The Insula’s Interoceptive Role In Scoliosis Development Interoception, that sense of how we feel in our bodies is processed in the insula

Since my article on the emotional fascia and its implications in the development of scoliosis,  I wanted to know how the fascia connects to the brain and which part of it.

On researching,  I learned that the insular cortex or insula could play a big role in how we process our feelings – good and bad. The insula is a key brain region responsible for interoception – the ability to feel one’s own body states and emotions.

Interception is a complex bidirectional interplay between the brain and other organs that are necessary to monitor and regulate internal physicological states. The fascia is the largest interoceptive organ – major of its nerve endings called C-fibres have projections in the insula.

The Insula’s Interoceptive Role In Scoliosis Development
The insular cortex is the brain area responsible for our bodily feelings

The insula also processes pain. One interesting thing to note is that there is a neural overlap between physical and emotional pain. The same regions of the brain get activated, namely the dorsal anterior cingulate cortex (dACC) and the anterior insula.

So social rejection and twisting your foot activates these same regions. That is why sometimes taking pain medications like Tylenol can ease the pain of a broken heart.

So guess what happens when you feel sad, rejected, abandoned, lonely? Your insula gets activated and concurrently your fascia tightens up as a protective response to threat.

What Is Interoception?

Have you felt your muscles tighten, your fists and teeth clench, your heartbeat quicken, and your face get warmer when you feel angry? Or felt the blood draining from your face, your shoulders drooping, and feel tightness in the pit of your stomach when you feel the shame of rejection. These physical sensations that you feel in your body are your sense of interoception.

Research has shown that our ability to read our own physical signals directly relates to how well we can identify and regulate our emotional states.

However, when we grow up in environments that were dysfunctional and toxic. We learn to tune out of our body sensations and numb our intense visceral feelings.

This could lead to damage of our interoceptive sense which has far-reaching ramifications on our emotional, physical and social well-being.

Where Is The Insula

Insula–Latin for “island”–since it is located deep inside the folds of the cortex—the outer layer of the cerebrum in the floor of the Sylvian fissure. It has been considered to be paralimbic or ‘‘limbic integration cortex.’ since there are massive reciprocal connections between the insular cortex and the amygdala. Hence it is also considered to be part of the  ‘fear network’.

Additionally, this multimodal structure is also connected to several cortical areas in the frontal, temporal, parietal, and occipital lobes, as well as subcortical regions such as the thalamus,  and hippocampus.

The insula acts as the key integration hub linking large-scale brain systems. Receiving and processing the information it receives and relaying it to the body and vice versa.

Parts of The Insula

Neuroscientists now divide the insular cortex into two distinct regions: the large anterior insula, and the small posterior insula. The right anterior insula processes interoceptive emotional feelings – how we feel in the present. While the posterior insula handles recognition, intensity encoding, localization, learning, and memory of somatically painful events.

Now, the insula also consists of two lobes, the right insula,  which is connected to our sympathetic nervous system, and the left insula which is mainly connected to our parasympathetic part of the nervous system.

Additionally, the right fronto-insular cortex is key in switching between central-executive and default-mode networks.

Functions of The Insula – How Do You Feel?

The insula is the part of your brain where all of your internal sensory input comes together, from your heart, lungs, stomach, intestines, and so on. They signal needs such as thirst, hunger, pain, and the need to breathe. It also gets input from a separate set of receptors on your skin and mouth: temperature, pain, itch, ache, and touch.

Furthermore, it plays a central role via the vagus nerve in the regulation of the heart-brain axis and the gut and brain axis. No wonder, it becomes activated in response to disgust, ‘intuitive decision making, and social response – areas where the gut feelings and emotional thoughts collide.

The insula plays a key role in the development of the sensation of self and self-awareness which enables the development of insight.  Which is key to making good decisions with regards to ourselves or trusting others.

 Mirror Neurons, Insula and Empathy

When we attune to another’s behavior and expressions of intention – facial expressions, body gestures, tone of voice, mirror neurons fire in our brain. Information from these mirror neurons travels from the cortex of our brain through the insula.

The insula transmits the information from the cortex through the limbic regions to the neurons of interoception – how we sense what is happening internally in our bodies. The information gathered through interoception, tension, tightness, tiredness, travels back up through the insula through the limbic regions where the sensations are given emotional meaning, back up to the structures of the middle pre-frontal cortex.

The insula integrates somatic experience with conscious awareness. We feel pain when another feels pain. That is how we feel empathy.

The Mind-Body Connection

The insula’s strategic location and extensive connectivity serve as key integration hub of most of our body inputs. From the processing of visceral, somatosensory, gustatory, olfactory, and auditory inputs, language, motivation, awareness, craving, addiction, and emotions such as empathy and disgust.

Sensory inputs, such as being touched, will signal both the insula and your body touch maps. It also decodes the type of touch – good, not so good, or repulsive.

The insula is a critical part of what it means to be a feeling human – to relate socially and intuitively. And it is here that the mind and body unite.

Insula and Childhood Trauma

Recent studies on traumatized children have shown how the insula is negatively impacted by Adverse Childhood Experiences (ACEs).

Moreover,  trauma impacts the brains of boys and girls very differently. In girls, the insula shrinks while in boys it grows larger.

Culturally, girls are programmed to shut up and repress their feelings, they literally shrink to accommodate their toxic environment.  While boys are given a free pass to express their rage and fight back. Not surprisingly, scoliosis is more common in girls than boys. My brother became violent and reactive while I developed scoliosis.

