Why it matters if you can feel your heartbeat

If you close your eyes and become aware of your body, can you detect your heartbeat — without touching your chest or checking your pulse?

Now, can you do it with your eyes open?

This is a quick measure of your ability to practice “interoception.”

What Is Interoception?

Interoception is the ability to sense your internal states — sensations arising from your inner organs, muscles, and so on. This includes an awareness of the heart.

Many people find it hard to detect their heartbeat at all, or can only do it with difficulty. Their interoceptive powers aren’t well developed. For others, detecting the heartbeat is easy. They have a higher level of interoceptive ability.

Interoception is a word that not a lot of people know. I’ve used the word a lot in my teaching since I first encountered it a few years ago, and there’s almost always someone in the class who hasn’t come across it before.

You’re probably going to hear it a lot more in the future, because it’s become obvious that there are drawbacks to having poor interoception.

Not being able to sense the body’s inner states leads to poor emotional regulation. Imagine you were driving a car with no fuel gauge. You’d probably keep running out of fuel, because vital information about the state of your vehicle wasn’t available to you.

Similarly, if you can’t detect the signals your body is giving you until they’re very strong, you can’t regulate your emotions very well. By the time you’re aware that you’re anxious, for example, you’re already really anxious. Being able to detect those signals sooner means you’re able to decide earlier to do something to help stay calm.

Interoception and Depression

Low interoceptive ability is related to depression. In a study, women who suffered from depression (but not anxiety), showed lower ability on the heartbeat test than a control group did.

Also, the worse their ability to detect the heart, the less positive feelings they reported experiencing in their lives.

Interoception and Poor Decision-Making

And this had an interesting knock-on effect. Low interoceptive awareness is also correlated with difficulty in making decisions. The reason for this is that decision-making is not a purely logical process. Logic can tell us that two slices of chocolate cake is more than one slice of chocolate cake, but not whether we prefer one or two slices. We make decisions largely on the basis of how we feel about things. If we can’t detect our feelings, then we can’t easily make decisions. In fact if we can’t feel our feelings, then we might well be more prone to making bad decisions — e.g. trusting someone who’s untrustworthy, or choosing a job that’s likely to make us unhappy.

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Interoception and Anxiety

My partner is prone to anxiety, and when I asked her to do the heartbeat detection test, she wasn’t sure if she could feel her heart at all. I don’t know if there’s research supporting this, but I suspect that certain people can only feel their heartbeat when they’re already anxious, and because they’re not used to being able to detect the heart under normal circumstances, feeling their heart beat in an exaggerated way is taken as a sign that something is really, really wrong — which precipitates yet more anxiety.

She may be atypical, though: people who suffer from anxiety disorder typically are more aware than average of interoceptive signals from the body. What may be going wrong is that those signals (increased rate and strength of the heartbeat, intestinal queasiness, and so on) are misread, and taken as a sign (again) that something abnormal is happening. It’s possible, in fact, to become anxious about being anxious.

Meditators are Better at Interoception

Meditation, in the Buddhist tradition at least, emphasizes awareness of the body, which means paying attention to the body’s sensations. Many meditators, myself included, will report that training in meditation has helped to sensitize them to the body.

For myself, this has been like going from a black-and-white line drawing of the body to a full-color image. Any time I bring my attention to the body now I experience currents of energy, tingling, and pleasure—which is called pīti in Pāli and prīti in Sanskrit. That’s very different from how my body used to be experienced. But that’s anecdotal evidence.

Dancers Versus Meditators

In one study I’ve long found fascinating, in a study in 2010, published in Emotion, researchers from the University of California, Berkeley, explained how they showed short, emotive, film clips to experienced meditators (their average time practicing was seven years), professional dancers, and a control group. They measured the physiological responses of all these people, and also asked the study participants to indicate their ongoing feeling state (from very negative, through neutral, to very positive) using a dial.

The aim of the study was to assess to what degree the self-reported experience of the members of each of the three groups matched (or was “coherent” with) their physiological states.

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It turned out that the meditators had the highest degree of coherence (that is, their self-reported feelings matched what was going on in their bodies), with the dancers being intermediate, and the control group having the lowest coherence.

Additionally, when it came to self-reported visceral awareness (how well they could feel their feelings), the meditators reported the highest levels, the dancers were intermediary, and the controls reported the lowest levels.

So it does seem that meditation training does improve internal awareness, which is what you might expect. Of course it could be that people with greater visceral awareness are more likely to be drawn to meditation for some reason, so the researchers looked to see if there was a correlation between length of practice and body awareness. They didn’t find any significant correlation, but then the sample size was too small for them to draw any definite conclusions.

Interoception Can Be Learned

More recently (2021), in a study published in The Lancet, researchers explained the effects of giving six sessions of interoception training to autistic adults with persistent anxiety symptoms. People with autism tend not to be good at interoceptive tasks. For example they’re not good at counting their heartbeats. At the same time they tend to over-emphasize the internal sensations they do experience. In other words, they’re over-reacting to signals from the body.

The researchers hoped that their training would help people with autism to perform better on heartbeat detection tasks, and that this would in turn help increase their ability to interpret and regulate interoceptive signals.

Amazingly, three months after the intervention, 31 percent of the participants no longer had an anxiety disorder.

So not only can interoception be learned, but doing so can have profound effects on people’s well-being.

Meditation for Interoception

Many approaches to mindfulness of breathing meditation tend to focus narrowly on the breath – that is, the sensations of air touching the passages as it moves in and out of the body. This helps with learning interoception in only a very limited way.

My own approach has been increasingly to encourage an awareness of the movements and sensations of the breathing in the whole body.

The meditation practice below, which accompanies my book, “This Difficult Thing of Being Human,” helps you to sense the entire body breathing — including subtler sensations you might habitually ignore. Please try it, and see how you get on.