Sarah Garfinkel

British clinical neuroscientist. Professor at University College London's Institute of Cognitive Neuroscience since 2020; previously at Brighton and Sussex Medical School (Department of Psychiatry) and the University of Sussex (Sackler Centre for Consciousness Science). Wellcome Trust Senior Research Fellow. Her research line is cardiac interoception, with particular emphasis on metacognition, autism, and emotional processing. The principal author of the three-way distinction that disambiguated the interoception field's terminology.

Stake§

Garfinkel's stake is methodological and clinical. The 2015 paper is the methodological pivot that cleaned up a literature in which interoceptive awareness, accuracy, and sensibility were being used interchangeably and producing incomparable results. Her later work on autism interoception — the finding that autistic adults can show normal interoceptive accuracy but reduced interoceptive awareness — has been particularly influential in autism research and in the clinical thinking about emotional processing in autism.

Garfinkel's first-author position on Knowing your own heart (2015) is the canonical entry-point. The paper proposed and validated the three-way distinction between accuracy, sensibility, and awareness, showed that the three dimensions dissociate in a normative sample of 80 subjects, and gave the field the operational vocabulary it would adopt in the 2018 Khalsa Roadmap.

The Sussex work continued through the late 2010s and into the 2020s with extensions to clinical populations (anxiety, depression, autism, schizophrenia), to the metacognitive measurement of confidence and its dissociation from accuracy, and to specific psychophysiological collaborations with Hugo Critchley and the Sackler Centre's Anil Seth. The autism work in particular has shifted the clinical reading of autistic emotional processing from a deficit frame toward a dissociation frame: not that autistic adults feel less or less accurately, but that the metacognitive correspondence between accuracy and sensibility runs differently than in non-autistic controls.

Garfinkel is the figure who turned a methodologically muddled construct into three operationally distinct constructs, and one of the clinicians who has been most careful about what the measurements actually measure. The Wellcome Senior Research Fellowship and the UCL chair are recognition of work that the methodological-refinement tradition of psychology and psychiatry needs more of.