Abstract
Interoception, the ability to feel the body’s internal sensations, is an essential aspect of emotional experience. There is mounting evidence that interoception is impaired in common mental health disorders and that poor interoceptive awareness is a major contributor to emotional reactivity, calling for clinical interventions to address this deficit. The manuscript presents a comprehensive theoretical review, drawing on multidisciplinary findings to propose a metatheory of reinforcement mechanisms applicable across a wide range of disorders. We present a reconsideration of operant conditioning through the co-emergence model of reinforcement, which is a neurophenomenological account of the interaction between cognition and interoception, and its consequences on behavior. The model suggests that during memory processing, the retrieval of autobiographical memory (including maladaptive cognition) is dependent upon its co-emerging interoceptive cues occurring at the encoding, consolidation and reconsolidation stages. Accordingly, “interoceptive reinforcement” during emotional distress is a common factor to all emotional disorders and a major cause for relapse. We propose that interoceptive desensitization has transdiagnostic benefits, readily achievable through the cultivation of equanimity during mindfulness training and can be integrated in cognitive and behavioral interventions to permit a transdiagnostic applicability. We summarize the contributions of this approach into 10 specific and testable propositions.
Highlights
Whereas exteroception refers to the sensory perception of non-self-referential stimuli, such as seeing, smelling and hearing the external environment, interoception is the perception of the body’s internal states through body sensations that one tends to associate with the sense of self (Seth and Critchley, 2013)
We describe how the model provides a more accurate and integrated account of behavior reinforcement, which explains how the mechanisms of action in mindfulness help decrease the typical symptoms of emotional disorders
This study demonstrates the transdiagnostic efficacy of Mindfulness-integrated CBT (MiCBT) and supports its applications with heterogenous groups in community-based primary mental health care
Summary
Whereas exteroception refers to the sensory perception of non-self-referential stimuli, such as seeing, smelling and hearing the external environment, interoception is the perception of the body’s internal states through body sensations that one tends to associate with the sense of self (Seth and Critchley, 2013). As noted by others (e.g., Gibson, 2019), under the umbrella of ‘mindfulness interventions,’ the methods that patients are asked to practice can differ greatly because the original instructions from traditional Buddhist teachings, which are already diverse, have been modified to varying degrees to adapt to various mental health conditions and clinical populations (e.g., Linehan, 1993; Kristeller and Hallett, 1999; Segal et al, 2002; Bowen et al, 2009) Some of these adaptations have prioritized certain mindfulness skills (e.g., exteroceptive awareness) and deemphasized others (e.g., interoceptive awareness and equanimity) to increase congruence with the targeted symptomatology. We describe how specific mindfulness practices can be used to overcome this deficit transdiagnostically
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
