Norm Farb

Interoception in Practice with Bo Forbes (LBP 053)

Bo Forbes is a clinical psychologist, yoga teacher, and Integrative Yoga Therapist. She and I had a chance to talk way back in season one, and today I'm delighted that she joins the show again. A central guiding theme of Bo’s work is with interoception, and she has put together the Interoception Tribal Council which is bringing together researchers, primarily neuroscientists, who are looking at interoception and its effect on the whole person’s health both physically and mentally. In this conversation we talk about some of the amazing research that is coming out these days, but we also talk about her own experience putting her interoceptive abilities to the test when she underwent hip surgery this year- which was her 4th hip surgery in 8 years. It’s a really beautiful story of living one’s practice. I hope you enjoy it as much as I did.

GET IT ON ITUNES

GET IT ON STITCHER

GET IT ON LIBSYN

Conversation highlights

  • The creation of the Interoception Tribal Council- who is participating and what are they working on together?
  • How has interoception become a central part of Bo's work?
  • Bo talks about the study by David Creswell which demonstrates that mindfulness leads to reduced inflammation markers in the body.
  • Remarkably, these changes were absent in people who practiced relaxation without mindfulness.
  • The Default Mode Network of the brain- thinking about the past, wishing things were different, imagining what things will be- the tendency it creates towards a negative self-referential way of being in the world. "I am not worthy" or, "I will never get what I need" messages.
  • This DMN (Default Mode Network) plays a huge role in depression. Mindfulness separates this mode from direct experience. This creates changes in the brain related to depression.
  • The Creswell study encourages specifically people to pay close attention to their bodies- even to notice the negative feelings in their bodies- so he was leading them in increasing interoceptive awareness.
  • Bo's hip surgeries- two doctor errors and one hospital error led to 4 surgeries in 8 years. There was a strong PTSD issue with this, and a compelling narrative that made her look closely at chronic pain, the DMN, and interoception.
  • The idea that someone had damaged her body and ruined it forever was pervasive in her life. The tendency to look for and predict the same pain she had felt the day before. It made her very stuck.
  • Bo's choice to not be put under general anesthesia during the surgery- how that changed her interaction with the doctors and nurses.
  • How Bo used her interoceptive practice to manage the experience of being awake through the surgery. Her intimate relationship with her breath and heart rate in order to maintain staying awake for the surgery.
  • The direct impact the lack of general anesthesia had on her rate of recovery. For whose benefit are patients put under? Is it perhaps a protocol that has become so automatic that it never gets questioned? What happens when we question its necessity?
  • Based on the Creswell study, cultivating this interoceptive ability also likely has a remarkable effect on immunity and the experience of pain. It was amazing how many times in the hospital they wanted her to take something but she didn't need it because she only had some soreness.
  • It's also clear from this experience why we don't want to be in our bodies. Our bodies can be like a vacation home that you haven't gone back to in years and it's gone into disrepair- as you approach that home that hasn't been inhabited in a long time its intimidating.
  • We get deliberate training to be out of body and to focus mostly on what is coming in through the visual cortex. Trauma also makes us not want to be in our body. It doesn't feel like a safe space to be in the body.
  • Nervous system hyper-arousal is a form of collective trauma that we all go through in our culture.
  • Being disembodied is also a form of trauma.
  • Connective tissue has this amazing linkage with interoceptive awareness. Using self-care methods like Yoga Tune Up or MELT- these are objects without emotional load that can help us to check in with our bodies.
  • Just putting our hands on our bodies and bringing attention to our bodies and where our hands meet our bodies can be so helpful.
  • In modern yoga in our culture we have a focus on proprioceptive movement. We start with action, "do this". Then if there's time we will add in an instruction to breath. Then if we really have time there might be an awareness based cue. In [Bo's tradition] they reverse that. Starting with an awareness based instruction, from that place of awareness they can breath or move where awareness is growing.

Resources

Bo's beautiful post on her surgery experience The Beauty of Broken

Bo's article on the Creswell study in Yoga Journal

The New York Times on the Creswell study

The Creswell study in Biological Psychiatry 

Farb and Segal research on the Default Mode Network and depression

Dave Vago

Catherine Kerr

Mind and Life Institute Fellow Program

Mindfulness Based Stress Reduction

If you’re inspired to support the show, you can do that here. You can also leave a review on iTunes or Stitcher  , or simply tell your favorite body nerds about the show. It keeps the show rolling and connects us more as a community. Body nerds unite!

Interoception, Contemplative Practice, and Health with Norm Farb (LBP 052)

Norm Farb is a neuroscientist whose research focuses on the relationship between present moment awareness and well-being. He is in the department of psychology at the RAD Lab (Regulatory and Affective Dynamics Lab) at the University of Toronto Mississaugua. In today’s episode we are talking abouta paper of his titled Interoception, Contemplative Practice, and Health. We dive deep into what the benefits- and risks- are to honing one’s ability to connect with a sense of what is going on in our bodies, and what we appraise that input to mean based on our perceptions of who we are in the world.

