Chapter 2 46 network [10, 77, 78]. A somewhat less obvious reason is the neural representation of the body in the brain. According to Damasio [77], physical processes and signals are essential in complex social-emotional decisions. Over time, these physical sensations have become associated with emotions and guide behavior (such as nausea in the case of aversion), becoming what Damasio calls ‘somatic markers’. In recent years, interoception, the perception of the inner body, has systematically been linked to the perception of emotion [9, 12, 79]. This concerns not only the perception of the signals emanating from the central organs, but all physiological tissues that transmit a signal to the central nervous system: the intestines, the respiratory system (breathing), the systems that regulate temperature and hunger, the genitourinary system (bladder, genital tract), the nociceptive system (pain), the endocrine (hormones) and immunological systems. Basically, it concerns interpretation of all types of changes in how the body feels [12, 79]. The insula, a brain structure that works closely together with the limbic system in the brain, has a key role in the integration of (representations of) external sensory stimuli with internal somatic awareness [9, 12]. Sensory information is supplied from the body to the thalamus, which transmits this information to the (posterior dorsal) insula. There, a primary picture of the state of the entire internal body is formed [80]. This sensory image then acquires an emotional meaning through its connections to the anterior cingulate cortex (ACC) [81]. See Table 1 in which the functions of various brain areas are described. For example, the experience of pain, shortness of breath and hunger not only include a sensory perception, but above all a feeling of discomfort that is the impetus to act and change the situation. As these perceptions help to serve the organism’s survival, emotion and interoception are thus closely intertwined for vital reasons [82, 83]. It is presumed this connection is bidirectional: interoception influences the emotional response, but the (perceived) emotion in turn also influences (the perception of) the body [81]. Within this interaction, a finegrained process takes place, involving all kinds of (conscious or subconscious) decisions, resulting in certain cues receiving attention while others are ignored. Such processes are commonly recognized as ‘styles of appraisal’ and ‘evaluations of emotions’ (e.g., [59]). Bodily awareness even plays a role with regard to higher cognitive processes in emotional decision-making [79]. A striking example of this are experiments in which people had to provide subjective ratings. People who were aware of their bodily sensations, as opposed to people who were not (i.e., those who had low interoception), rated currency as more valuable when they held a heavier object (in this case a clipboard), or they rated people as more friendly when they sat on a soft (as opposed to a hard) cushion [84].
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