How do we relate to our heart? Neurobehavioral differences across three types of engagement with cardiac interoception

Standard measures of interoception are typically limited to the conscious perception of heartbeats. However, the fundamental purpose of interoceptive signaling, is to regulate the body. We present a novel biofeedback paradigm to explore the neurobehavioral consequences of three different types of engagement with cardiac interoception (Attend, Feel, Regulate) while participants perform a 'cardiac recognition' task. For both the Feel and Regulate conditions, participants displayed enhanced recognition of their own heartbeat, accompanied by larger heartbeat-evoked potentials (HEPs), suggesting that these approaches could be used interchangeably. Importantly, meta-cognitive interoceptive insight was highest in the Regulate condition, indicative of stronger engagement with interoceptive signals in addition to greater ecological validity. Only in the passive interoception condition (Feel) was a significant association found between accuracy in recognising one's own heartbeat and the amplitude of HEPs. Overall, our results imply that active conditions have an important role to play in future investigation of interoception.