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Listening to your heart: Interoceptive awareness as a gateway to feeling

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Abstract

When you see the person you are in love with, your heart may race, your skin may flush, and your facial muscles may contract in a smile. You may also hear your heartbeat or sense 'butterflies' in your stomach. In addition, you experience feelings of love and elation directed toward your loved one. Without experimental evidence, James and Lange 1 suggested that feelings are the conse- quence of these body sensations, but philoso- phers have argued that the two differ because they have different objects. Body sensations involve awareness of the body's internal state; feelings are directed toward objects in the external world. Damasio 2,3 has argued, how- ever, that emotional feelings require the two objects—the body, which provides a sub- strate for feeling, and the external object that triggers the body changes in the first place, and toward which the feeling is directed. Critchley and colleagues 4 now provide data suggesting that the subjective experience of emotions results from brain activity caused by such body states. Using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (which estimates the size of a brain region), they identified brain areas engaged when subjects tried to sense whether their heartbeat was in sync with a series of tones. The size and activity of the right anterior insular cortex were related to individuals' accu- racy in sensing the timing of their own heart- beats. Activity in this region was also correlated with an individual's propensity to subjectively experience certain emotions. These findings provide important validation of the theoretical view of James and Lange 1 that neural systems supporting the perception of body states are a fundamental ingredient in the subjective experience of emotions. They also support Damasio's 2,3 and Craig's 5 view that the Probably the cortical representation (rather than brainstem activity) produces conscious feelings. Damasio and Craig agree that the right anterior insular cortex is important in mapping visceral states and in bringing interoceptive sig- nals to conscious perception. However, Craig suggests that this region also translates the vis- ceral states into subjective feeling and self- awareness. In Damasio's view, a first-order mapping of 'self ' is supported by brainstem regions, insular cortex and somatosensory cor- tex. However, additional regions, such as thala- mus and anterior cingulate cortex, are required for second-order mapping of the relationship between organism and emotional object and for integration of information about the body with information about the world.
When you see the person you are in love
with, your heart may race, your skin may
flush, and your facial muscles may contract
in a smile. You may also hear your heartbeat
or sense ‘butterflies’ in your stomach. In
addition, you experience feelings of love and
elation directed toward your loved one.
Without experimental evidence, James and
Lange
1
suggested that feelings are the conse-
quence of these body sensations, but philoso-
phers have argued that the two differ because
they have different objects. Body sensations
involve awareness of the body’s internal state;
feelings are directed toward objects in the
external world. Damasio
2,3
has argued, how-
ever, that emotional feelings require the two
objects—the body, which provides a sub-
strate for feeling, and the external object that
triggers the body changes in the first place,
and toward which the feeling is directed.
Critchley and colleagues
4
now provide data
suggesting that the subjective experience of
emotions results from brain activity caused by
such body states. Using functional magnetic
resonance imaging (fMRI) and voxel-based
morphometry (which estimates the size of a
brain region), they identified brain areas
engaged when subjects tried to sense whether
their heartbeat was in sync with a series of
tones. The size and activity of the right anterior
insular cortex were related to individuals’ accu-
racy in sensing the timing of their own heart-
beats. Activity in this region was also correlated
with an individual’s propensity to subjectively
experience certain emotions.
These findings provide important validation
of the theoretical view of James and Lange
1
that
neural systems supporting the perception of
body states are a fundamental ingredient in the
subjective experience of emotions. They also
support Damasio’s
2,3
and Craig’s
5
view that the
Probably the cortical representation (rather
than brainstem activity) produces conscious
feelings. Damasio and Craig agree that the right
anterior insular cortex is important in mapping
visceral states and in bringing interoceptive sig-
nals to conscious perception. However, Craig
suggests that this region also translates the vis-
ceral states into subjective feeling and self-
awareness. In Damasios view, a first-order
mapping of ‘self is supported by brainstem
regions, insular cortex and somatosensory cor-
tex. However, additional regions, such as thala-
mus and anterior cingulate cortex, are required
for second-order mapping of the relationship
between organism and emotional object and
for integration of information about the body
with information about the world.
