Interoception can be broadly defined as the sense of signals originating within the body. As such, interoception is critical for our sense of embodiment, motivation, and well-being. And yet, despite its importance, interoception remains poorly understood within modern science. This paper reviews interdisciplinary perspectives on interoception, with the goal of presenting a unified perspective from diverse fields such as neuroscience, clinical practice, and contemplative studies. It is hoped that this integrative effort will advance our understanding of (...) how interoception determines well-being, and identify the central challenges to such understanding. To this end, we introduce an expanded taxonomy of interoceptive processes, arguing that many of these processes can be understood through an emerging predictive coding model for mind–body integration. The model, which describes the tension between expected and felt body sensation, parallels contemplative theories, and implicates interoception in a variety of affective and psychosomatic disorders. We conclude that maladaptive construal of bodily sensations may lie at the heart of many contemporary maladies, and that contemplative practices may attenuate these interpretative biases, restoring a person’s sense of presence and agency in the world. (shrink)

Feelings are conscious mental events that represent body states as they undergo homeostatic regulation. Feelings depend on the interoceptive nervous system (INS), a collection of peripheral and central pathways, nuclei and cortical regions which continuously sense chemical and anatomical changes in the organism. How such humoral and neural signals come to generate conscious mental states has been a major scientific question. The answer proposed here invokes (1) several distinctive and poorly known physiological features of the INS; and (2) a unique (...) interaction between the body (the ‘object’ of interoception) and the central nervous system (which generates the 'subject' of interoception). The atypical traits of the INS and the direct interactions between neural and non‐neural physiological compartments of the organism, neither of which is present in exteroceptive systems, plausibly explain the qualitative and subjective aspects of feelings, thus accounting for their conscious nature. (shrink)

The feeling of being alive still constitutes a major blind spot of contemporary affective sciences research. The mainstream view accepts it as an ‘umbrella notion’ comprising different states, such as M. Ratcliffe’s «feelings of being», T. Fuchs’s «feeling of being alive», E.M. Engelen’s «Gefühl des Lebendigseins», etc. In contrast, I argue for an account of the feeling of being alive as a unique feeling that can be described in several ways. Empirical support for this view comes mainly from Carvalho and (...) Damasio’s hypothesis of the distinctiveness of the interoceptive system as the physiological underpinning of this feeling. This account is also in line with many other approaches recognizing the role of interoception proper in mind and subjectivity grounding, collected by Tsakiris and De Presteer. Over recent decades, Damasio’s organic descriptions have been widely acknowledged as neurophysiological counterparts of philosophical/psychological concepts. However, in my view they have been often misinterpreted, especially due to the mainstream Ratcliffian interpretation mediating his ideas amongst philosophers. Throughout the paper, a critical inquiry into Damasio’s conceptualization is provided, by means of conceptual analysis and an overall taxonomy of the several affective states he has proposed over the past few decades. Ultimately, a critical discussion of his own account of the feeling of being alive is offered from a philosophical viewpoint. (shrink)

The feeling of being alive still constitutes a major blind spot of contemporary affective sciences research. The mainstream view accepts it as an ‘umbrella notion’ comprising different states, such as M. Ratcliffe’s «feelings of being», T. Fuchs’s «feeling of being alive», E.M. Engelen’s «Gefühl des Lebendigseins», etc. In contrast, I argue for an account of the feeling of being alive as a unique feeling that can be described in several ways. Empirical support for this view comes mainly from Carvalho and (...) Damasio’s hypothesis of the distinctiveness of the interoceptive system as the physiological underpinning of this feeling. This account is also in line with many other approaches recognizing the role of interoception proper in mind and subjectivity grounding, collected by Tsakiris and De Presteer. Over recent decades, Damasio’s organic descriptions have been widely acknowledged as neurophysiological counterparts of philosophical/psychological concepts. However, in my view they have been often misinterpreted, especially due to the mainstream Ratcliffian interpretation mediating his ideas amongst philosophers. Throughout the paper, a critical inquiry into Damasio’s conceptualization is provided, by means of conceptual analysis and an overall taxonomy of the several affective states he has proposed over the past few decades. Ultimately, a critical discussion of his own account of the feeling of being alive is offered from a philosophical viewpoint. (shrink)

