Focusing your mind on physical sensations in your skin might help your body tamp down sudden inflammation, according to a new investigation. Researchers found that when individuals deliberately paid attention to a localized skin reaction rather than distracting themselves, the resulting swelling and redness were substantially smaller, and the swelling subsided faster. The findings, published in Nature Human Behaviour, suggest that voluntary thought processes can influence physiological defenses that were previously viewed as purely automatic.
Acute inflammation is the rapid, protective response the body mounts against injury or irritation, characterized by localized heat, swelling, and redness. In laboratory settings, scientists often test this process using histamine, a chemical the body releases during allergic reactions that causes blood vessels to widen and leak fluid. Applying a droplet to the skin and piercing the surface triggers a raised, fluid-filled bump called a wheal and a surrounding patch of redness called a flare. In this type of challenge, a smaller, faster-settling reaction is viewed as a sign of better-regulated immune activity, reflecting a body that resolves swelling without overreacting.
The research was led by Nofar Mizrachi and Liron Rozenkrantz of the Azrieli Faculty of Medicine at Bar-Ilan University in Israel, where Rozenkrantz is an assistant professor and principal investigator of the Psycho-Biology of Beliefs Lab. The team wanted to explore whether conscious awareness plays an active role in how the body manages sudden immune challenges.
“We’ve known for a long time that attention changes how the body feels. When we distract ourselves from pain or an itch, it feels less intense,” Rozenkrantz told PsyPost. “What has not been tested before was whether attention also changes what the body does in response, specifically whether it affects immune regulation.”
“Inflammation is usually treated as an automatic process, one that is not dependent on or affected by cognition,” she continued. “My lab studies how cognitive processes, such as beliefs and perceptions, influence biological function, so the question was natural for us: is our experience of the body a passive process, or is it part of regulation itself?”
To ground this question in existing biology, the researchers drew upon predictive models of brain-body communication, an idea known as allostasis. In a 2015 theoretical paper, neuroscientists proposed that the brain constantly anticipates bodily needs and adjusts internal biological processes before problems escalate. Another biological pathway of interest is the inflammatory reflex; a 2009 review outlined how the vagus nerve, a major neural highway running between the brain and internal organs, helps suppress excessive inflammation. The authors reasoned that intentionally attending to bodily signals might sharpen the brain’s internal monitoring systems and engage these calming nerve pathways.
To test this idea, the researchers designed three pre-registered experiments, meaning they publicly recorded their hypotheses and analysis plans in advance. In the first experiment, 37 healthy adults received a histamine prick on their forearm during two different sessions. In one session, participants were told to keep their gaze on a screen while focusing all their attention on the physical feelings of itching or burning occurring at the skin site. In the comparison session, participants watched engaging video clips on the screen to distract their attention away from the arm, while skin responses were tracked for 20 minutes.
The person measuring the skin did not know which condition each participant was in during any given test. Session order was balanced across participants, and participants were not told the study’s purpose; when asked to guess at the end of the experiments, only 14 percent correctly identified it.
The team found that focusing attention internally resulted in markedly smaller inflammatory reactions. At the 20-minute peak, the swelling bump averaged 3.5 millimeters under internal attention compared to 5.0 millimeters during distraction, representing roughly a 1.5-fold increase under distraction. The surrounding redness averaged 10.6 millimeters under internal attention compared to 14.0 millimeters during distraction, though unlike the swelling, it did not fade on a different timeline.
About 90 percent of the participants showed a larger swelling reaction when their attention was directed away from the arm. In an additional analysis that was not part of the pre-registered plan, nearly 90 percent of participants showed swelling that had stopped growing or begun to shrink by the 20-minute mark during internal focus, compared to 46 percent during distraction.
Because the video clips in the first experiment introduced different visual stimulation and mental demands, the scientists conducted a second experiment with 20 new participants. In this trial, every participant viewed the identical visual slideshow of 37 abstract geometrical shapes. In the internal attention condition, each new shape served as a mental reminder to bring focus back to the itching sensation in the arm. In the distraction condition, participants spent the time mentally evaluating whether each shape could plausibly exist in real life.
Even with identical visual input and matched mental effort, the immune divergence persisted. Swelling bumps and redness were roughly 1.6-fold smaller when participants paid attention to their arm sensations rather than assessing the abstract shapes. Once again, 90 percent of participants developed larger reactions under distraction. Interestingly, participants reported that the itching and burning felt stronger when they paid attention to it, showing that heightened awareness of discomfort coincided with a smaller physical immune response.
“What I find most surprising is that a process as basic and fundamental as acute peripheral inflammation is affected by cognition at all,” Rozenkrantz observed. “Inflammation is generally thought of as an autonomous physiological process, largely independent of cognition, so finding that something as voluntary as where we direct our attention can participate in its regulation really challenges that separation between cognition and basic bodily regulation. In a sense, this is exactly why we asked the question in the first place: to understand how deeply cognitive processes are embedded in physiological regulation.”
The finding that attention made the itch feel stronger led the researchers to test whether sensory feedback from the skin is required for the brain to regulate the swelling. In a third experiment, 17 participants from the earlier experiments returned for an additional session where a topical numbing cream, lidocaine, was applied to dull nerve signals at the test site. With sensory feedback dampened, the peak swelling bump averaged 4.0 millimeters, which was larger than the 3.1 millimeters seen during internal attention with intact sensation in their earlier visit. The numbing cream also hindered the later recovery phase, meaning the swelling did not drop toward baseline as quickly.
Despite this sensory blunting, the response under numbing cream remained smaller than the 4.9-millimeter average observed under ordinary distraction. This suggests that sensory signals from nerves help the body resolve inflammation in its later stages, while attention may still regulate the response through other routes when local sensation is reduced. Perceived itching ratings between the numbing condition and the distraction condition did not differ in a statistically significant way, suggesting that sensory experience alone did not dictate the outcome.
