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Co-emergence Reinforcement and Its Relevance to Interoceptive Desensitization in Mindfulness and Therapies Aiming at Transdiagnostic Efficacy

Bruno Cayoun, Alice Shires

Frontiers in Psychology December 22, 2020 DOI: 10.3389/fpsyg.2020.545945 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Theoretical or philosophical paper Peer reviewed
Intervention Mindfulness training
Topics Meditation
Citations 35
Key points Argues that interoceptive cues co-emerging with autobiographical memory retrieval reinforce emotional distress across disorders, making "interoceptive reinforcement" a common factor and major cause of relapse. Proposes that interoceptive desensitization through equanimity cultivated in mindfulness training could yield transdiagnostic benefits and be integrated into cognitive and behavioral interventions, summarized as 10 testable propositions.

Abstract

Interoception, the ability to feel the body's internal sensations, is an essential aspect of emotional experience. There is mounting evidence that interoception is impaired in common mental health disorders and that poor interoceptive awareness is a major contributor to emotional reactivity, calling for clinical interventions to address this deficit. The manuscript presents a comprehensive theoretical review, drawing on multidisciplinary findings to propose a metatheory of reinforcement mechanisms applicable across a wide range of disorders. We present a reconsideration of operant conditioning through the co-emergence model of reinforcement, which is a neurophenomenological account of the interaction between cognition and interoception, and its consequences on behavior. The model suggests that during memory processing, the retrieval of autobiographical memory (including maladaptive cognition) is dependent upon its co-emerging interoceptive cues occurring at the encoding, consolidation and reconsolidation stages. Accordingly, "interoceptive reinforcement" during emotional distress is a common factor to all emotional disorders and a major cause for relapse. We propose that interoceptive desensitization has transdiagnostic benefits, readily achievable through the cultivation of equanimity during mindfulness training and can be integrated in cognitive and behavioral interventions to permit a transdiagnostic applicability. We summarize the contributions of this approach into 10 specific and testable propositions.

Comparable studies

Other theoretical and historical papers on meditation, most cited first.

Study Year Design Participants
Mindfulness: A proposed operational definition. 2004 Theoretical or philosophical paper
Mechanisms of mindfulness 2005 Theoretical or philosophical paper
How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective 2011 Theoretical or philosophical paper
Mindfulness-based cognitive therapy for depression 2006 Theoretical or philosophical paper
Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness 2012 Theoretical or philosophical paper

Citations in the library

Cited by 15

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Cites 33

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