Critchley and colleagues
4
aimed to isolate a
component of feeling, namely the mapping of
the visceral state. They scanned the brains of
subjects with fMRI during a heartbeat detec-
tion task. In half the trials, subjects tried to
determine whether a series of notes occurred in
sync with their heartbeat (an interoceptive
event). In the other half, they were asked
whether one of the notes had a different pitch
than the rest (exteroceptive). Subjects were
rated on validated clinical questionnaires that
reflect anxiety, depression and other emotional
states. Finally, using voxel-based morphometry,
the authors measured the size of a region of
interest, the insular cortex.
They found that focusing awareness on
heartbeat timing, as opposed to note pitch,
increased neural activation in anterior insular
cortex, lateral somatosensory cortex and dorsal
anterior cingulate cortex. Most importantly,
subjects’ accuracy in detecting their heartbeats
correlated with both activity and gray matter
volume of right anterior insular cortex. Self-
report measures of anxiety (and to some extent
other negative emotions) correlated with accu-
racy of heartbeat detection and activity in right
anterior insular cortex. The authors conclude
that individual differences in the ability to per-
right anterior insular cortex is important in
mapping body states into feelings.
In one aspect, however, the findings depart
slightly from the view of Damasio
2,3
that feel-
ings arise in conscious awareness through a sec-
ond-order representation of body changes in
relation to the object or event that initiated
them. Damasio distinguishes emotions from
feelings. Emotions are changes in body and
brain states triggered by a dedicated brain sys-
tem that responds to the content of one’s per-
ceptions, actual or recalled. Body responses
range from changes in heart rate or smooth
muscle contraction to changes perceptible to an
external observer (such as those to posture or
facial expression). The signals generated by
these body responses produce brain changes
that are perceptible mostly to the individual and
provide the essential ingredients for what is ulti-
mately perceived as a feeling. Thus emotions are
what an outside observer can see; feelings are
what the individual subjectively experiences.
An emotion begins with appraisal of an
emotional stimulus, such as the person you
love. Even after brief presentation, signals
evoked by that stimulus are carried from sen-
sory areas to a number of emotion-triggering
sites elsewhere in the brain, including the
amygdala and orbitofrontal cortex (Fig. 1).
There may be differences in how these
regions process emotional information: the
amygdala is more engaged in triggering emo-
tions when the emotional stimulus is present;
the orbitofrontal cortex is more important
when it is recalled from memory
6
.To create
an emotional state, activity must propagate
to execution sites, which include the hypo-
thalamus, the basal forebrain and nuclei in
the brainstem tegmentum (Fig. 1).
Feelings result from neural patterns that rep-
resent changes in the body’s response to an
emotional stimulus. Representations of these
body states are formed in visceral sensory
nuclei in the brainstem, insular cortex and lat-
eral somatosensory cortex (SII and SI).
NEWS AND VIEWS
9. Wightman, B., Ha, I. & Ruvkun, G. Cell 75, 855–862
(1993).
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Jewell, D. Curr. Biol. 13, 807–818 (2003).
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12. Lim, L.P. et al. Genes Dev. 17, 991–1008 (2003).
13. Lin, S.Y. et al. Dev. Cell 4, 639–650 (2003).
14. Abrahante, J.E. et al. Dev. Cell 4, 625–637 (2003).
15. Rhoades, M.W. et al. Cell 110, 513–520 (2002).
102 VOLUME 7
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NUMBER 2
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FEBRUARY 2004 NATURE NEUROSCIENCE
Listening to your heart: interoceptive awareness as a
gateway to feeling
Antoine Bechara & Nasir Naqvi
Does awareness of the internal state of one’s body relate to the conscious experience of feeling? A new imaging study suggests
that body awareness mediated by activity in the anterior insular cortex may contribute to the intensity of negative emotions.