I now feel that if I had not believed in and followed my tyrannical indoctrination of forgiving instead of fighting back, I  probably wouldn’t have had scoliosis.

How We Feel and Relate To The World

The interoceptive-insular pathway is deeply connected with our autonomic and emotional brain.

According to research, the anterior insula-cingulate system integrates interoceptive information with emotional salience to form a subjective representation of the body; while the mid-cingulate cortex is more likely involved in environmental monitoring, response selection, and body orientation.

These two systems of resting-state connectivity between the insula and cingulate cortex help create our body maps which in turn shape our body schema – how we feel and relate to the world.

Mind Maps – Body Schema – Scoliosis

Our brain creates maps that correspond to our body and the environment around us.

The insular cortex connects sensory experience and emotional valence from both our past and present. It decodes the sensory signals from within our body and the sensory inputs from the environment to form our insight and internalized beliefs.

If we grew up being rejected and abused we usually end up feeling an inherent sense of shame and defectiveness. That I am not worthy and unloveable.

The brain maps this within our interoceptive system with regards to how feel about ourselves and the world.

This is the basis of the development of our own unique body schema – fear, shame, defectiveness, sadness becomes the schema through which we relate to the world.

Alterations in body schema have been suggested as a potential factor in the development of idiopathic scoliosis.

Scoliosis – The Habituated Trauma Reflex

Traumatic experiences affect our body schema. The sensorimotor loops become embedded within the trauma and cannot release themselves from that moment. Our emotional personality (EP) is fixated in the traumatic experience, which in turn leads to tightened myofascial system.

According to somatotherapist Thomas Hanna, this involuntarily side bending and rotations in the pelvis/trunk/shoulder/head is a trauma reflex.

Subsequently, this chronic state of tension leads to sensory-motor amnesia. Our body forgets to relax and we grow into this armored state.

Scoliosis is nothing but a habituated trauma reflex, with the spine curving and tilting our body.

Changing Our Trauma Mind and Body  Using The Insula Switch

The insular cortex is now thought to be the specific brain region that assists in switching between networks, the Default Mode Network(DMN) or the resting state network and the Salience Network (SN).

It is the watchman that decides what to focus on while recruiting relevant functional networks, namely the Task Positive Network (TP) towards taking action.

Since the insula is responsible for both good and bad feelings, we can learn to change our earlier patterns of dysfunction. By focussing and doing things that make us feel good.

Bottoms Up – Using Our Senses and Body

Simple ways we can feel good are:

1)  Indulging in self- caressing

Those C-fibres which are present in our skin are directly connected to the insula. They are activated by light caressing touch. This also releases oxytocin in our bodies. One simple way when upset is to gently caress your lips, face, arms, or bottom of your feet with your fingertips. You could also use a feather to do this.

2) Or ask/pay someone for some caressing touch

Have sex, cuddle, go for a massage, or facial or hair treatment like cutting and styling or coloring.

3) Indulge your senses

The pleasurable smell of cooking, baking can soothe your insula.

4) Sing, particularly in the shower

The feeling of water falling on your body and the exercising of your vocal cords positively changes the insula.

5) Become aware of your peripersonal space, particularly your back space

Often those of us who are traumatized try to make our small and take up as little space as possible. Posture is shaped by our relationships with people. How we perceive ourselves in our interactions with others is the ultimate organizer of posture.

By increasing our personal space mentally we are psychologically giving ourselves permission to take up space in the world. I have incorporated this trying to increase my back space while doing the horse-stance. I can feel my spine actually untwisting. Visualization does work.

6) Or watch movies/videos of pleasant interactions and caressing touch

The insula cortex because of its connection to the mirror neurons reacts even if the caress is not actively felt but observed to affect others.

7) Using somatic or body-based metaphors to understand your feelings

When you say ‘someone is a pain in the neck, you can actually feel the tightness in your neck. Or saying ‘seeing him makes my heart sing and dance’. you can actually feel the joy and aliveness.

Our body expresses itself through symptoms. And by tuning into our bodily states we can learn to engage with our feelings, process, and release them; instead of stuffing them down.

Putting Together The Pieces of The Puzzle

The brain and the body is one interconnected system. No one part of the brain works autonomously. Every part works in tandem – as one part receives the information it is transmitted to other parts within the brain and then to the body or vice versa.

It is amazing when you ponder over the incredible working of the brain-body system. This amazing symphony of interaction is modulated by our environment, relationships, and past experiences.

Moreover, the best part, is that we can change our brain and body through the process of neuroplasticity. Every small action to change how we feel in the present can lead to long-lasting changes in our brains and bodies.

Finding a solution to scoliosis is like peering into a Russian doll- you keep finding something more inside.  I keep pushing forward, trying to find the pieces to the puzzle of scoliosis. Why did I a healthy girl turn into a twisted caricature post her mother’s death?

Image Source:  Pexels


The pain of social disconnection: examining the shared neural underpinnings of physical and social pain
Interoception. A new correlate for intricate connections between fascial receptors, emotion, and self-recognition 
Saliency, switching, attention, and control: a network model of insula function 
The insular cortex  
The Emerging Science of Interoception: Sensing, Integrating, Interpreting, and Regulating Signals within the Self 
Body Disownership in Complex Posttraumatic Stress Disorder 

Further Reading:

Meaning-Full Disease: How Personal Experience and Meanings Cause and Maintain Physical Illness –  Brian Broom 

The Psychophysiology of Self-Awareness: Rediscovering the Lost Art of Body Sense Alan Fogel  

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