Taking time to feel our body: Steady increases in heartbeat perception accuracy and decreases in alexithymia over 9 months of contemplative mental training

Abstract

The ability to accurately perceive signals from the body has been shown to be important for physical and psychological health as well as understanding one's emotions. Despite the importance of this skill, often indexed by heartbeat perception accuracy (HBPa), little is known about its malleability. Here, we investigated whether contemplative mental practice can increase HBPa. In the context of a 9-month mental training study, the ReSource Project, two matched cohorts (n = 77 and n = 79) underwent three training modules of 3 months' duration that targeted attentional and interoceptive abilities (Presence module), socio-affective (Affect module), and socio-cognitive (Perspective module) abilities. A third cohort (n = 78) underwent 3 months of practice (Affect module) and a retest control group (n = 84) did not undergo any training. HBPa was measured with a heartbeat tracking task before and after each training module. Emotional awareness was measured by the Toronto Alexithymia Scale (TAS). Participants with TAS scores > 60 at screening were excluded. HBPa was found to increase steadily over the training, with significant and small- to medium-sized effects emerging after 6 months (Cohen's d = .173) and 9 months (d = .273) of mental training. Changes in HBPa were concomitant with and predictive of changes in emotional awareness. Our results suggest that HBPa can indeed be trained through intensive contemplative practice. The effect takes longer than the 8 weeks of typical mindfulness courses to reach meaningful magnitude. These increments in interoceptive accuracy and the related improvements in emotional awareness point to opportunities for improving physical and psychological health through contemplative mental training.

Effects of mindfulness-based interventions on alexithymia: a systematic review

“…The mean age ranged from 23.5 to 53.8, with one study restricting the age range of eligible participants to between 20 and 55 35. Three studies were drawn from non-clinical samples35–37 and two studies35 37 additionally excluded individuals in poor psychological health.…”

“…A third study tested a bespoke mindfulness-based programme of contemplative mental training delivered in three different 3-month modules 35. In this study, two intervention cohorts participated in all three modules in a different order, one intervention cohort only took one 3-month module and a control group had no training.…”

“…All four studies measured alexithymia using the Toronto Alexithymia Scale (TAS20) 1. In one study,35 individuals with a TAS20 score of over 60 were excluded. Other variables measured are described in table 1.…”

“…In two studies, the study endpoint coincided with the end of treatment for all participants 36 37. In Bornemann and Singer,35 data from the three experimental cohorts at the end of their respective treatment periods were combined. In the case of Viding et al ,38 the study endpoint occurred at the 6-month follow-up assessment.…”

“…At T 1 , the results from the four studies show that although alexithymia levels were lower in the experimental group than the control group, the overall effect of treatment was not significant, with significant heterogeneity (MD=−4.59, 95% CI −9.31 to 0.12, p=0.06; I 2 =64%, 441 participants). Excluding Bornemann and Singer,35 on the grounds that the intervention was not complete for most participants at T 1 , produced a significant model (MD=−6.91, 95% CI −11.52 to −2.30, p=0.003, 134 participants), and reduced heterogeneity to I 2 =19%. The difference between experimental and control groups at T 2 , based on two studies, was not significant (MD=−3.04, 95% CI −7.24 to 1.16, p=0.16, 276 participants).…”