The authors are in the Department of Neurology,
University of Iowa, Iowa City, Iowa 52242, USA.
e-mail: becharaa@mail.medicine.uiowa.edu
© 2004 Nature Publishing Group http://www.nature.com/natureneuroscience
NEWS AND VIEWS
ceive one’s internal state relate to the capacity to
subjectively experience certain types of feelings,
and that right anterior insular cortex is a com-
mon substrate for interoceptive awareness and
feelings. The use of voxel-based morphometry
to corroborate the fMRI findings is newswor-
thy because such attempts to use convergent
techniques are rare, and the additional data
boost confidence in the conclusions.
The new findings
4
do suggest that right ante-
rior insular cortex supports a representation of
bodily states that is accessible to awareness.
However, they do not necessarily mean that
being aware of a visceral sensation is the same
as feeling an emotion, nor do they necessarily
show that the subjective experience of an emo-
tion is accomplished within the insular cortex.
The heartbeat detection task was designed to
focus attention on bodily sensations, but it
lacked an emotional stimulus.When we feel joy
on seeing someone we love, information from
the viscera is passed on to a second-order map
to be re-represented in relation to an emotional
stimulus in the world. The heartbeat detection
task using tones with different pitches lacks this
quality; there is no object of value to the organ-
ism to be re-represented in juxtaposition with
information from the viscera. Therefore, the
findings could mean that interoceptive aware-
ness and emotional feeling share a common
process up to a point—that is, up to the ante-
rior insular cortex. However, if the experiment
were repeated,for example, with emotional pic-
tures of weddings or funerals instead of neutral
tones, then additional neural regions, such as
cingulate cortex, might be recruited. Although
the authors’ conclusion that anterior insular
cortex,without the cingulate, provides a sub-
strate for awareness of subjective feelings awaits
further confirmation, the study is significant
because it clarifies how representations of vis-
ceral information and feeling states are organ-
ized in the nervous system.
Functional neuroimaging research should be
complemented by studies in patients with focal
brain damage. Several regions are involved in
appraisal of emotional stimuli, triggering of
emotional responses, mapping of visceral states
and bringing of interoceptive signals to con-
scious perception (Fig. 1). Functional neu-
roimaging is an excellent approach for
identifying the entire neural system, but it is less
useful for dissecting the role of individual
regions. Lesion studies are valuable comple-
mentary methods that enable one to ask what
happens to the ability to emote and feel when a
specific component of that system is removed.
Specific emotional and feeling deficits result
from localized brain damage
2,3
.Frontal lobe
damage (ventromedial orbitofrontal) alters
patients’ability to emote in social contexts, such
as situations leading to embarrassment, guilt or
sympathy. Amygdala damage causes an emo-
tional lopsidedness: negative emotions are less
frequent and less intense in comparison to pos-
itive emotions. Patients with right hemisphere
damage, including damage to the insular cor-
tex, suffer from a condition known as anosog-
nosia; the classical example is that the patient is
paralyzed in the left side of the body, unable to
move hand, arm and leg and unable to stand or
walk. However, these patients report that they
feel fine, and they seem oblivious to the entire
problem. Patients with similar damage on the
left are usually cognizant of their deficit and
often feel depressed. Patients with anterior cin-
gulate damage, especially bilaterally, suffer from
akinetic mutism: they are profoundly apathetic,
are indifferent to dire circumstances and dis-
play no emotion, even when in pain. Some
patients with brainstem lesions burst into
arresting crying or spectacular laughter for no
apparent reason.
2,3
The new study
4
raises several questions. We
need to determine how information about the
viscera is conveyed from right anterior insular
cortex,where it is accessible both to feeling and
to interoceptive awareness, to regions with a
more specific role in feeling. Is the function of
the right anterior insular cortex shared by dif-
ferent feelings? In patients with focal brain
damage, one should ask, for example: would
lesions in the right anterior insular cortex dis-
rupt interoceptive awareness? Would these
lesions alter one or several types of feelings?
Would they spare the patient’s capacity to trig-
ger emotions? The study of Critchley and col-
leagues is only the beginning in solving the
neural puzzle that allows our thoughts to trig-
ger emotions, engender feelings and guide our
behavior.
