Abstract
Emotional awareness and somatic interoceptive awareness are essential processes for human psychosomatic health. A typical trait of lacking emotional awareness related to psychosomatic symptoms is alexithymia. In contrast, alexisomia refers to the trait of lacking somatic awareness. Links between emotional and somatic awareness and homeostatic processing are also significant for the psychosomatic health. The purpose of the present paper is to review the links among emotional awareness, somatic interoceptive awareness and autonomic homeostatic processing. On the basis of the collected evidence, the following arguments were presented1: (1) The main subcortical neural substrates for these processes are limbic-related systems, which are also responsible for autonomic functions for optimization of homeostatic efficiency. (2) Considerable studies have shown that autonomic activity and/or reactivity to stress correlate with both emotional and interoceptive awareness. A hypothesis was advocated about the links between the two types of awareness and autonomic function: Autonomic dysfunction, especially high sympathetic tone at baseline and/or attenuated reactivity or variability to stress, appears to be involved in disturbance of emotional and interoceptive awareness. (3) Several studies suggest that a link or a cooperative relationship exists between emotional and somatic awareness, and that somatic awareness is the more fundamental of the two types of awareness. Emotional awareness, somatic awareness and autonomic homeostatic processing generally occur in parallel or concurrently. However, some complex features of pathologies include coexistence of reduced interoceptive awareness and somatosensory amplification. The autonomic homeostatic process is fundamentally involved in emotional and somatic awareness. Investigation of these types of awareness with both neuroimaging evaluations and estimation of peripheral autonomic function are required as next steps for exploration of the relationship between awareness and human somatic states including somatic symptoms as well as general psychosomatic health.
Highlights
Emotional awareness and somatic awareness are essential processes for human psychosomatic health, because disturbance of these types of awareness leads to unhealthy conditions through obstruction of homeostatic processing
This paper reviewed links between emotional awareness, somatic awareness including interoception, and autonomic homeostatic processing, and advocated a hypothesis about the links between the two types of awareness and autonomic function
The first point relates to the context in the Background and to the subsection titled “Neural substrates for emotional/ somatic awareness and autonomic homeostatic processing.”
Summary
Emotional awareness and somatic awareness are essential processes for human psychosomatic health, because disturbance of these types of awareness leads to unhealthy conditions through obstruction of homeostatic processing. A typical trait of lacking emotional awareness related to psychosomatic symptoms is Kanbara and Fukunaga BioPsychoSocial Medicine (2016) 10:16 awareness, somatic awareness, and autonomic homeostatic processing. Patients with psychosomatic disorders often present with difficulties in awareness and expression of their emotions, or alexithymia trait [13]. The alexithymia trait is involved in generation and expansion of somatic symptoms and related to psychosomatic disorders and to several physical illnesses [16, 17], functional somatic disorders such as functional gastrointestinal disorders [18] or so-called “medically unexplained symptoms” [19], chronic pain [20, 21] and certain types of illness behavior [22]. Better understanding of alexithymic features for patients with psychosomatic or functional somatic disorders, in both general medical settings and specialized clinical settings, is required
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