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How accurate is your interoception?

As we discussed in last week’s post, interoception is the ability to sense and perceive the internal state of your body, such as your heartbeat, breathing, hunger, or pain. Interoception is crucial for maintaining homeostasis, regulating emotions, and developing a sense of self (Tsakiris, 2017).

But how accurate is your interoception? How well can you detect and identify the signals from your body? This is what interoceptive accuracy (IA) measures. IA is typically assessed by asking people to count their heartbeats without feeling their pulse or using any external cues. The difference between the actual and the reported number of heartbeats indicates the level of IA.

IA varies widely across individuals and contexts. Some factors that can influence IA are age, gender, personality, mood, attention, and physical activity. For example, women tend to have higher IA than men, and anxiety and depression are associated with lower IA (Paulus & Stein, 2010). Additionally, IA can be improved with training and practice, such as mindfulness, meditation, or biofeedback.

Heart rate variability and interoceptive accuracy

One aspect of interoception that has received a lot of attention in recent years is heart rate variability (HRV). HRV is the variation in the time intervals between consecutive heartbeats. HRV reflects the balance between the sympathetic and parasympathetic branches of the autonomic nervous system, which control the fight-or-flight and the rest-and-digest responses, respectively.

HRV is considered a marker of physiological and psychological flexibility, resilience, and adaptability. Higher HRV is associated with better physical and mental health outcomes, such as cardiovascular fitness, immune function, emotional regulation, and cognitive performance. Lower HRV is linked to increased risk of stress, inflammation, and chronic diseases.

However, how does HRV relate to IA? Several studies have shown that people with higher HRV tend to have higher IA and vice versa. This suggests that HRV and IA share some common neural and psychological mechanisms, such as the insula, the anterior cingulate cortex, and the prefrontal cortex, which are involved in interoceptive processing, attention, and executive control (Mehling et al., 2011).

Heart rate variability biofeedback and interoceptive accuracy

If HRV and IA are correlated, can we improve one by enhancing the other? This is the idea behind heart rate variability biofeedback (HRVB). This technique involves monitoring and modulating your own HRV by using real-time feedback from a device or an app. HRVB aims to increase your awareness and control of your cardiac activity and autonomic balance, as well as your emotional and cognitive states.

HRVB typically involves breathing exercises that synchronize your inhalation and exhalation with your heart rate, creating a harmonious pattern of HRV. This pattern, called resonance frequency breathing, usually occurs at around six breaths per minute, but it can vary depending on the individual. Resonance frequency breathing can optimize your HRV and enhance your parasympathetic activity, resulting in a state of relaxation, calmness, and coherence. The Optimal HRV app allows you to establish your resonance frequency breathing rate and utilize that rate for a range of HRVB and mindfulness practices.

Several studies have shown that HRVB can improve IA and other outcomes related to interoception, such as emotion regulation, stress reduction, and psychological well-being. For example, a recent meta-analysis found that HRVB can significantly increase IA, especially when combined with other interoceptive training methods, such as mindfulness or body scanning (Zamariola et al., 2018).


Interoceptive accuracy is an essential skill that can affect your physical and mental health and sense of self. HRV is a crucial component of interoception that reflects your autonomic balance and flexibility. HRVB is a technique that can help you improve your HRV and IA, as well as your emotional and cognitive functioning. By practicing HRVB, you can become more aware and attuned to your body and mind and achieve a state of harmony and coherence. Learn more about how you and measure your HRV and practice HRVB at


  • Mehling, W. E., Gopisetty, V., Daubenmier, J., Price, C. J., Hecht, F. M., & Stewart, A. (2011). Body awareness: construct and self-report measures. PloS one, 6(4), e18785.

  • Paulus, M. P., & Stein, M. B. (2010). Interoception in anxiety and depression. Brain structure and function, 214(5-6), 451-463.

  • Tsakiris, M. (2017). The multisensory basis of the self: from body to identity to others. The Quarterly Journal of Experimental Psychology, 70(4), 597-609.

  • Zamariola, G., Maurage, P., Luminet, O., & Corneille, O. (2018). Interoceptive accuracy scores are mainly unaffected by metacognitive processes: A latent variable analysis of the heartbeat perception task. Biological psychology, 137, 12-20.


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