UCLouvain researchers are shaking up research in psychology. Interoceptive awareness, the ability to feel the inner states involved in emotional experiences, may have been measured a bit too clumsily over the past 30 years. Examining whether particularly ‘interoceptive’ people could manage their diet better, Professors Olivier Corneille and Olivier Luminet realised that the traditional method of measuring interoceptivity, the ‘Heartbeat Counting Task’—whereby an individual attempts to count his own heartbeats—lacked validity. After two recent publications in Biological Psychology, the professors are preparing to publish in Cognition & Emotion a series of studies that question HCT results in more depth. They are currently looking for a compromise between measure accuracy and measure applicability to the greatest possible number.
‘Butterflies’, ‘blushing’, ‘goose bumps’: the body expresses emotions physiologically. It's not always easy to be aware of, understand, or verbally express them. The brain receives this information, expressed by sensory organs, interprets and translates it into words, thoughts, poems, paintings ... but not everyone is adept at collecting and processing this information. ‘Some people have better “interoceptive” skills than others, in which case we speak of “interoceptive ability”,’ explains Prof. Corneille, a researcher at UCLouvain's Psychological Sciences Research Institute (IPSY). ‘Others are less sensitive to these signals, pay less attention, even don’t know how to give them meaning and express them, in which case, we speak of “alexithymia”.’
Sources of interoceptive measurement
Prof. Corneille, who researches the psychology of attitudes, joined forces with Prof. Luminet, who researches the psychology of emotions. ‘About five years ago,’ Prof. Corneille says, ‘we looked at these notions with the help of Walloon Region research funding coordinated by Prof. Nathalie Delzenne. Initially, we were interested in the links between eating behaviours and emotional processes. It was in trying to examine the impact of emotions on eating behaviour that we looked at interoceptive issues. We then sought to understand whether the regulation of eating behaviours was linked to emotional aspects. We hypothesised that better emotional skills could facilitate food regulation.’
However, to be able to know and regulate one's emotions, an acute awareness of one's bodily states is necessary. The researchers supervised a PhD thesis on the subject written by Giorgia Zamariola. Initial conclusions shattered their hypotheses. ‘First of all, we found no link between body awareness measures and emotional awareness measures’, Prof. Corneille says. ‘Next, while research suggests that greater interoceptive awareness allows individuals to better regulate their emotions, none of the four experiments performed in our laboratory allowed us to establish this link. Then, after two years of inconclusive results, we dared to consider that the validity of the most frequent measure of interoceptive awareness was perhaps ... doubtful.’
Beating hearts to butterflies
For four decades, one measure has been widely accepted within the scientific community as a benchmark for assessing interoceptive skill. ‘In order to assess it,’ Prof. Corneille explains, ‘it’s necessary to be able to establish a link between a biologically measurable interoceptive signal—body expression—and the individual's ability to identify this signal—body awareness. How can we objectively evaluate the quality of this identification?’ Ideally for researchers, by introducing probes into the viscera, but a less intrusive method is widely practised: the ‘Heartbeat Counting Task’ (HCT). An individual is asked to count the number of heartbeats he or she feels over a certain period of time; that number is compared to the actual number. ‘Researchers believe the lesser the absolute difference between objective measurement and subjective perception, the greater the individual’s interoceptive ability. However, such a difference can translate non-interoceptive processes.’
In 90% of cases, individuals underestimate the number of beats. ‘It's very rare for their count to be equal to or higher than the actual count’, Prof. Corneille says. ‘Trust rather than accuracy in signal perception could play an important role in interoceptive performance scores. More generally, we think that tested individuals don’t feel much, if anything at all, under the typical measuring conditions. They’d be satisfied with a simple intellectual estimate, on the basis of their general knowledge. If subjects are asked to report only felt heartbeats, excluding any non-interoceptive calculations or estimates, scores drop by 50%.’
