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Anthony Quintiliani, Ph.D, LADC

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March 6, 2017 By Admin

What is Interoception and Why is it Important?

About Interoception and It’s Importance

Interoception (some may also call it neuroception) is the conscious detection and perception of sensory signals in the body and on the skin. Most often these signals are processed as sensations.  Sensation, as the foundation of emotional experience, is always there in our bodies; however, we are not always fully conscious of its existence or its experiential range. Perceived interoceptive sensations may be extremely subtle, thus requiring considerable practice and mind training for conscious registering of these body-based “feeling.”  Sometimes, awareness of interoception can be highly dramatic like sharp crushing chest pain in heart attacks and severe autonomic reactivity in panic attacks.  Perceived interoceptive sensations are always evaluated cognitively.  Some interoceptive experiences may be evaluated autonomically via limbic system and stress response system activation.  Once we are aware, we evaluate consciously. Western neuroscience has strong interest in neuroception for embodied contemplative experience as well as for clinical applications. Self-sensed bodily sensations are coded as pleasant, unpleasant and neutral. These are the same categories used in Buddhism to evaluate personal sense-door experience in life: pleasant, unpleasant, and neutral.

There are neuro-anatomical pathways interacting between and among externally based sensory experiences (thalamic processing of external sensory perception regarding seeing, hearing, feeling, smelling, and tasting) and internal “felt-sense” experiences of inner body sensations. This is highly complex processing. Afferent sensory signals communicate with higher order cognitive and affective brain regions and processes; these brain-body-mind-heart interactions provide direct understanding of self in context with environment, personal history, emotions, and goal-oriented behaviors. In times of extreme stress and/or personal danger, interoception may be an early warning signal for unsafe conditions and the possibility of physical harm or death. In substance use disorders, interoception may serve dual purposes: craving and strong discomfort signal the need to ingest mind-altering substances, or an early warning signal to modify your current
situation or condition to avoid relapse. In mindfulness training such as still and moving meditation or yoga practice, interoception can guide us in breathing, being still, and bodily movement and awareness. Key clinical conditions (anxiety, depression, trauma, substance misuse, and eating disorders) include subtle and not-so-subtle interoceptive experiences – often leading to a multitude of self-medication behaviors  to avoid unpleasant experiences. With training and personal experience, interoception may help us with bio-psycho-social-spiritual realities and self-regulated emotional balance. Even the human face plays a role in interoception. Facial emotions are powerful influencers (proprioceptive feedback) in brain-mind experiences of emotional life. These experiences are intrapersonal and interpersonal in nature, and their “felt-sense” tends to be quite subtle.

Neuroscience research tends to examine coherence between interoceptive awareness and self-reported experiences in the
body. Physiological measurement and cognitive self-report are examined. Narrowed focus of attention on soft signals
(threshold sensitivity to feelings of well-being, mood, heart rate, respiration rate and depth, body temperature, etc.) are
the subjects of various studies. Thus far most outcomes do not support the premise that experienced meditators and yogis have superior interoceptive detection skills.  Although these practitioners in their own experience believe that they do have stronger sensitivity to “picking up” interoceptive signals. Based on my own experience, I think their assumption is correct.  This question will remain in limbo; generally, experienced practitioners do perform better in detection here, but the differences between groups of subjects tends to be non-significant. Some studies note that with a greatly expanded number of subjects, the differences may well fall into the statistically significant range. This may be a measurement and target sensitivity issue. Or, mindfulness practice with its brain plasticity changes may not lead to superior neuroception.

In practical terms related to clinical interventions, such practices as Dialectical Behavior Therapy, Mindfulness-Based Stress Reduction, Acceptance and Commitment Therapy, Feldenkrais, Alexander Method, Focusing, Somatic Awareness, and Hakomi Breath Training all appear to produced heightened sensitivity to interoceptive awareness.  Practice makes perfect!

