More than meets the mirror

My latest story for Scientific American, More Than Meets the Mirror, is actually relevant to this blog (it doesn't happen very much!).  It's about the relationship between body image and what's known as interoceptive awareness.

Are you cold?  Thirsty?  Hungry?  Short of breath?  Whatever your answer, you used interoceptive awareness to answer the question.  Previous research has linked interoceptive awareness to the insula, and people with eating disorders have been shown to have deficits in both of these areas.  But that didn't mean the two were necessarily related.  After all, I have red hair and green eyes, but my green eyes didn't cause my red hair (for that, I thank Garnier Nutrisse Honeydip).

So a neuroscientist at the University of London devised an experiment where he tested students' interoceptive awareness by having them measure their heartbeat without taking their pulse.  Then he used a trick known as the rubber hand illusion to trick the students into thinking that a rubber hand was actually a part of their body.  Those students with low interoceptive awareness were more susceptible to the rubber hand illusion.

From the story (I do feel a little weird quoting myself, but whatever):

"People with low interoceptive awareness might have a less strict distinction between what is 'my body' and what is the external world," Tsakiris says. "They might be ruled more by vision, rather than by internal sensation." Previous studies have also found that people with anorexia have an impaired ability to sense internal cues, making the results of this new work useful for understanding and potentially treating severe body-image disturbance.
To be sure, the study used a small sample size and has not yet proved causation, but "if we can train people to sense their interoceptive states," Tsakiris says, "it might make a change in their body image. An interesting avenue for future research would be to see if improving interoceptive awareness impacts different areas of these disorders."

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Unknown said...

id be interested to read more about the study! reminds me of a placebo effect

Fellow OCD Sufferer said...

Wow! I admire the fact that you write articles for Scientific American! Being the science nerd that I am, I love reading Scientific American Mind just for fun. :)

I haven't read your actual article yet, but I'm looking forward to it! I find this topic interesting because I often feel like I have deficits in my own interoceptive awareness. I realize it's not quite the same thing, but in the process of OCD treatment, I have always been slightly baffled when therapists' have asked me to rate my anxiety level. My response: "Uh...I don't know. I can't tell. How am I supposed to determine how I feel or the degree of anxiety I'm experiencing?"

Maybe being able to recognize and rate your own feelings is somewhat different from being able to recognize more physical sensations like thirst or hunger or body temperature, but if recognizing your emotions is also part of interoceptive awareness, I think I definitely struggle with it!

Cathy (UK) said...

Love the article Carrie; you always write so well :)

When I first read about the study by Tsakiris et al. (and the media got rather excited about it in the UK...) I must admit that I felt a little frustrated with the link it made to anorexia nervosa (AN).

The study itself is interesting, but when the data are linked to AN, the inference is made that individuals with AN reduce their food intake with the objective of reducing their body size. In other words, the cause of AN is assumed to be body dissatisfaction and/or body dysmorphia (where the latter assumes that the individual's perception of their body size/shape is erroneous).

But some people with AN, and I was one, NEVER have body dysmorphia. When my BMI was 13, 14, 15, 16, 17, 18 I could see that I was thin. There was no misperception. Yet, I felt compelled to restrict and control my diet because it made me less anxious. The failure I had was being sufficiently bothered by my thinness to do anything about it - in conjunction with being terrified of having a lot of food inside me.

hm said...

Something about this is cracking me up- people disowning their hands in favor of rubber hands. Ha ha ha! Poor real hands that get abandoned. That would so be me!!! "Are you hungry? Are you cold? Are you sick? Are you tired?" would all elicit an "I don't know" from me on the spot, with further concentration and thought needed to come up with an actual answer. I so do not feel like a part of my body most of the time.

The implications are pretty cool- that training in body awareness and signals could positively affect dysmorphia. Now as to how that training would be accomplished- ??? Hmmm...

I wonder if it is also a kind of dysmorphia, not just to see "dangerously skinny" as "fat," but also to see "dangerously skinny" as "not dangerous." That seems like cues not going off appropriately in the brain w/regards to physical self perception too.

Regardless. In yoga, my (wonderful, dear) teacher has us take time to focus in on different parts of our body and define them internally (does your leg feel heavy? light? warm? cold? tense? relaxed?) and then acknowledge how they feel to ourselves. I never saw the validity in this and have rolled my eyes behind my closed eyelids more than once during these exercises. (Come ON- I want to WORK this muscle, not freaking ACKNOWLEDGE it!!!) But this article is making me consider that such strange exercises might not be a waste of my time, and might actually contribute to my recovery process. Wouldn't THAT be nice? I think I'll tune in next time and see if I can define and acknowledge along with the rest of the class...

In the meantime, I've got this urge to go out and buy myself a rubber hand!!!

Jessica said...

First of all, I have to say, this is the first article I've read that was written by you - you are a wonderful writer! I already knew that from your blog, but reading an article about science from you let me a see a different writing "technique" of yours. :)

The whole concept is amazing. I think that the mind is so interesting, in that people CAN actually see themselves so much larger than they are, and yet this actually affects more things then just that. I do have to say, that at times getting my heart rate done at the doctors, I did think that my heart was beating faster than it showed up to be beating. I do not have a good sense of it, usually when i go to my appointments I can not tell how my heart rate will be.

The article kind of makes me want to do an experiment when I go to my appointment tomorrow, letting me count my pulse and then having my doctor do it. I think it'd be interesting to try it out myself!

HikerRD said...

Great article, Carrie! The research, however, is less impressive. Besides, as you point out, that it merely shows association (vs. causation), we don't even know what came first. Perhaps having anorexia causes a decrease in internal awareness, as opposed to the other way around.There's certainly evidence for that--there's a decrease in perception of hunger, for instance, with starvation.

And how would they explain a lower interoceptive awareness in anorexics when they didn't always have (and often don't have) body dysmorphia, as another reader pointed out? (Unless it is secondary to the EDz)
Thanks for this interesting piece!

hm said...

I don't know- dysmorphia or not, there is a pretty well researched disconnect between anorexics and their bodies and feelings- just like I can't tell when I feel sick, I also can't tell when I feel sad- I absolutely see the validity in developing the ability to recognize internal cues, whether they are physical or emotional- does it really matter which came first, the disconnect or the anorexia? The point is it needs to be reworked- connections made between brain and body, brain and feelings, body and feelings- to help develop into a "whole" person who can make healthy choices and live in recovery.

I guess the article emphasizes becoming more interospective with the goal of making a change in body image- *shrugs*- that's neither here nor there to me. I see the real treasure coming from this research being the link that people who are less interospective are more likely to disown their own bodies and not take care of them [the temperature decrease in the disowned hand]. It makes sense that you'd need to acknowledge something in order to be capable of taking care of it.

If, for instance, you had a pet cat but for some reason you couldn't hear it mew and you kept forgetting it existed (or weirder yet, you kept mistaking it for the porcelain statue by the front door), it'd be mighty hard to remember to feed it, to change the litter box, etc. Whether it was a cute cat or an ugly cat (are there ugly cats???) wouldn't matter- a decent person would still take care of it- but not if their brain kept not allowing them to acknowledge it was THERE.

You have to be aware of something in order to tend to it.

Cammy said...

Have you read the book 'The Body has a Mind of its Own?' Really great look at proprioception and related issues, including how we perceive our own weight loss or gain, gave me the idea for the body image vs body schema blog post I did a while back. The brain is so fascinating. And major congrats on the SciAm article!

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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