GET IT ON ITUNES

GET IT ON STITCHER

GET IT ON LIBSYN

Conversation highlights

  • Norm researches how people develop habits that serve them well or cause suffering, and is focused particularly on contemplative practices.
  • Interoception is a sense of what is going on in our bodies. Bodily sensation comes from inside the skin- for example our heart beat is felt most through skin of chest. Interocpetion also includes what we do with that sensation- it is linked to our conceptual representations of what the sensations mean.
  • There is not a thing such as pure perception- nothing is unadulterated. We always try to fit our perception to our interpretation.
  • Even when signals are first hitting the brain they are already being compared to what it’s similar to.
  • Initial thoughts on interoception were naive in that people thought more interoception was good and blocking sensation was bad. Want to have access to bodily signals, but also to regulate how much impact they have over mood or decision making. It comes down to a person’s interpretive framework.
  • Most people out of touch with their bodies, but it’s too simplistic to say that if people got in more touch with their bodies they would do great. People with anxiety disorders have more awareness of their heartbeat. Interoceptive sensitivity is not a one way street into wellbeing.
  • Panic attacks are an example of interoception gone awry. It is good to have a ping of butterflies in your stomach when public speaking, but n panic attacks there is catastrophization. “What if this is actually threatening to me?”
  • Many contemporary health problems are a result of disregulated interoceptive processes.
  • When people are aimlessly binge watching shows or mindlessly putting food in their mouths- or whatever self soothing there is- they are trying to get away from some discomfort in the body.
  • Let the body be the canary in the coal mine. This isn’t to put the body above cognition- we can do incredible things with our minds- but there is a reason why intelligence doesn’t predict happiness for instance. We can get caught in a local maximum- doing the best we can do in a rational sense but that’s a limiting way of seeing the world.
  • How are you going to escape a depressive self justification unless you can open up to conflicting information?
  • Because the body is an untamed wilderness that’s a really rich place for inquiry.
  • How does interoceptive awareness get integrated? We don’t have strong neural evidence for how it is substantiated in the brain.
  • None of our perceptions are the actual thing.
  • in situations where people have the misfortune to have part of the spinal cord severed and cannot receive input from bodies still they still can have rich emotional lives.
  • Dimasio’s somatic marker hypothesis (in resources)
  • Anhedonia is an example of pleasure signals not making their way through to the representation map. People are living less rich lives when they are not tapping into their bodies- we are cognitive misers and most of us live a life based on what has happened to us.
  • A lot of the path is noticing things i do that make me or other people crazy. Without awareness that conditioning is running my behavior and conditions don’t change
  • Things might seem darker before the dawn because you are coming into contact with how you have been conditioned. You need to open the door and see how cluttered and messy the room is before you can clean it out.
  • Not all habit or behavior needs to be changed but to have deeper meaning one has to be around to witness what’s going on.
  • Presence is allowing oneself to minimize the need to change or regulate what is occurring right now.
  • At the heart of any regulatory state is a rejection of what is happening.
  • The pursuit of happiness as a goal is self-defeating. Allowing experiences to play out without having to react to them.
  • Agency- the feeling that one’s actions can effect desired outcomes in the world.
  • Any systems that fire together wire together. The more we respond with the same response it’s more likely we will respond the same way in future.
  • If you can do something to explore the quality of that stimulation you can starve the resources that would be allocated to responding to that stimulation.
  • Thinking “don’t eat ice cream” is suppressive and we know in long term it’s not successful. As soon as we take energy away from “don’t eat ice cream” it’s the strongest signal. Stick with the sensory aspect of the stimulus arc. In doing that it is literally not reacting with overt behavior- we give the signal the attention not the non-desired outcome.
  • How is interoception an intervention for chronic pain? There is evidence that paying attention to your body and not jumping into actions can turn down inflammatory markers. In the broader sense they are helpful because the suffering that comes from chronic pain is not the same thing as the sensory pain itself.
  • In chronic pain conditions there is a recurring threat message coming from the body. The secondary appraisals about the ability to live the life one wants effects quality of life to a much greater degree than the pain signal itself. Migraine sufferers completely shut down when they feel one coming on. Yet every moment of a headache is not going to be peak intensity. Not every impending migraine is going to have the same catastrophic effect.
  • How can people play with restoring interoception to a healthy state?

Resources

Norm Farb's site

The RAD Lab at the University of Toronto Mississagua

Norm Farb's publications

Paper we discussed: Interoception, contemplative practice, and health

Damasio- The Somatic Marker Hypothesis and the Possible Functions of the Prefrontal Cortex

If you’re inspired to support the show, you can do that here. You can also leave a review on iTunes or Stitcher  , or simply tell your favorite body nerds about the show. It keeps the show rolling and connects us more as a community. Body nerds unite!