Interoceptive awareness
Whether a person's confidence in reading their own body matches how well they actually read it. The question is not how good the bodily sensing is, nor how good it feels, but how closely the two align: someone who is right and sure of it, or wrong and rightly doubtful, has it; the confident-but-mistaken person does not. It is a knowing-that-you-know dimension, distinct from the sensing itself.
The metacognitive correspondence between interoceptive accuracy (behavioural performance) and interoceptive sensibility (subjective self-report) — whether a person's confidence in their interoceptive judgements tracks the actual accuracy of those judgements. Operationalised as the trial-by-trial correlation between confidence ratings and detection-task performance in Garfinkel et al. 2015. The third axis of the three-way distinction the Garfinkel paper introduced.
Etymology§
The term interoceptive awareness in the pre-2015 literature was used loosely — sometimes to mean what is now called accuracy, sometimes sensibility, sometimes the conscious experience of an interoceptive signal. Garfinkel and colleagues narrowed the term to a specific metacognitive construct: the correspondence between objective performance and subjective confidence. Pre-2015 papers using interoceptive awareness have to be read in context to know which construct each meant.
Interoceptive awareness in the post-2015 sense is a metacognitive construct — not about whether the body's signals are detected, and not about whether the person feels attuned to them, but about whether the person's confidence in their detection matches their actual performance. A person with high accuracy and high confidence has high awareness. So does a person with low accuracy and appropriately low confidence. The poor case is the confident-but-wrong subject: high sensibility, low accuracy, low awareness.
Awareness is the dimension that connects interoception to general metacognition — the cognitive-science literature on whether and how the brain knows what its own perceptions are doing. The Sussex group, working alongside Hugo Critchley, has been the most active in pushing this connection; Suzuki, Garfinkel, Critchley and Seth across the 2010s have developed the metacognitive framework for interoception, and the inference frame gives a theoretical reason to expect interoceptive metacognition to be tightly coupled to interoceptive inference itself. The construct is what the Khalsa Roadmap flags as most important for distinguishing genuine interoceptive change from belief-change in clinical settings.
The construct is harder to measure than either accuracy or sensibility — it requires trial-by-trial confidence ratings, decent sample sizes, and methodological care that not every interoception study has done. The post-2015 clinical literature has used the term awareness liberally without always doing the metacognitive measurement properly. Each paper that claims to measure awareness has to be checked against the operational definition: are they measuring metacognitive correspondence, or are they using awareness as a loose synonym for sensibility in the older fashion?