In the vast, intricate landscape of human experience, few phenomena are as fundamental yet as elusive as interoception—the capacity to detect and interpret signals originating from within the body itself. This internal sensory system underpins not only our perception of physiological states such as hunger, heartbeat, and respiration but also plays a profound role in shaping our emotional landscape, mental well-being, and physical health. In recent years, an explosion of scientific interest has illuminated interoception’s critical function as a bridge between body and mind, revealing its influence on everything from emotional regulation to chronic disease. Yet, despite these advances, the roots and vulnerabilities of interoceptive processes remain only partially understood.
A particularly compelling frontier in interoceptive research intersects with the shadowy domain of childhood maltreatment—a spectrum of adverse experiences including physical, emotional, and sexual abuse, as well as neglect. These early life adversities have long been implicated in heightened risks for a variety of psychological and medical disorders, but how they might sculpt or disrupt the neural and sensory frameworks of interoception has, until now, remained elusive. To address this knowledge gap, a rigorous meta-analytic review published in Nature Mental Health has synthesized findings from 17 independent studies to elucidate the relationship between childhood maltreatment and multiple dimensions of interoception.
This comprehensive analysis is groundbreaking not only because of its scope but also through its nuanced examination of interoception’s subcomponents: accuracy, sensibility, awareness, and body trust. Interoceptive accuracy refers to the objective ability to detect internal bodily signals such as heartbeat, while interoceptive sensibility covers subjective confidence in these detections. Awareness reflects conscious recognition of bodily sensations, and body trust relates to an individual’s overarching confidence in the reliability and safety of their internal bodily experiences. The review’s multi-faceted approach allows a more detailed understanding of how childhood maltreatment may differentially influence these interrelated but distinct aspects.
Surprisingly, the meta-analysis revealed no consistent or robust association between exposure to childhood maltreatment and impaired interoceptive accuracy, sensibility, or awareness. This finding challenges some prevailing assumptions in both clinical and theoretical domains, which have posited a more generalized disruption of interoceptive functions following early trauma. Instead, the evidence points to a very specific aspect of interoception that appears vulnerable: body trust. Participants with histories of childhood maltreatment, particularly emotional maltreatment, exhibited significantly diminished trust in their own bodily signals, indicating a fundamental erosion of the perceived reliability and safety of their internal sensations.
The implications of this selective effect on body trust are profound. Body trust is more than a sensory judgment; it is a cornerstone of embodied selfhood and a critical substrate for emotional resilience. When an individual’s internal bodily signals are consistently misinterpreted or distrusted, this can give rise to dysregulated emotional states, heightened anxiety, and somatic symptoms. Emotional maltreatment—which may include verbal abuse, emotional neglect, or chronic invalidation—seems particularly pernicious in undermining this trust, perhaps because it directly erodes foundational developmental processes linked to self-regulation and secure attachment.
From a neurobiological perspective, interoception is closely linked with insular cortex function, a brain region integrally involved in mapping and integrating internal bodily states. Early adverse experiences are known to affect insular connectivity and functioning, yet the meta-analysis suggests that generic interoceptive detection capabilities may remain intact even in maltreated individuals. Instead, the disruption may be more contextual and conceptual: the cognitive and affective interpretation of these bodily cues, their integration into a coherent sense of self, and the safety appraisal of internal states are what appear compromised.
Clinically, this refined understanding offers a more targeted pathway for therapeutic interventions. Traditional approaches to trauma often emphasize reprocessing or reframing cognitive and emotional memories. However, interventions designed explicitly to rebuild body trust—such as mindfulness-based body awareness practices, somatic therapies, and interoceptive training exercises—may prove crucial adjuncts for fostering recovery in trauma survivors. Enhancing a patient’s confidence in their bodily signals may alleviate persistent psychophysiological symptoms and improve emotional regulation.
Moreover, this research underscores the complexity of interoceptive processing and cautions against oversimplified links between trauma and global sensory deficits. The absence of consistent impairments in interoceptive accuracy and sensibility suggests a remarkable resilience or compensatory adaptation of neural systems responsible for basic bodily signal detection. Alterations reside instead in higher-order evaluative processes that govern how these signals are internally appraised and integrated into conscious experience.
These insights also raise fascinating questions about developmental trajectories and timing. For instance, the sensitive periods during which emotional maltreatment exerts the greatest impact on establishing body trust remain to be elucidated. Similarly, the potential reversibility of diminished body trust through early intervention is a promising avenue warranting further longitudinal research. Investigating how these processes unfold from childhood into adulthood could inform preventive strategies and help identify individuals at risk for impairments in bodily self-awareness.
The meta-analytic approach employed in the study brings statistical rigor and overarching clarity to a field marked by methodological disparities and inconsistent findings. By aggregating data across diverse populations, measurement tools, and maltreatment profiles, the authors provide an authoritative synthesis that bolsters confidence in their conclusions. Nonetheless, heterogeneity across studies underscores ongoing challenges in operationalizing interoception and maltreatment, calling for standardized methodologies and multimodal assessment paradigms in future work.
In sum, this landmark meta-analysis reframes how we think about the visceral scars of childhood maltreatment—not as wholesale diminutions in the capability to sense our internal states but rather as a deep-seated erosion of the fundamental trust in the body’s signals. This distinction is more than semantic; it shifts the conceptual and therapeutic landscapes, emphasizing the restoration of embodied confidence as a critical target for healing. The work profoundly enriches our understanding of the embodied consequences of trauma and opens new vistas for research and intervention aimed at reconnecting individuals with their internal worlds.
As science continues to unravel the threads connecting early adversity, brain function, and interoceptive experience, these findings illuminate a vital aspect of human resilience and vulnerability. They challenge us to rethink trauma not only as psychological damage but as a disruption of the very dialogue between body and mind. Reclaiming this dialogue, starting with cultivating body trust, may hold the key to restoring wholeness in those shaped by the shadows of their earliest experiences.
Subject of Research: Childhood maltreatment and its impact on dimensions of interoception.
Article Title: A meta-analytic review of child maltreatment and interoception.
Article References:
Ditzer, J., Woll, C.F.J., Burger, C. et al. A meta-analytic review of child maltreatment and interoception.
Nat. Mental Health (2025). https://doi.org/10.1038/s44220-025-00456-w
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