Attention to internal body sensations is practiced in most meditation traditions. Many traditions state that this practice results in increased awareness of internal body sensations, but scientific studies evaluating this claim are lacking. We predicted that experienced meditators would display performance superior to that of nonmeditators on heartbeat detection, a standard noninvasive measure of resting interoceptive awareness. We compared two groups of meditators (Tibetan Buddhist and Kundalini) to an age- and body mass index-matched group of nonmeditators. Contrary to our prediction, (...) we found no evidence that meditators were superior to nonmeditators in the heartbeat detection task, across several sessions and respiratory modulation conditions. Compared to nonmeditators, however, meditators consistently rated their interoceptive performance as superior and the difficulty of the task as easier. These results provide evidence against the notion that practicing attention to internal body sensations, a core feature of meditation, enhances the ability to sense the heartbeat at rest. (shrink)

Attention to internal body sensations is practiced in most meditation traditions. Many traditions state that this practice results in increased awareness of internal body sensations, but scientific studies evaluating this claim are lacking. We predicted that experienced meditators would display performance superior to that of nonmeditators on heartbeat detection, a standard noninvasive measure of resting interoceptive awareness. We compared two groups of meditators (Tibetan Buddhist and Kundalini) to an age- and body mass index-matched group of nonmeditators. Contrary to our prediction, (...) we found no evidence that meditators were superior to nonmeditators in the heartbeat detection task, across several sessions and respiratory modulation conditions. Compared to nonmeditators, however, meditators consistently rated their interoceptive performance as superior and the difficulty of the task as easier. These results provide evidence against the notion that practicing attention to internal body sensations, a core feature of meditation, enhances the ability to sense the heartbeat at rest. (shrink)

Time processing is a multifaceted skill crucial for managing different aspects of life. In the current work, we explored the relationship between interoception and time processing by examining research on clinical models. We investigated whether time processing deficits are associated with dysfunction of the interoceptive system and/or insular cortex activity, which is crucial in decoding internal body signaling. Furthermore, we explored whether insular activation predicts the subjective experience of time (that is, the subjective duration of a target stimulus to (...) be timed). Overall, our work suggests that alteration of the interoceptive system could be a common psychophysiological hallmark of mental disorders affected by time processing deficits. (shrink)

The perception of being located within one’s body is an essential feature of everyday self-experience. However, by manipulating exteroceptive input, healthy participants can easily be induced to perceive themselves as being spatially dislocated from their physical bodies. It has previously been suggested that interoception, i.e., the processing of inner physiological signals, contributes to the stability of body representations; however, this relationship has not previously been tested for different dimensions of interoception and bodily self-location. In the present study, using (...) an advanced automatized setup, we systematically manipulated participants’ perspective of their own body as well as the synchrony of visuotactile stimulation. The malleability of bodily self-location was assessed using a questionnaire targeting in-body and out-of-body experiences. Participants also performed a heartbeat discrimination task to assess their interoceptive accuracy, interoceptive sensibility, and interoceptive awareness. Bodily self-location was significantly influenced by perspective, with third-person perspective being associated with stronger out-of-body experiences compared to first-person perspective. Furthermore, there was a significant perspective × stimulation interaction, with subsequent analyses showing that participants reported out-of-body experiences particularly under third-person perspective combined with synchronous visuotactile stimulation. Correlation and regression analyses revealed that meta-cognitive interoceptive awareness was specifically and negatively related to the exteroceptively mediated malleability of body experiences. These results indicate that the perception of the self being located within one’s body relies on the interaction of exteroceptive input and higher-order interoceptive abilities. This has implications for theoretical considerations about the bodily self in health as well as for the understanding of disturbed bodily self-processing in clinical contexts. (shrink)

The paper presents a new philosophical theory of blurred vision according to which visual experiences have two types of content: exteroceptive content, characterizing external entities, and interoceptive content, characterizing the state of the visual system. In particular, it is claimed that blurriness-related phenomenology interoceptively presents acuity of vision in relation to eye focus. The proposed theory is consistent with the representationalist thesis that phenomenal character supervenes on representational content and with the strong transparency thesis formulated in terms of mind-independentness. Furthermore, (...) the interoceptive approach is free from controversial assumptions adopted by other philosophical theories of blurred experiences and is able to account for the epistemic and motivational role of visual blur, i.e. that blurred experiences provide a prima facie justification for beliefs regarding our vision and motivate actions directed toward our eyes. (shrink)

