability.

There are different aspects to interoceptive ability. Hugo Critchley and Sarah Garfinkel proposed the following aspects:

  • Accuracy/sensitivity: your objective ability perceive a particular internal signal. eg. Accuracy in counting heartbeats.
  • Sensibility: how much do you report noticing and focusing on your internal states.
  • Metacognitive awareness: Your accuracy of your perception of your interoceptive accuracy/sensitivity.

There are treatments that train both sensibility (focusing more on internal signals) and accuracy. Sensibility can be targeted through mindfulness-based interventions. Accuracy can be targeted by providing external feedback at the same time a an internal signal, most commonly heartbeart.

It is not yet clear whether training heartbeat perception translates to improved perception of other interoceptive signals, and the other psychological processes that involve interoception, such as understanding emotions, empathy, processing risk and reward.

21:45 – On what Rebecca hopes the next wave of interoception research

On of the main things is to develop better tests of interoception. And, of course, larger studies looking at whether altering interoceptive ability changes cognitive functioning and psychopathological symptomatology.

26:00 – On the importance of interpretation of interoceptive signals

Alongside the objective accuracy one’s ability to perceive interoceptive signals, the interpretation of perceived signals is important. Interoceptive signals can be over-interpreted, as in the case of someone with anxiety who might think that they are having a heart attack when it is really just a slight increase in their heart rate, or under-interpreted, as in the case of those with alexythymia who tend to report heart attacks too late.

28:30 – On whether interoception is an area of interest for positive psychology

There have been some studies on non-clinical populations, looking at for example the relation between interoceptive ability and decision making. However, the majority of the work is clinically focused.

30:30 – On the focus of upcoming research for Rebecca’s group

One thing that Rebecca’s group will be looking at the link between interoception and social perception. For example, does your ability to perceive whether you are tired correlate with your ability to perceive if someone else is tired. This work could inform interpersonal interactions in medical and care-based professions, and any work where empathy is important.

39:40 – What Rebecca wishes she new when she was a student.

Rebecca wishes she new how much freedom and flexibility academia provides, both in terms of collaborators and research areas. Also, that not every piece of work needs to entail a groundbreaking idea. And that she had a better understanding of the publication process.

_

Episode References

Other key researchers working on interoception include Sarah Garfinkle, Hugo Critchley, Anil Seth, Sahib Khalsa, Karen Quigley and Manos Tsikiris.

Leave a Reply

Your email address will not be published. Required fields are marked *