3.8 Article

Modeling and controlling the body in maladaptive ways: an active inference perspective on non-suicidal self-injury behaviors

Journal

NEUROSCIENCE OF CONSCIOUSNESS
Volume 2023, Issue 1, Pages -

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/nc/niad025

Keywords

non-suicidal self-injuries; intolerance of uncertainty; interoception; adolescence; active inference

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Many individuals engage in paradoxical behaviors, such as extreme food restriction or self-injury, especially during periods of rapid changes like adolescence. Researchers propose that these behaviors may serve as maladaptive strategies to reduce uncertainty by eliciting salient physical sensations, such as pain or hunger. Despite their maladaptive nature, these strategies may not only provide short-term rewards but also reduce uncertainty and restore a coherent model of oneself.
A significant number of persons engage in paradoxical behaviors, such as extreme food restriction (up to starvation) and non-suicidal self-injuries, especially during periods of rapid changes, such as adolescence. Here, we contextualize these and related paradoxical behavior within an active inference view of brain functions, which assumes that the brain forms predictive models of bodily variables, emotional experiences, and the embodied self and continuously strives to reduce the uncertainty of such models. We propose that not only in conditions of excessive or prolonged uncertainty, such as in clinical conditions, but also during pivotal periods of developmental transition, paradoxical behaviors might emerge as maladaptive strategies to reduce uncertainty-by acting on the body- soliciting salient perceptual and interoceptive sensations, such as pain or excessive levels of hunger. Although such strategies are maladaptive and run against our basic homeostatic imperatives, they might be functional not only to provide some short-term reward (e.g. relief from emotional distress)-as previously proposed-but also to reduce uncertainty and possibly to restore a coherent model of one's bodily experience and the self, affording greater confidence in who we are and what course of actions we should pursue.

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