Quattrocki and Friston (2014) argued that abnormalities in interoception—the process of representing one’s internal physiological states—could lie at the heart of autism, because of the critical role interoception plays in the ontogeny of social-affective processes. This proposal drew criticism from proponents of the alexithymia hypothesis, who argue that social-affective and underlying interoceptive impairments are not a feature of autism per se, but of alexithymia (a condition characterized by difficulties describing and identifying one’s own emotions), which commonly co-occurs with (...) autism. Despite the importance of this debate for our understanding of autism spectrum disorder (ASD), and of the role of interoceptive impairments in psychopathology, more generally, direct empirical evidence is scarce and inconsistent. Experiment 1 examined in a sample of 137 neurotypical (NT) individuals the association among autistic traits, alexithymia, and interoceptive accuracy (IA) on a standard heartbeat-tracking measure of IA. In Experiment 2, IA was assessed in 46 adults with ASD (27 of whom had clinically significant alexithymia) and 48 NT adults. Experiment 1 confirmed strong associations between autistic traits and alexithymia, but yielded no evidence to suggest that either was associated with interoceptive difficulties. Similarly, Experiment 2 provided no evidence for interoceptive impairments in autistic adults, irrespective of any co-occurring alexithymia. Bayesian analyses consistently supported the null hypothesis. The observations pose a significant challenge to notions that interoceptive impairments constitute a core feature of either ASD or alexithymia, at least as far as the direct perception of interoceptive signals is concerned. (shrink)

Adopting the perspective of another person is an important aspect of social cognition and has been shown to depend on multisensory signals from one’s own body. Recent work suggests that interoceptive signals not only contribute to own-body perception and self-consciousness, but also to empathy. Here we investigated if social cognition – in particular adopting the perspective of another person – can be altered by a systematic manipulation of interoceptive cues and further, if this effect depends on empathic ability. The own-body (...) transformation task – wherein participants are instructed to imagine taking the perspective and position of a virtual body presented on a computer screen – offers an effective way to measure reaction time differences linked to the mental effort of taking an other’s perspective. Here, we adapted the OBT with the flashing of a silhouette surrounding the virtual body, either synchronously or asynchronously with the timing of participants’ heartbeats. We evaluated the impact of this cardio-visual synchrony on reaction times and accuracy rates in the OBT. Empathy was assessed with the empathy quotient questionnaire. Based on previous work using the cardio-visual paradigm, we predicted that synchronous cardio-visual stimulation would increase self-identification with the virtual body and facilitate participants’ ability to adopt the virtual body’s perspective, thereby enhancing performance on the task, particularly in participants with higher empathy scores. We report that participants with high empathy showed significantly better performance during the OBT task during synchronous versus asynchronous cardio-visual stimulation. Moreover, we found a significant positive correlation between empathic ability and the synchrony effect. We conclude that synchronous cardio-visual stimulation between the participant’s body and a virtual body during an OBT task makes it easier to adopt the virtual body’s perspective, presumably based on multisensory integration processes. However, this effect depended on empathic ability, suggesting that empathy, interoception and social perspective taking are inherently linked. (shrink)

‘Interoception’ is an umbrella term describing internal processes and the unconscious and conscious processing of these, e.g., perception of one’s heartbeat, respiration, or more generally a sense of the internal milieu. A considerable body of theoretical and empirical work suggests that bodily sensations play an important role in the experience of emotion. Psychiatric disorders generally involve emotional disturbance, and consideration of interoception is important in helping to illuminate the underlying cognitive and neurophysiological mechanisms. Scientific study of interoceptive processes (...) and experiences can help further our understanding of clinical psychopathology and may suggest potential new treatment modalities for psychiatric conditions. Alongside the development of a fine-grained phenomenology of subjective emotional experience and its relationship to internal bodily states, the physiological systems through which emotions are generated are important targets of study for psychiatry. (shrink)

Previous studies have revealed the effect of interoceptive accuracy, a behavioral measure of the ability to feel physiological states and regulation for that, which origin emotion on decision-making such as gambling. Given that decision-making in moral dilemma situations is affected by emotion, it seems that IAcc also affects moral decision-making. The present study preliminarily investigates whether IAcc affects decision-making and emotional ratings such as regret for one’s own choices in moral dilemma situations. IAcc did not affect moral choice, but affected (...) regret ratings for one’s moral choice in portions of dilemma scenarios. Moreover, people with higher IAcc make deontological choices more rapidly than those with lower IAcc in self-related dilemma scenarios. These results suggest that people with higher IAcc feel stronger emotional conflicts about utilitarian choices but weaker conflicts about deontological choices than people with lower IAcc depending on the moral dilemma scenario. (shrink)