To explore how the brain might be communicating with the skin, the researchers recorded measures of the autonomic nervous system, which controls involuntary functions such as heart rate and sweating. Measures tied to its “fight or flight” branch, including skin conductance (a sign of sweating), heart rate, and skin temperature, showed no differences between conditions, and participants’ self-reported anxiety scores did not differ in a statistically significant manner.
However, heart rate variability, the natural beat-to-beat fluctuation in heart rhythm and an indirect indicator of activity in the calming “rest and digest” branch carried by the vagus nerve, was modestly higher during internal attention. This difference persisted even when the skin was numbed, which the authors interpret as consistent with inward focus engaging the vagus nerve’s anti-inflammatory pathway independently of incoming sensory signals.
“It appears that focusing attention towards the part of the body where a chemical has challenged the immune system leads to a great visible reduction in its effects on the skin, compared to focusing away from the site,” Warren Mansell, director of the LEx Mental Health Research Group and a professor of mental health at Curtin University in Australia, who was not involved in the research, told PsyPost.
“This raises the possibility that through willingly attending to unpleasant feelings in our bodies, we may support our body’s immune reaction to it. It also raises the possibility that chronically distracting ourselves from distress in our body may undermine our immune system. None of these generalizations can be concluded from this study, but the study sets the stage for research that could.”
Mansell noted that the results might seem to clash with common advice to distract oneself from discomfort, as well as with the view that dwelling on bodily sensations worsens worry, panic, and pain. But he argued that reading the findings as contradicting that advice would be a mistake.
“Distraction can still be an effective short-term strategy to manage unpleasant feelings, even if it is not helpful for long-term physiological restoration,” Mansell explained. “Also, the focus on the body that happens in worry, panic and chronic pain is typically involuntary unlike the voluntary attending in this study, and is often elaborative and ruminative regarding thoughts about the bodily feeling, not the feeling itself.”
“The work is consistent with earlier work on the beneficial impact of techniques that include focused attention on the body such as Gendlin’s focusing and interoceptive exposure,” he added. Gendlin’s focusing is a therapy method built around tuning in to subtle bodily feelings, while interoceptive exposure, used to treat panic disorder, has people deliberately bring on feared sensations such as a racing heart.
The authors raise a related point in their paper. They suggest that habitually turning attention away from unpleasant bodily sensations might carry a physiological cost in some situations, and they note that attention-based treatments such as mindfulness, which involve sustained focus on the body, have been linked to improvements in inflammatory markers, though whether avoidance itself prolongs pain or inflammation remains untested.
“I think the main takeaway is that these findings may change how we think about the relationship between cognition and physiological regulation – and more specifically, that our subjective experience of the body may be more biologically consequential than we usually assume,” Rozenkrantz said. “We tend to think of sensations like itch or burning as simply reflecting what is happening in the body. Our findings suggest a fascinating attention-perception-regulation loop: signals from the body shape what we feel, attention changes how we perceive those signals, and that perception may in turn help regulate what is happening in the body.”
“I think the conceptual significance is more important at this stage than the practical significance,” Rozenkrantz added. “This is an initial demonstration in a very specific experimental model, not yet something we can translate into a clinical recommendation.”
As with all research, there are some caveats to consider. The study examined an allergy-like skin reaction triggered by histamine in healthy young adults. Because of this specific setup, it remains unknown whether voluntary attention would exert similar effects on infectious diseases, long-term autoimmune conditions, or full-body illnesses.
Mansell expressed confidence in the experimental rigor while stressing the need for caution in interpreting the reach of the findings. “I have great confidence in the results owing to the controlled experimental design, the pre-registration and replication,” Mansell noted. “However, the results are modest and specific as opposed to the various interpretations of the results, which are not directly supported by this study.”
Rozenkrantz similarly cautioned against overstating the practical reach of the data. “I think this is crucial: these findings should not be immediately generalized,” Rozenkrantz emphasized. “We studied a small, localized, acute inflammatory response in healthy people. We cannot assume that the same effect occurs in chronic inflammation, disease, wound healing, or other physiological processes, and this is not evidence that people can simply ‘think away’ inflammation or illness.”
There are also practical realities regarding the immune system to keep in mind, as smaller inflammatory responses are not always ideal when fighting off an active pathogen. In addition, the scientists did not measure the immune cells or signaling molecules involved, which leaves the fine-grained biochemical steps unmapped. The numbing cream may not have blocked every type of sensory nerve fiber, and heart rate variability is only an indirect gauge of vagus nerve activity.
The experiments were also small, with 37 and 20 participants in the first two experiments and 17 returning participants in the third, most of them young women, and the numbing-cream session’s order was not balanced against the other conditions.
When considering future directions, Mansell highlighted the need for broader testing. He stated that he would most want to see tested “the impact of more extensive training on more global and enduring indices of immune functioning.”
“What excites us most is how many new questions this opens up,” Rozenkrantz said. “If attention can participate in regulating inflammation, what other physiological processes might it influence? When does this happen, for whom, and under what conditions? And eventually, how might we harness it clinically?”
Even with remaining questions, the findings provide evidence that voluntary attention does more than simply filter our conscious experience of physical discomfort. In this specific laboratory model, paying attention to bodily sensations was linked to smaller, faster-settling skin reactions and to signs of greater vagus nerve activity, offering a fresh perspective on how mental states and physical responses interact.
The study, “Voluntary attention regulates acute immune responses in humans,” was authored by Nofar Mizrachi, Menachem Rottem, and Liron Rozenkrantz.
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