I hate being ill. When I have flu, a stomach ache or one of those vague “something is coming on” feelings, I become remarkably good at looking away. Netflix goes on. I scroll. I take something for the headache. Anything, really, except sitting with the unpleasant sensation itself.
Distraction can be a kindness. Turning attention away from pain or itch often makes it feel less distressing, and distraction is used during medical procedures. But a new study asks a slightly uncomfortable question:
If we turn attention away from the body, could the body respond differently too?
I have previously written about how love and intimacy (Trachtenberg E., 2026; Schneider et al., 2026) and positive expectations (Trachtenberg E., 2026; Lubianiker et al., 2026) shape immune responses. Both pointed to the same idea: the brain is not a passive observer of the immune system. Rather, thoughts, expectations and relationships can influence bodily responses.
This matters for mental health too. Interoception (i.e., how we notice and make sense of bodily signals) is altered in conditions such as panic, health anxiety, depression and chronic pain (Khalsa et al., 2018). Paying attention to the body can both amplify fear/pain, or be helpful in reducing it. Perhaps the key question is not whether we listen to the body, but how.
Mizrachi and colleagues (2026) tested this directly, asking whether focusing on sensations from a histamine skin-prick test, rather than being distracted from them, changed the body’s physiological response.
Methods
Three preregistered, within-participant experiments were conducted with 57 healthy adults who each served as their own control under counterbalanced conditions. Sessions in the main experiment occurred 3 to 5 days apart.
A standard histamine skin-prick test (similar to an allergy test) was performed on the forearm to produce a short-lived local skin reaction. A researcher blind to participant’s experimental condition measured the wheal (i.e., swelling) and flare (i.e., redness) of the skin six times during the following 20 minutes, in addition to heart rate, skin conductance, skin temperature, heart-rate variability and state anxiety.
- Experiment 1 (37 participants): focused on sensations at the test site or watched video clips as a distraction.
- Experiment 2 (20 new participants): viewed abstract shapes that either reminded participants to focus on their hand or asked them to judge whether the shapes could plausibly exist in real life.
- Experiment 3 (17 returning participants): focused on sensations at the test site after applying lidocaine cream, which reduced sensory signals from the skin.
Results
Experiment 1: Internal attention versus distraction
At 20 minutes, the wheal was ~1.5 mm smaller when people attended to the sensations in their arm (3.5 mm compared with 5.0 mm during distraction). The flare was also smaller: 10.6 mm with internal attention and 14.0 mm with distraction.
Around 90% of participants showed a larger wheal or flare when distracted. Differences appeared within approximately three minutes and grew over time. In an exploratory analysis of the later phase of the response, 89% of participants showed a stable or declining wheal between 15 and 20 minutes while attending internally, compared with 46% during distraction.
Experiment 2: Same screen, different focus
The main finding appeared again: wheal and flare responses were ~1.6 times smaller during internal attention, and 90% of participants showed the same overall pattern. Importantly, participants also rated itch and burning as stronger when they attended to their hand. In other words, attending to the body made the sensations feel more noticeable, while being associated with a smaller measured skin reaction.
Experiment 3: The role of sensory signals
Under internal attention with lidocaine, the 20-minute wheal was larger than with internal attention alone: 4.0 mm versus 3.1 mm. However, it was still smaller than under distraction: 4.0 mm versus 4.9 mm. This suggests that sensory feedback from the skin contributes to the effect, but attention still mattered when that feedback was reduced.
Physiological response
Heart-rate variability was higher during internal attention than distraction. Heart-rate variability is often used as an indirect indicator of parasympathetic activity, sometimes linked with vagal regulation. In contrast, across the first two experiments, skin conductance, heart rate, skin temperature and self-reported state anxiety did not differ significantly between internal attention and distraction. Heart-rate variability remained higher when sensory input was reduced by lidocaine. This pattern is consistent with a possible top-down autonomic contribution, but it cannot establish that vagal activity was responsible for the change in the skin response.
Conclusions
Mizrachi and colleagues conclude that voluntary attention can influence a local, acute inflammatory response in humans. Their findings add to growing evidence that the brain and body are in constant conversation, with attention, expectations and autonomic nervous system activity shaping the body’s response.
The authors propose two complementary processes. Sensory feedback from the inflamed skin may help the response settle, while internally directed attention may engage top-down autonomic regulation.
