Mindful Awareness in Body-oriented Therapy (MABT)
MABT has been in this wiki since the first Farb et al. (2015) ingest as a vignette — the named therapy in the interpersonal-trauma case on interoceptive-training-clinical, cited to Price 2005/2007, with outcomes described qualitatively (bodies experienced as resources rather than threat; intimacy without dissociation). Weng et al. (2021), with Cynthia Price as co-author, is the first source here to attach trial results to it. See cynthia-price.
It gets its own page for a reason the wiki cares about: it is the most explicitly interoceptive of the psychological interventions held here. MBSR and MBCT train interoceptive attention as one component of a broader programme that also addresses relationship to thought; MABT was designed from the outset to teach interoceptive awareness and nothing else, which makes it the closest thing available to a manipulation check on the whole contemplative rationale.
What it does
Three features distinguish it from the generic mindfulness protocols on mindfulness-meditation:
- Skills are taught explicitly and in sequence — identifying, accessing and sustaining attention to inner bodily sensation, rather than assuming these emerge from sitting practice. Price and Hooven (2018) frame this as interoceptive awareness skills for emotion regulation.
- It integrates bottom-up and top-down processing deliberately — experiential contact with sensation, plus evaluative work on what the sensation means. This is the appraisal construct, not the sensitivity construct.
- It is topographically specific — targeting chest and abdomen (respiratory and vagal territory) and the regions that hold muscular tension (shoulders, neck, jaw, back). Compare bodily-sensation-maps: this is a therapy that makes claims about where in the body to attend, which most do not.
The stated theoretical warrant is that self-representation grounded in embodied sensory experience supports a sense of self adequate for engaging the environment (Seth 2013 is the citation), and that dissociation from accurate self-representation produces dysregulation (Gu & FitzGerald 2014). So MABT’s own theory is the wiki’s interoceptive-inference material, applied clinically.
The evidence
Two studies of MABT as an adjunct to women’s SUD treatment, versus control conditions:
| outcome | result |
|---|---|
| substance use | significant longitudinal reduction |
| craving | reduced |
| emotion dysregulation | reduced |
| interoceptive awareness (self-report) | improved |
| respiratory sinus arrhythmia (RSA) | improved |
| durability | maintained at 12-month follow-up |
The RSA result is the one to keep. A psychological training produced a change in a physiological index of parasympathetic influence on the heart, sustained at a year. Weng et al. read it as conscious interoceptive skills feeding back onto bodily process — the framework’s causal arrow running upward, from psychological level to autonomic. Higher RSA in turn predicts greater self-reported regulatory control and less negative emotional arousal under stress (Fabes & Eisenberg 1997).
The wiki should hold this carefully: RSA is a vagal measure, and the wiki now has two independent vagal literatures (see polyvagal-theory). This result belongs to the mainstream one — it needs no evolutionary claim about parasympathetic branches to be interesting.
The proposed mechanism, and where it is strongest
The transdiagnostic story is emotion regulation: interoceptive awareness reduces reactivity to bodily sensation, replacing “negative, ruminative, and catastrophizing” responses (Cioffi 1991) with insight into what a sensation means and what action fits it. The review’s own example is unusually concrete and worth recording, because it names something the wiki’s other pages leave abstract:
a tightening in the chest may indicate breath obstruction (where coughing would be adaptive) or feelings of anxiety (where self-soothing would be adaptive)
That is a claim that the clinical payoff of interoception is disambiguation of a sensation’s functional significance, not amplification of the sensation. It is the same distinction Farb et al. draw with selective rather than maximal attention, and it is the cleanest statement of it in the wiki.
In SUD specifically, the proposed mechanism is de-automation: unconscious interoceptive signals increase drug-seeking motivation (Paulus & Stewart 2014), and developing interoceptive awareness “reveals and de-automates such conditioning.” Compare the conditioned-interoceptive-cue account on craving — same architecture, treated from the awareness side.
What it does and does not settle
MABT is the wiki’s best answer to a question interoceptive-training-clinical keeps posing — what does “skillful guidance” actually consist of? — alongside SE’s titration/resourcing protocol, and unlike SE it has RCT evidence behind it.
What it does not settle is whether interoception is the active ingredient. Self-reported interoceptive awareness improved, but so does the thing every mindfulness questionnaire measures; no objective interoceptive measure was taken, and no mediation was tested. The honest summary: the most interoception-specific psychological therapy in the wiki produces durable clinical benefit, and still does not demonstrate that it works through interoception. See does-mindfulness-enhance-interoceptive-accuracy, is-more-interoceptive-awareness-better.