Dissociative Symptoms and Interoceptive Integration.

Dissociative symptoms involve disturbances in self-experience and perception, linked to a breakdown in the integration of consciousness, memory, identity, emotion, and perception. This paper examines dissociation through the lens of interoception, the sense of the body's internal state. Dissociative symptoms are associated with blunted autonomic reactivity and reduced interoceptive precision. Interoceptive signals shape emotional feelings, memory, and self-representation. Disrupted integration of these signals into cognition may contribute to detachment from the body and world, blunted emotions, and altered recall. Understanding altered interoceptive integration could reveal neurophysiological mechanisms underlying dissociative disorders and inform new therapeutic approaches targeting interoceptive processing.

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Abstract

Dissociative symptoms and disorders of dissociation are characterised by disturbances in the experience of the self and the surrounding world, manifesting as a breakdown in the normal integration of consciousness, memory, identity, emotion, and perception. This paper aims to provide insights into dissociative symptoms from the perspective of interoception, the sense of the body's internal physiological state, adopting a transdiagnostic framework.Dissociative symptoms are associated with a blunting of autonomic reactivity and a reduction in interoceptive precision. In addition to the central function of interoception in homeostasis, afferent visceral signals and their neural and mental representation have been shown to shape emotional feeling states, support memory encoding, and contribute to self-representation. Changes in interoceptive processing and disrupted integration of interoceptive signals into wider cognition may contribute to detachment from the body and the world, blunted emotional experience, and altered subjective recall, as experienced by individuals who suffer from dissociation.A better understanding of the role of altered interoceptive integration across the symptom areas of dissociation could thus provide insights into the neurophysiological mechanisms underlying dissociative disorders. As new therapeutic approaches targeting interoceptive processing emerge, recognising the significance of interoceptive mechanisms in dissociation holds potential implications for future treatment targets.