Abstract
Emotions are by nature embodied, as the brain has evolved to quickly assess the emotional significance of stimuli and output signals to the body’s viscera and periphery to aid adaptive responses. Emotions involve both implicit bodily and explicit narrative processes, and patients may experience transdiagnostic distress when bodily signals are not attended to and holistically integrated with explicit narratives about experience. Similarly, therapists may be trained in more implicit body-based approaches (i.e., massage/bodywork, physical and occupational therapy, and nursing/medicine) or more explicit narrative-based approaches (i.e., psychotherapy), and may lack training in skills that integrate both levels of emotion processing to aid healing and growth. To address these gaps, we propose a framework where the bridge between implicit bodily sensations and explicit narratives lies in cultivating mindful awareness of bodily sensations associated with emotions. This process brings subjective awareness to notice inner body experience (or interoceptive awareness) that is often outside of conscious awareness, so that it may be understood and re-integrated in more adaptive ways, which we call somatic reappraisal. Using clinical theory and example vignettes, we present mindful interoceptive awareness for adaptive emotion processing as a framework to cultivate and enhance somatic reappraisal. Mindful interoceptive awareness brings more focused and sustained attention to inner body experience; likewise, internal sensations associated with emotions become more granular, vivid, and can shift in ways that facilitate somatic reappraisal. Learning to sustain interoceptive awareness when engaged with mindfulness qualities of nonjudgment and compassion promotes an experience where new associations between emotions, meanings, and memories can be made that generate insights that are holistic and integrative. A clinical vignette is used in this paper to provide examples of this approach in psychotherapy. An example script for use in mindfulness groups is included, and resources are suggested for clinicians to gain more experience. Mindful interoceptive awareness for adaptive emotion processing is a clinical process that can be learned and applied by a range of clinicians to treat mental and physical health conditions that may benefit greater embodied awareness.
Highlights
Clinical interest is growing in how mindfulness-based interventions may cultivate interoceptive awareness, and may aid emotion recognition, processing, and regulation in a variety of mental and physical health conditions (Farb et al, 2015; Khalsa et al, 2017; Weng et al, 2020a)
Attending to sensations through sustained attention in an internal experiential space supports the malleability of connections between and interpretations of experiences, so that adaptive somatically informed reappraisal may occur
These adaptive reinterpretations of experiences that are rooted in bodily experience support a fuller sense of embodiment and a more integrated sense of self
Summary
Clinical interest is growing in how mindfulness-based interventions may cultivate interoceptive awareness, and may aid emotion recognition, processing, and regulation in a variety of mental and physical health conditions (Farb et al, 2015; Khalsa et al, 2017; Weng et al, 2020a). Mindfulness-based interventions train qualities of interoceptive awareness that aid focused, sustained, and nonjudgmental attention to regions of the body This allows more internal sensory information to enter conscious awareness that is sustained over time, while thought-based narrative processes become more muted (Farb et al, 2012). The ability to sustain nonjudgmental attention on interoceptive experience can facilitate increased emotional awareness and engage somatically based reappraisal processes in therapy that promote wellbeing as described for the therapeutic approach Mindful awareness in body-oriented therapy (MABT; Price and Hooven, 2018). Psychotherapists who are trained in cognitive approaches and talk-therapy may need to increase their understanding of how emotions are often tied to bodily sensations In both cases, therapists can learn new skills to help their clients bypass word-based cognitions as the initial orientation for selfunderstanding and develop their capacity to feel (their bodies and their emotions). One way to do this is by integrating interoceptive awareness and mindfulness processes to facilitate more sustained and nonjudgmental acceptance of feeling states
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