For more information refer to Khalsa, S. S. et al. (July, 2008). Interoceptive awareness in experienced meditators. Psychophysiology, 45 (4), 671-677.  Melloni, M. et al. (December, 2013). Preliminary evidence about the effects of meditation on interoceptive sensitivity and social cognition. Behavioral and Brain Functioning online, Biomedical Central, 1-10.brainfunctioning-biomedicalcentral.com… retrieved December 5, 2016. See also Farb, N. et al. (June, 2015). Interoception, contemplative practice and health. Frontal Psychology, 1-69. Journal.frontiersin.org/article…retrieved December 15, 2016.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

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New Edition of Mindful Happiness in Production…Coming soon!

 

Filed Under: Brain, Featured, Interoception, Science Tagged With: INTEROCEPTION, MINDFUL HAPPINESS, NEUROCEPTION, NEUROSCIENCE, SENSATION

November 7, 2016 By Admin

Trauma Informed Care – The Avoidance Process

Trauma Informed Care – Avoidance Process

Although more and more clinicians are learning about and using principles/practices of Trauma Informed Care, too few understand the behavioral dynamics of negative reinforcement in the avoidance of trauma-related cues (people, places, things, internal sensations, emotions and images). This post will give a very brief description of negative reinforcement via habitual avoidance. Psychologist B. F. scienceandhumanbehavior_mindfulhappinessSkinner in his explanation of operant conditioning explained negative reinforcement as a behavioral response being strengthened by avoiding or removing a negative (in this case emotional) consequence or aversive stimulus. Behaviors are negatively reinforced when they enhance escape from aversive stimuli. Here the behavior of avoidance is reinforced; such conditioning leads to habitual avoidance of trauma-related cues and stimuli. This conditioned behavior is adaptive in that it reduces painful emotional suffering. In a sense, it is a form of emotional self-medication: short-term emotional relief by avoidance behavior but long-term suffering continues. The removal of a punishing  experience is a highly reinforced, conditioned outcome. Therefore, a person suffering from psychological trauma learns that avoiding trauma-related stimuli leads to less suffering.  Thus avoiding traumatic stimuli reduces emotional suffering activated by those same stimuli.  Avoidance is learned as an adaptive coping response to tic-mindfulness_mindfulhappinesstraumatic fear of suffering on-going traumatic symptoms and reactions. In behavioral chain analysis, the person suffering from trauma learns avoidance improves their emotion state because it reduces consequential emotional suffering.  The positive consequence is often immediate, making the reinforced conditioning stronger; habit formation occurs quickly. The behavior becomes stronger over time.  As avoidance becomes habitual, the person cannot benefit from successive approximations – the slow, safe. steady approach behaviors related to facing and being with traumatic cues and stimuli.  Longer-term, slow and safe exposure to these traumatic cues and stimuli improves emotional coping as it reduces negative physiological and emotional reactivity. The consequence of  learning the avoidance cycle implies little progress will occur in recovering from powerful  traumatic experience/s.

In the current scientific treatment of trauma, slowly weakening the habit of the learned avoidance cycle helps the person to approach and cope with traumatic cues and stimuli with less emotional reactivity and fear. Therapeutically supported cognitive restructuring, slow and safe behavioral exposure to cues and stimuli, and the application of mind body coping skills (use of the therapeutic alliance, supportive self-talk, cognitive and behavioral rehearsal, breathing retraining, mindfulness, meditation/yoga, etc.) will eventually improve coping, emotion traumainformedcare_mindfulhappinessregulation, and recovery process. People suffering from trauma can get well, but only if their therapists and medical providers understand how to treat psychological trauma.  It is not just prescribing another medication. Co-occurring conditions (depression, other forms of anxiety, substance abuse) often mean that the treatment of trauma is NOT unidimensional in nature.

For more information refer to Skinner, B. F. (1953). Science of Human Behavior. New York: Macmillan. See also Kanazawa, S. (2010). Common misconceptions about science: Negative Reinforcement. Psychology Today. Retrieved 9-20-16.

 

 

By Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Behavior, Featured, Science, Therapist, Trauma, Trauma Informed Care Tagged With: ANTHONY QUINTILIANI, BEHAVIORAL, BF SKINNER, SCIENCE, THERAPY., TRAUMA INFORMED CARE

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