Research has shown repeatedly that attention influences implicit learning effects. In a similar vein, interoceptive awareness might be involved in unaware fear conditioning: The fact that the CS is repeatedly presented in the context of aversive bodily experiences might facilitate the development of conditioned responding. We investigated the role of interoceptive attention in a subliminal conditioning paradigm. Conditioning was embedded in a spatial cueing task with subliminally presented cues that were followed by a masking stimulus. Response times to the targets (...) that were either validly or invalidly predicted by the cues served as index of conditioning. Interoceptive attention was manipulated between-subjects. Half the participants completed a heartbeat detection task before conditioning. This task tunes attention to one’s own bodily signals. We found that conditioned responding was facilitated in this latter group of participants. These results are in line with the hypothesis that a rise interoceptive attention enhances unaware conditioned responding. (shrink)

The body-oriented approach in the philosophy of cognitive sciences is gaining in importance in the conditions of the formation of new high-tech contexts. The problem of interoception and integration of bodily data into socio-economic processes requires a comprehensive analysis and ethical assessment. This article examines the conceptual foundations of the body-oriented approach and its impact on the essence of cognitive processes. The main advantages and disadvantages of this approach are presented. We consider the methodological conflict zones of the bodily (...) paradigm and traditional methodological attitudes of the cognitive sciences. The system ofinteroceptive sensations is a special «layer» of bodily experience. The social functions of interoceptive sensations are an interdisciplinary research area that focuses on the mechanisms of interaction between the private content of bodily experience and systems of social interaction. The regularity between interoceptive sensations and human behavioral patterns reflects the importance of examining bodily data. Today, the market for bodily data is just beginning to form, but at the same time it is already playing an important role in global digital transformation processes. A multitude of applications and wearable digital devices that track bodily activity and generate gigantic amounts of data are used today by millions of people around the world. The identification of bodily activity leads to the emergence of new forms of interaction between a person and socio-institutional systems, the specific properties of which are also considered in this article. (shrink)

Tourette syndrome (TS) has been associated with a rich set of symptoms that are said to be uncomfortable, unwilled, and effortful to manage. Furthermore, tics, the canonical characteristic of TS, are multifaceted, and their onset and maintenance is complex. A formal account that integrates these features of TS symptomatology within a plausible theoretical framework is currently absent from the field. In this paper, we assess the explanatory power of hierarchical generative modelling in accounting for TS symptomatology from the perspective of (...) active inference. We propose a fourfold analysis of sensory, motor, and cognitive phenomena associated with TS. In Section 1, we characterise tics as a form of action aimed at sensory attenuation. In Section 2, we introduce the notion of epistemic ticcing and describe such behaviour as the search for evidence that there is an agent (i.e., self) at the heart of the generative hierarchy. In Section 3, we characterise both epistemic (sensation-free) and nonepistemic (sensational) tics as habitual behaviour. Finally, in Section 4, we propose that ticcing behaviour involves an inevitable conflict between distinguishable aspects of selfhood; namely, between the minimal phenomenal sense of self—which is putatively underwritten by interoceptive inference—and the explicit preferences that constitute the individual’s conceptual sense of self. In sum, we aim to provide an empirically informed analysis of TS symptomatology under active inference, revealing a continuity between covert and overt features of the condition. (shrink)

Background. The perception of internal bodily states (interoception) serves as a fundamental mechanism of traumatic experience. In clinical practice, this experience often remains unarticulated and phenomenologically inaccessible due to a deficit in the skill of tacting private events. This creates a fundamental obstacle to the integration of traumatic experience within Trauma-Focused Acceptance and Commitment Therapy (TF-ACT). The study aims to conceptualize the philosophical and methodological dimensions of phenomenological explication as a pragmatic tool for stimulus discrimination in TF-ACT. Methods. The (...) research relies on a comprehensive integration of Contextual Behavioral Science (CBS) and phenomenological methods. Historical and philosophical reconstruction is applied to overcome Cartesian dualism through the 4E cognition paradigm (enactivism). To analyze the transformation of interoceptive experience, the frameworks of Relational Frame Theory (RFT) and micro-phenomenological analysis (EASE scale) are utilized. Results. The complementarity of descriptive contextualism (phenomenology) and functional contextualism (ACT) is demonstrated. Trauma is conceptualized as an ontological rupture in the mode of "being-in-the-world" and a total disruption of stimulus control, where interoceptive signals acquire aversive functions through arbitrarily applied relational framing. It is substantiated that under conditions of continuous traumatic stress (the military context of Ukraine), phenomenological explication acts as a necessary epistemological bridge that translates undifferentiated somatic terror into a structured phenomenon, enabling the processes of defusion and acceptance. Conclusions. Maintaining authentic contact with embodiment requires the integration of micro-phenomenological interviewing into TF-ACT protocols. Phenomenological explication does not contradict radical behaviorism but serves as an instrument of behavioral shaping to establish precise stimulus control over private events, ensuring psychological flexibility under conditions of objective existential threat. (shrink)

