Interoceptive pathways to understand and treat mental health conditions,2022, Nord & Garfinkel

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Trends in Cognitive Sciences, Interoceptive pathways to understand and treat mental health conditions, 2022, Camilla L. Nord, Sarah N. Garfinkel

Highlights
  • Patients with neuropsychiatric disorders associated with altered emotional or physical experiences show disruptions in interoception.
  • Interoception may be an important target of both existing and novel mental health treatments.
  • Antidepressants modulate aspects of interoception and specific psychological therapies target interoceptive processes, particularly breathing.
  • Medications for certain physical health conditions are associated with better mental health.
  • Interoceptive measures could be used to stratify patients for treatment selection.
An increasing recognition that brain and body are dynamically coupled has enriched our scientific understanding of mental health conditions. Peripheral signals interact centrally to influence how we think and feel, generating our sense of the internal condition of the body, a process known as interoception. Disruptions to this interoceptive system may contribute to clinical conditions, including anxiety, depression, and psychosis. After reviewing the nature of interoceptive disturbances in mental health conditions, this review focuses on interoceptive pathways of existing and putative mental health treatments. Emerging clinical interventions may target novel peripheral treatment mechanisms. Future treatment development requires forward- and back-translation to uncover and target specific interoceptive processes in mental health to elucidate their efficacy relative to interventions targeting other factors.

Open Access: https://www.cell.com/trends/cognitive-sciences/fulltext/S1364-6613(22)00062-6
 
"Figure 1. The varying recognition of organs and senses as interoceptive.
The classification of bodily organs and senses as interoceptive varies according to different definitions, with varying degrees of broad acceptance and controversy within the field. Green indicates organs and senses universally recognised as interoceptive: visceral organs included under Sherrington’s original conceptualisation of interoception. Light green indicates those widely recognised as interoceptive today, although absent from the original conceptualisation. Yellow indicates potential sources of interoceptive information which have been recognised more recently or less consistently across definitions. Red indicates more controversial potential interoceptive sources, which are considered by some researchers to be interoceptive but are often excluded from traditional definitions. Example (i.e., nonexhaustive) references provided."

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An increasing recognition that brain and body are dynamically coupled has enriched our scientific understanding of mental health conditions.
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But not physical health conditions? Causation doesn't run the other way?

Furthermore, even if there is causation in the mind–>body direction, I don't think it can be taken for granted that the degree of causation is the same in both directions.

The mind may well be able to override the body, on a temporary and partial basis, particularly at the raw immediate survival level. But there is no evidence it can do so to an arbitrary degree, nor on a permanent basis.

If we could, then most of us would choose not to decay, get sick, and ultimately die.
 
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