Frontiers in Psychology
January 1, 2012
Anil K. Seth, Keisuke Suzuki, Hugo Critchley
971 citations
Conscious presence—the feeling of being a self located in a here and now—arises when the brain successfully suppresses interoceptive prediction errors via top-down predictions. A theoretical model links presence to the anterior insular cortex (AIC), which compares predicted versus actual bodily signals. When afferent sensory signals are judged as self-generated, predicted interoceptive signals differ from when they are externally caused, connecting presence to agency. The model integrates evidence from predictive coding, dopamine signaling, virtual reality studies, and depersonalization/derealization disorder. It proposes that emotion results from interoceptive inference and offers testable predictions for experiments manipulating both agency and presence.
Neuropsychologia
August 28, 2013
Keisuke Suzuki, Sarah N. Garfinkel, Hugo Critchley et al.
491 citations
Identifying with a body is central to being a conscious self. The classic rubber hand illusion shows that body-ownership can be modulated by timing visual and tactile feedback, and its strength relates to individual differences in sensitivity to internal bodily signals (interoception). Here, an innovative cardiac rubber hand illusion using augmented reality and feedback of cardiac information demonstrates that both subjective and objective measures of virtual-hand ownership are enhanced by cardio-visual feedback in-time with the actual heartbeat compared to asynchronous feedback. These measures correlate with interoceptive sensitivity and are also modulated by integrating proprioceptive signals via real-time visual remapping of finger movements. Interoceptive signals directly influence body ownership through multisensory integration, supporting models of conscious selfhood based on interoceptive predictive coding.
Neuroscience and biobehavioral reviews
December 1, 2023
Guy W Fincham, Amy Kartar, Malin V Uthaug et al.
41 citations
High Ventilation Breathwork (HVB)—volitional manipulation of breathing used historically for psychological distress—produces extraordinary changes in subjective experience and profound effects on central and autonomic nervous systems by modulating neurometabolic parameters and interoceptive sensory systems. Clinical observations and neurophysiological studies indicate these practices may have therapeutic potential for trauma-related, affective, and somatic disorders. The evidence base suggests that the phenomenological effects of HVB can be understood and potentially harnessed through volitional perturbation of psychophysiological state, but further research is needed for detailed mechanistic knowledge and rigorous clinical testing of these potential uses.
Cognitive Neuropsychiatry
February 27, 2018
Geoff Davies, Charlotte L. Rae, Sarah N. Garfinkel et al.
23 citations
People in the early stages of psychosis show a reduced ability to accurately evaluate their own perceptions, a metacognitive deficit. In a perceptual decision-making task, individuals with first-episode psychosis performed worse on metacognitive accuracy than healthy controls, even when their basic perceptual performance was accounted for. Grey matter volume was also reduced in the superior frontal gyrus, a brain region linked to metacognition. However, no direct relationship was found between grey matter volume and metacognitive accuracy, leaving the neural basis of this deficit unclear. These findings suggest that a specific problem in scrutinizing one's own perceptions may underlie later functional difficulties in schizophrenia.
August 1, 2023
Guy W. Fincham, Amy Kartar, Malin V. Uthaug et al.
3 citations
preprint
High Ventilation Breathwork (HVB), which involves deliberate manipulation of breathing, has a long history of use for psychological distress. This review examines its potential as a treatment for psychiatric disorders by analyzing its phenomenological and neurophysiological effects. Clinical observations and neurophysiological data show HVB produces extraordinary changes in subjective experience and profoundly affects central and autonomic nervous system functions by modulating neurometabolic parameters and interoceptive sensory systems. These effects may guide understanding and harnessing of HVB's volitional perturbation of psychophysiological states. Reports of beneficial effects for trauma-related, affective, and somatic disorders warrant further mechanistic research and rigorous clinical testing.
PLoS ONE
August 27, 2025
Amy Kartar, Toru Horinouchi, Balázs Örzsik et al.
1 citation
High ventilation breathwork (HVB), which involves rapid or deep breathing often accompanied by music, can produce altered states of consciousness (ASCs) similar to those caused by psychedelic substances, including euphoria, bliss, and perceptual changes. The neurobiological mechanisms behind these effects were largely unknown. In experienced practitioners, the intensity of ASCs from HVB was proportional to cardiovascular sympathetic activation and to changes in cerebral blood flow in the left operculum/posterior insula and right amygdala/anterior hippocampus—brain regions involved in sensing breathing and processing emotional memories. These brain changes may underlie the positive therapeutic outcomes associated with HVB.