Action understanding of children develops from simple associative learning to mentalizing. With the rise of embodied cognition, the role of interoception in action observation and action understanding has received more attention. From a developmental perspective, this study proposes a novel developmental model that explores how interoception promotes action understanding of children across ages. In early infancy, most actions observed in infants come from interactions with their caregivers. Babies learn about action effects through automatic interoceptive processing and interoceptive feedback. (...) Interoception in early infancy is not fully developed, such as the not fully developed gastrointestinal tract and intestinal nervous system. Therefore, in early infancy, action understanding is based on low-level and original interoceptive information. At this stage, after observing the actions of others, infants can create mental representations or even imitate actions without external visual feedback, which requires interoception to provide internal reference information. By early childhood, children begin to infer action intentions of other people by integrating various types of information to reach the mentalizing level. Interoception processing requires the integration of multiple internal signals, which promotes the information integration ability of children. Interoception also provides inner information for reasoning about action intention. This review also discussed the neural mechanisms of interoception and possible ways by which it could promote action understanding of children. In early infancy, the central autonomic neural network (CAN) automatically processes and responds to the actions of caregivers on infants, providing interoceptive information for action understanding of infants. In infancy, the growth of the somatomotor system provides important internal reference information for observing and imitating the actions of infants. In early childhood, the development of interoception of children facilitates the integration of internal and external information, which promotes the mentalization of action understanding of children. According to the proposed developmental model of action understanding of children promoted by interoception, there are multilevel and stage-dependent characteristics that impact the role of interoception in action understanding of children. (shrink)

There is growing attention towards atypical brain-body interactions and interoceptive processes and their potential role in psychiatric conditions, including affective and anxiety disorders. This paper aims to synthesize recent developments in this field. We present emerging explanatory models and focus on brain-body coupling and modulations of the underlying neurocircuitry that support the concept of a continuum of affective disorders. Grounded in theoretical frameworks like peripheral theories of emotion and predictive processing, we propose that altered interoceptive processes might represent transdiagnostic mechanisms (...) that confer common vulnerability traits across multiple disorders. A deeper understanding of the interplay between bodily states and neural processing is essential for a holistic conceptualization of mental disorders. (shrink)

The mainstream science of consciousness offers a few predominate views of how the brain gives rise to awareness. Chief among these are the Higher-Order Thought Theory, Global Neuronal Workspace Theory, Integrated Information Theory, and hybrids thereof. In parallel, rapid development in predictive processing approaches have begun to outline concrete mechanisms by which interoceptive inference shapes selfhood, affect, and exteroceptive perception. Here, we consider these new approaches in terms of what they might offer our empirical, phenomenological, and philosophical understanding of consciousness (...) and its neurobiological roots. (shrink)

Addiction remains a challenging disorder, both to treat and to conceptualise. While the temporal dimension of addiction has been noted before, here the aim is to ground this understanding in a coherent phenomenological-neuroscience framework. Addiction is partly understood as drawing the subject into a predominantly “now” orientated existence, with the future closed or experienced as extremely distant. Another feature of this temporal structuring is that past experiences, which are crucial in advancing intentionally forward, are experienced in addiction as a void. (...) This has implications for the generation of meaning and forming of self, amongst others. While there are areas of the brain that regulate temporal processing, there is no single location. Recent addiction research has implicated the insula and in turn this area is implicated in temporal and interoceptive awareness. Similarly these areas of disruption may affect self processes. Disruption of interoception and thus of self, may help explain why addiction is complex and involves multiple aspects of subjectivity. (shrink)

Psychology distinguishes between a bodily and a narrative self. Within neuroscience, models of the bodily self are based on exteroceptive sensorimotor processes or on the integration of interoceptive sensations. Recent research has revealed interactions between interoceptive and exteroceptive processing of self-related information, for example that mirror self-observation can improve interoceptive awareness. Using heartbeat perception, we measured the effect on interoceptive awareness of two experimental manipulations, designed to heighten attention to bodily and narrative aspects of the self. Participants gazed at a (...) photograph of their own face or at self-relevant words. In both experimental conditions interoceptive awareness was significantly increased, compared to baseline. Results show that attention to narrative aspects of self, previously regarded as relying on higher-order processes, has an effect similar to self-face stimuli in improving interoceptive awareness. Our findings extend the previously observed interaction between the bodily self and interoception to more abstract amodal representations of the self. (shrink)

