Interoception, contemplative practice, and health (Farb et al. 2015)
An integrative theory paper written by a working group convened at the Mind and Life Institute (April 2013) to unify neuroscience, clinical psychology, and contemplative-studies perspectives on interoception. It takes Seth’s (2013) predictive-coding model of interoceptive inference as its scientific spine and builds outward toward mechanisms of contemplative practice and clinical application — making it the applied/clinical counterpart to Seth’s more purely theoretical piece.
The simulation map
Farb et al. introduce the simulation-map: a layered “as-if” representation of body state (cf. Damasio), continuously constructed from the integration of current sensory afferents and prior expectations. Critically, the simulation map — not raw current sensation — is proposed as the construct closest to interoceptive awareness. Only a subset of its layers is consciously accessible (the “phenomenal map” is a subset of the broader simulation map). This is offered as the scientific counterpart to the contemplative subtle-body construct (channels, chi/prāṇa, energy centers), with the relationship between the two explicitly flagged as unresolved.
Active vs. perceptual inference
The paper’s central theoretical move is splitting prediction-error minimization (already present in Seth’s framework) into two named, contrasted regulatory routes — see active-inference and perceptual-inference:
- Active inference: weight priors over sensation; act (behaviorally or autonomically) to make sensation match expectation.
- Perceptual inference: weight sensation over priors; update expectation to match sensation.
Modern psychological emotion regulation (suppression, distraction, reappraisal) is mapped onto active inference; contemplative strategies (acceptance, equanimity, non-interfering observation) onto perceptual inference. The authors explicitly note this classification of acceptance as “bottom-up” rather than “top-down cognitive” may be controversial — see does-mindfulness-enhance-interoceptive-accuracy and the broader feedforward-vs-predictive-interoception debate for related territory. Their working (untested) hypothesis: because bodies show more variance than people expect, contemplative practice broadens (de-precisifies) priors rather than sharpening them.
Presence and agency, extended
Building on Seth, Suzuki & Critchley (2011), presence and agency are recast as presence-and-agency. Where Seth et al. attributed presence only to active-inference-based error minimization, Farb et al. argue presence is also reachable via perceptual inference (“effortless presence”) — broadening priors so fewer sensations register as prediction error. Agency remains tied to overt active inference and is clinically double-edged: in anxiety, agency achieved through avoidance is reinforcing but prevents disconfirmation of the feared outcome, entrenching the disorder.
Interoceptive taxonomy
Following Garfinkel & Critchley (2013) and anticipating Garfinkel et al. (2015), the paper proposes a interoceptive-taxonomy of seven partially dissociable constructs (awareness, coherence, attention tendency, sensitivity, accuracy, sensibility, regulation), arguing that collapsing them under one “interoceptive sensitivity” label produces spurious inferences — e.g., meditators’ strong interoceptive attention does not predict superior heartbeat-detection accuracy (Khalsa et al. 2008; Parkin et al. 2013). See interoceptive-sensitivity for the pre-existing wiki treatment this updates.
Mechanisms of mindfulness and clinical applications
Seven proposed mechanisms of contemplative training are reviewed (enhanced sensitivity, non-reactivity, regulation, insight, presence/agency, positive experience, embodied effects), alongside concrete clinical vignettes — sexual-trauma recovery, chronic pain, substance use, and a sharp caution around anorexia nervosa, where interoceptive attention can increase maladaptive behavior absent skillful, trauma-informed support. See interoceptive-training-clinical and mindfulness-interoceptive-training.