Leaping into the unknown
So how do we evaluate interoceptive sensitivity with greater validity? In supervising a second PhD thesis, funded by FNRS and written by Olivier Desmedt, this question became central to the professors’ project. Other researchers, PhD students and postdocs are also contributing under the supervision of Prof. Luminet. ‘We came back to the heart of the notion of interoception,’ Prof. Corneille says, ‘by asking ourselves, simply but crucially, how to define it more precisely and measure it in a valid way.’ While there are already other measures of interoception, the problem is knowing what to restrict in its definition. For some researchers, measurements inside the body are the only valid ones. However, numerous other measures are possible, such as taste, skin sensations, feeling warm. There is also the question of integrating different signals. ‘The ideal measure should be integrative but not very intrusive, so that it can be done easily. This is the next step in our research: to try to develop a practical, non-invasive, inexpensive measure that advances research with solid results and is, ultimately, clinically useful.’
With a big smile, he adds, ‘We’re leaping into the unknown. For more than 30 years, researchers have been trying to develop this kind of task. Pierre Maurage, an FNRS research associate specialising in psychophysiology, recently joined us on the project. It’ll take all of us to penetrate the subject in the coming years!’
A glance at Olivier Corneille's bio
Olivier Corneille is a UCLouvain full professor in the Faculty of Psychology and Education Sciences (PSP), an FNRS honorary research associate, and member of the Psychological Sciences Research Institute (IPSY). The core of his research concerns preference acquisition.
A glance at Olivier Luminet's bio
Olivier Luminet is an FNRS research director, a part-time UCLouvain professor in the Faculty of Psychology and Education Sciences (PSP), and member of the Psychological Sciences Research Institute (IPSY). He specialises in emotional psychology.
 Desmedt, O., Luminet, O., & Corneille, O. (2018). The heartbeat counting task largely involves non-interoceptive processes: Evidence from both the original and an adapted counting task. Biological Psychology, 138, 185-188; Zamariola, G., Maurage, P., Luminet, O., & Corneille, O. (2018). Interoceptive accuracy scores from the heartbeat counting task are problematic: Evidence from simple bivariate correlations. Biological Psychology, 137, 12-17.
 Giorgia Zamariola, Olivier Luminet, Adrien Mierop & Olivier Corneille (2019). Does it help to feel your body? Evidence is inconclusive that interoceptive accuracy and sensibility help cope with negative experiences, Cognition & Emotion, DOI: 10.1080/02699931.2019.1591345.
 Interoceptive ability or ability to perceive and interpret bodily signals (Cameron, 2001). The ability to detect subtle changes in bodily systems, including muscles, skin, joints, and viscera, is referred to as interoception (Dunn et al., 2010, p. 1835). Recent – but growing – relative study in psychology. Two important dimensions: objectivity (accuracy, with the Heartbeat Counting Task); subjectivity (sensitivity, measured by questionnaire).
 Alexithymia reflects lack of emotional awareness. Interest in it goes back further, with research dating to the 1970s: Sifneos, 1973, or Taylor, Bagby & Parker, 1999, who identify three dimensions to this notion: identifying emotions, describing emotions, operative thinking (measure: CAS questionnaire, Bagby, Parker & Taylor, 1994).
 No links between interoceptive accuracy (HCT) and alexithymia: Zamariola, Giorgia; Vlemincx, Elke; Corneille, Olivier; Luminet, Olivier. Relationship between interoceptive accuracy, interoceptive sensibility, and alexithymia. In: Personality and Individual Differences, Vol. 125, pp. 14-20 (2018). doi:10.1016/j.paid.2017.12.024. http://hdl.handle.net/2078.1/191697.
 Psychometric study of scores (low correlation between counting and beats recorded in HCT task, and a lower correlation among participants with higher scores than average scores of interoceptive accuracy; virtually only underestimation in counts): Zamariola, Giorgia; Maurage, Pierre; Luminet, Olivier; Corneille, Olivier. Interoceptive accuracy scores from the heartbeat counting task are problematic: evidence from simple bivariate correlations. In: Biological Psychology, Vol. 137, no. 1, pp. 12-17 (2018). doi:10.1016/j.biopsycho.2018.06.006. http://hdl.handle.net/2078.1/200261.