It has been known for over a century that there is an afferent(body-to-brain), as well as an efferent(brain-to-body), component to the visceral-atonomic nervous system. Despite the fundamental importance of bodily afferent information- sometimes called interoception- to central nervous system control of visceral organ function, emotional-motivational processes, and dysfunction of these processes, including psychosomatic disorders, its role did not receive much attention until quite recently. This is the first comprehensive review of this topic and it covers both neurobiological and psychobiological (...) aspects. The author first defines the issue and gives an historical background starting with the James-Lange theory of emotion, and addresses learning and motivation, roots in Pavlovian conditioning research, and operant conditioning of visceral function. In the second section he reviews recent scientific findings in the neural basis of visceral perception and studies in cardiovascular-respiratory and alimentary interoception. Finally, he discusses several related areas of research and theory including drug state issues, interoception and psychiatric disorders, and bodily consciousness, and suggests directions for future investigation. The book will be of interest to scientists in neurobiology, psychology, and brain imaging, to indivuals in related clinical fields such as psychiatry, neurology, cardiology, gastroenterology, and clinical psychology, and to their students and trainees. (shrink)

The processing, representation, and perception of bodily signals (interoception) plays an important role for human behavior. Theories of embodied cognition hold that higher cognitive processes operate on perceptual symbols and that concept use involves reactivations of the sensory-motor states that occur during experience with the world. Similarly, activation of interoceptive representations and meta-representations of bodily signals supporting interoceptive awareness are profoundly associated with emotional experience and cognitive functions. This article gives an overview over present findings and models on (...) class='Hi'>interoception and mechanisms of embodiment and highlights its relevance for disorders that are suggested to represent a translation deficit of bodily states into subjective feelings and self-awareness. (shrink)

The linguistic representation of interoceptive sensations is valuable not only for the study of cognitive processes, but also for conceptual analysis within the framework of the phenomenal approach in the philosophy of mind. This article focuses on the deep linguistic mechanisms of metaphorical conceptualization of corporeality and their relationship with various classes of judgments expressing awareness of internal bodily experience. Interoceptive sensations are associated with the representation of the image of the inner-body space and the processes occurring in it. The (...) content of these representations is extracted simultaneously from mental beliefs about the properties of one's own physicality and, at the same time, from both real (physical) and imaginary causes of internal states. The main purpose of the article is to reveal the relationship of the semantics of these judgments with the principles of forming a conceptual dictionary of interoceptive sensations coming from a variety of pragmatic contexts. Some results of clinical and semantic studies of psychopathology deserve special attention. Semantic intersections of metaphors in idiomatic expressions of emotional states and judgments describing an abnormal inner-body experience are found. The paper substantiates the thesis that body, in addition to the functions of the organismic “interface” device, also has deep representative properties. While attempting to formulate utterances expressing abnormal inner-body experience, a conceptually conditioned metaphorical dictionary is automatically used. Along with the formation of conceptual schemes, the formation of judgments of awareness about the qualities of one's own conscious experience takes place. (shrink)

Interoception, the ability to feel the body’s internal sensations, is an essential aspect of emotional experience. There is mounting evidence that interoception is impaired in common mental health disorders and that poor interoceptive awareness is a major contributor to emotional reactivity, calling for clinical interventions to address this deficit. The manuscript presents a comprehensive theoretical review, drawing on multidisciplinary findings to propose a metatheory of reinforcement mechanisms applicable across a wide range of disorders. We present a reconsideration of (...) operant conditioning through the co-emergence model of reinforcement, which is a neurophenomenological account of the interaction between cognition and interoception, and its consequences on behavior. The model suggests that during memory processing, the retrieval of autobiographical memory (including maladaptive cognition) is dependent upon its co-emerging interoceptive cues occurring at the encoding, consolidation and reconsolidation stages. Accordingly, “interoceptive reinforcement” during emotional distress is a common factor to all emotional disorders and a major cause for relapse. We propose that interoceptive desensitization has transdiagnostic benefits, readily achievable through the cultivation of equanimity during mindfulness training and can be integrated in cognitive and behavioral interventions to permit a transdiagnostic applicability. We summarize the contributions of this approach into 10 specific and testable propositions. (shrink)