Interventions and Manipulations of Interoception

Helen Y Weng; Jack L Feldman; Lorenzo Leggio; Vitaly Napadow; Jeanie Park; Cynthia J Price

doi:10.1016/j.tins.2020.09.010

Interventions and Manipulations of Interoception

Trends Neurosci. 2021 Jan;44(1):52-62. doi: 10.1016/j.tins.2020.09.010.

Authors

Helen Y Weng¹, Jack L Feldman², Lorenzo Leggio³, Vitaly Napadow⁴, Jeanie Park⁵, Cynthia J Price⁶

Affiliations

¹ Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA. Electronic address: helen.weng@ucsf.edu.
² Department of Neurobiology, David Geffen School of Medicine, Center for Health Sciences, University of California at Los Angeles, Los Angeles, CA, USA.
³ Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA; Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA; Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA.
⁴ Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Department of Anesthesiology, Brigham and Women's Hospital, Boston, MA, USA.
⁵ Renal Division, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Research Service Line, Department of Veterans Affairs Medical Center, Decatur, GA, USA.
⁶ School of Nursing, University of Washington, Seattle, WA, USA; Osher Center for Integrative Medicine, University of Washington, Seattle, WA, USA.

Abstract

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.

Keywords: PTSD; interoceptive awareness; mindfulness; neuromodulation; respiration; substance use disorder.

Interventions and Manipulations of Interoception

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