Linking Body Awareness to Health & Well-Being
A central focus of Rosen Method Bodywork (RMB) is to help clients increase their body awareness. Why is this important? Below are links to articles from leading neuroscience and medical journals showing that interoception, or body awareness, facilitates maintaining a healthy balance (homeostasis) in the immune, cardiovascular, digestive, respiratory, hormonal, and nervous systems.
Conscious awareness of how our bodies feel in health and illness is necessary for the nervous system to locate in the body the sources of disease and direct the body’s own resources to facilitate healing. Everyone knows, for example, that if there is a physical wound or injury, the immune system temporarily sends inflammatory cells, the first stage of healing before repair cells are activated, to that specific area of the body. What we did not know until recently is that paying conscious attention, bringing body awareness, to the location of the injury (feeling, for example, the pain, anger or sadness connected to the circumstances of the injury) allows us to activate additional forms of self-care. We can apply bandages and antibiotic ointments, seek medical attention if needed, and take time for rest so that we can recover more quickly. This simple example shows how interoception can boost the healing power of the immune system.
As you will see in the articles below, body awareness is a necessary component for healing both physical and emotional trauma and illness, alone or as an adjunct to medical and psychiatric care. In addition, these research articles show that the health-promoting functions of interoception can – like any other body function – become impaired under conditions of stress and trauma. The nervous system shifts the body into a defensive mode to protect against perceived threats from outside or inside of our bodies. If we are being attacked, threatened or in a stressful situation, interoception would take energy and resources away from self-protection. Illness is more likely to develop when our bodies continue in this defensive trauma mode even after the threat has passed. This is why body awareness therapies such as RMB are needed: to restore our ability to feel ourselves in the present moment to aid in trauma recovery.
Article 1: The Neurobiology of Interoception in Health and Disease, published in the Annals of the New York Academy of Sciences, Special Issue: Health Neuroscience (2018).
Adapted summary: This important article is a comprehensive review of the relationship between interoception and health. Compared to exteroception which gives us information about the environment outside the body (sight, sound, smell), interoception gives us information about the environment inside the body. Interoception begins as neural signals from different body organs and systems, transmitted along the spinal cord and brain stem to the interoceptive areas of the brain (the insula, thalamus, anterior cingulate and medial pre-frontal cortex) where it is transformed into felt experiences such as cold or warm, aroused or calm, healthy or ill, happy or sad.
This article describes the neurophysiology of how interoceptive neural networks in the brain and body are linked to networks that regulate physiological health in all body systems (immune, cardiovascular, digestive, hormonal, etc.) as well as to networks that control thinking, acting, and decision making. Interoceptive impairments are neurobiologically related to particular physical and mental health conditions, including sickness behaviors and fatigue, depression, eating disorders, and anxiety.
Treatments to enhance interoception have been shown to improve many different types of mental and physical health conditions. According to the authors, “There is increasing evidence that the signaling, sensing, and detection of bodily states are implicated in physical and mental well-being.”
Article 2: When the Brain does not Adequately Feel the body: Links between Low Resilience and Interoception. Biological Psychology (2016).
Adapted summary: This article reports on a research study in which activity in the interoception areas of the brain was compared between individuals with low resilience vs. high resilience. Resilience refers to one’s ability to positively adapt to stress, trauma, and adversity by using appropriate cognitive, emotional, and physiological resources in response to a stressor, and conservation of these resources once the stressor is removed. People who are low on resilience are less likely to regain normal function following stressful situations creating the conditions for a broad spectrum of both mental and physical illnesses because the body systems related to stress responses remain activated and drain resources for recovery and restoration.
The important finding of this research is that low resilience individuals were also low on interoception (they were less able to feel the effects and after-effects of stress) even though the brain regions related to interoception (insula and thalamus, for example) remained activated. This means that for these low resilience individuals, their brain continued to send signals related to distressed feelings, pain, and higher physiological arousal. Instead of these signals being brought into conscious awareness, they were re-directed to the brain regions related to activation of stress responses (amydala, hypothalamus, and hippocampus) resulting in increased stress hormones, constrained respiration, and altered heart rates. In other words, as low resilient individuals begin to feel their own pain, it activates a stress response coming from inside the body, and thus shuts down interoception before it can be fully experienced.
The authors recommend “bodily awareness training as potential interventions for those who report impaired stress resilience. . . because reduced interoceptive monitoring may lead to poor integration of current body states to predict future body states. In other words, low resilient individuals may not be effectively using information from the moment, which may lead to impaired decision making in the presence of stressful environments.”
The following four articles reveal similar findings as the two described above: prolonged stress responses reduce the ability of brain regions related to interoception to transform these neural signals into conscious awareness of body states and emotions. Impaired interoception under stress activates the amygdala, hypothalamus and hippocampus all of which keep the body in a state of high alert and produce low resilience, poor recovery, and illness states. Article 3 specifically links impaired interoception to chronic states of anxiety. Article 4 shows how chronic depression is also linked to impaired interoception and increased stress responses. Article 5 shows how impaired interoception increases chronic inflammation in the immune system which can lead to both mental and physical illnesses. Finally, article 6 is a summary of the combined effects of stress and low interoception on illness throughout the body and mind. All these articles propose adding body awareness treatments to standard medical, psychiatric and psychotherapeutic interventions.
Article 3: Altered Functional Connectivity of Interoception in Illness Anxiety Disorder. Cortex (2017).
Article 4. Major Depressive Disorder Is Associated With Abnormal Interoceptive Activity and Functional Connectivity in the Insula. Biological Psychiatry (2014).
Article 5. Interoception and Inflammation in Psychiatric Disorders. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging (2018).
Article 6. Interoception and Stress. Frontiers in Psychology (2015).
Rosen Method Bodywork (RMB) is an evidence-based therapy meant to develop an expanded capacity for interoception of felt body experiences in the present moment. RMB practitioners are trained to understand the basic biological facts described in these articles: that trauma shuts down the interoceptive networks of the nervous system and the ongoing post-traumatic memories and fears continue to activate stress responses that keep people at a distance from their own felt experience.
Trained RMB practitioners create security in the therapeutic environment so that over time, clients can gradually begin to sense that they are safe enough to allow their body feelings to re-emerge in present moment awareness. Clients come to understand how their body awareness has been impaired by stress and trauma. As they slowly regain their ability to access their body awareness, the interoception neural networks can locate the sources of disease and distress and send signals to other functional systems in the body that allow for a return of well-being, health, and self-confidence, eventually moving people out of dysfunctional post-traumatic stress states.
This page was prepared by Alan Fogel, a Rosen Method Bodywork practitioner and senior teacher. He is the founding editor of the Rosen Method International Journal and the author of the book, Body Sense: The Science and Practice of Embodied Self-Awareness (W. W. Norton, 2013).