1. James, W. Mind 9, 188–205 (1884).
2. Damasio, A.R. The Feeling of What Happens: Body
and Emotion in the Making of Consciousness
(Harcourt Brace, New York, USA, 1999).
3. Damasio, A.R. Looking for Spinoza: Joy, Sorrow, and
the Feeling Brain (Harcourt, New York, USA, 2003).
4. Critchley, H.D., Wiens, S., Rotshtein, P., Ohman, A. &
Dolan, R.J. Nat. Neurosci. 7, 189–195 (2004).
5. Craig, A.D. Nat. Rev. Neurosci. 3, 655–666 (2002).
6. Bechara, A., Damasio, H. & Damasio, A. in The
Amygdala in Brain Function: Basic and Clinical
Approaches (eds. Shinnick-Gallagher, P., Pitkanen,
A., Shekhar, A. & Cahill, L.) 356–369 (Annals of the
New York Academy of Science, New York, USA,
2003).
NATURE NEUROSCIENCE VOLUME 7
|
NUMBER 2
|
FEBRUARY 2004 103
Amygdala
Autonomic
responses
Emotional
stimulus
Visceral
Motor
Visceral
sensory
Insular
cortex
Anterior
cingulate
cortex
Orbitofrontal
cortex
Brainstem/hypothalamus
{
Sensory
systems
The brainThe world
The body
The
viscera
Sites for representing perceptual
properties of objects and events
in the world.
Sites for appraising emotional
value and triggering visceral
responses.
Sites for mapping the ongoing state
of the viscera.
Sites for representing the relationship
between changes in the organism
and the inciting object.
Kamal Masuta
Figure 1 The emotional stimulus is represented in one or more of the brain’s sensory processing
systems. This information, which can be derived from the environment or recalled from memory, is
made available to the amygdala and orbitofrontal cortex, which are trigger sites for emotion. The sites of
emotion execution include the hypothalamus, the basal forebrain and nuclei in the brainstem
tegmentum. Only the visceral response is represented, although emotion includes endocrine and
somatomotor responses as well. Visceral sensations reach the anterior insular cortex by passing through
the brainstem. Feelings result from the re-representation of changes in the viscera in relation to the
object or event that initiated them. The anterior cingulate cortex is a site of this second-order mapping.
© 2004 Nature Publishing Group http://www.nature.com/natureneuroscience
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Tur Porres, G. & Ires Correa, W. (2021). Re-thinking teachers’ body awareness to support well-being and resilience practices during COVID-19. Education Research Quarterly/Kwartalnik Pedagogiczny 66(2), 75-91.https://doi.org/10.31338/2657-6007.kp.2021-2.4 Abstract In this paper, the concept of body awareness is introduced in view of supporting teachers’ well-being and resilience practices, with a focus on COVID-19 pandemic. Teachers experience high rates of stress and pressure to cope with current working conditions due to COVID-19 pandemic. Depression and anxiety related to teachers’ duties have been largely researched worldwide. Research is being done around well-being from different perspectives, mental health, emotional and spiritual well-being, among other research done. However, little research has been done associated with body experiences and awareness from a holistic dimension that focuses on developing well-being and resilience practices; a state of mind and body that goes beyond acquiring physical skills to develop better physical condition. Thus far, despite relevant reviews and works have been published in relation to well-being and resilience practices in education, there is a need to explore the body experience to support teachers’ challenges during COVID-19 pandemic. For doing so, this work aims to review literature on the concept of well-being to elaborate, first, on the importance of supporting teachers’ well-being during COVID-19 pandemic. Second, we elaborate on the concept of body awareness in education. Third, we briefly explore the concept of resilience in relation to teachers’ well-being. Last, we raise some critical remarks about body experiences in education post COVID-19, and the need of re-thinking well-being and resilience practices in the school community to face with uncertainty. This is the link you can share: https://kwartalnikpedagogiczny.pl/resources/html/article/details?id=22476
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