The finding is striking: in healthy adults, deliberately attending to bodily sensations was linked with a smaller histamine-induced skin response than distraction. This offers an early example of measurable effects of voluntary attention.
Strengths and limitations
This is a thoughtful and unusually rigorous laboratory study. The experiments were pre-registered, reducing the risk that the main hypotheses and analyses were invented after the results were known. The within-participant design was another major strength: each person served as their own control, reducing differences caused by baseline skin reactivity, personality, sex or other stable individual characteristics.
The authors also did more than one simple comparison. Experiment 2 was particularly helpful because participants saw the same shapes in both conditions and reported similar task difficulty. This makes it less likely that the result can be explained simply by watching videos rather than a fixation cross, or by one task being more demanding. Using a blinded assessor for wheal and flare measurements also reduced the risk that expectations affected the primary outcomes.
However, there are important limitations. First, there was no neutral condition, such as resting without a specific attention instruction. We therefore cannot tell whether attending to the body reduced the skin reaction, distraction increased it, or both.
Second, the study measured wheal and flare following direct histamine exposure. These are meaningful physiological outcomes, but they are not the same as measuring cytokines, immune-cell activity or systemic inflammation. Histamine reactions include vascular, sensory and neurogenic processes, so claims about broad “immune regulation” go beyond what was directly measured.
Third, participants were healthy, young adults and mostly women. We cannot assume that the same effect would occur in people with anxiety, depression, trauma, chronic pain, autoimmune illness or acute infection.
Fourth, participants could not be blinded to where they were directing their attention. Although they did not know the precise hypothesis, 14% guessed the study aim. Expectations may therefore have influenced behaviour or physiological responses. The lidocaine condition was also completed as an additional later session by returning participants, making habituation or session-order effects difficult to rule out.
Implications for practice
This is an exciting controlled human study showing that a local skin inflammatory response differed depending on whether people directed their attention towards or away from bodily sensations. By comparing the same people under different attention conditions, the study suggests that attention may shape not only what we feel, but also how the body responds.
This does not mean that mental health practice should change tomorrow. Distraction remains a valuable way to reduce distress during painful or frightening procedures. Equally, this study does not suggest that people should monitor every ache or sensation. For people with panic, health anxiety, post-traumatic stress, chronic pain or compulsive checking, body-focused attention can become fearful and distressing.
However, the attention used here was not threat-scanning. Participants were simply asked to return their attention to sensations at the test site. This resembles the curious, accepting and non-judgemental attention encouraged in some mindfulness approaches more than hypervigilance. Mindfulness-based programmes can be helpful for some people with stress, anxiety, depression and chronic pain, although their effects vary between people and the evidence for effects on inflammation remains tentative. How we attend may matter as much as whether we attend.
The study opens useful questions for mental health research:
- Does accepting or compassionate attention have different effects from anxious, catastrophic attention?
- Would the findings look similar in people with panic disorder, chronic pain or functional neurological symptoms?
- Most importantly, could this influence outcomes that matter to people, including distress, pain, fatigue, functioning and quality of life?
Future studies should include a neutral rest condition, measure inflammatory markers directly and test whether changes in heart-rate variability explain the skin-response findings. They also need to establish whether these effects extend beyond a brief histamine skin reaction.
I am not about to give up Netflix, pain relief or the comfort of looking away when I feel unwell. But this paper makes me wonder whether attention is more than a mental spotlight. It may be part of the ongoing conversation between brain and body. The message is not “always listen to your body,” but that how we attend to it may matter.
Statement of interests
Estherina Trachtenberg knows the last author, Liron Rozenkrantz, personally. The study was thoroughly critically appraised despite this personal connection and Estherina has no professional or financial involvement in the research. She used AI-assisted tools, including Perplexity, to support editing and clarity of wording; all decisions about content, interpretation and emphasis are her own.
Editor
Edited by Éimear Foley. Claude assisted with language refinement and formatting during the editorial phase.
Links
Primary paper
Nofar Mizrachi, Menachem Rottem, Liron Rozenkrantz (2026) Voluntary attention regulates acute immune responses in humans. Nature Human Behaviour. Published online 17 August 2026. https://doi.org/10.1038/s41562-026-02541-1
Other references
Black DS, Slavich GM. (2016) Mindfulness meditation and the immune system: a systematic review of randomised controlled trials. Annals of the New York Academy of Sciences, 1373(1), 13-24.
Khalsa SS, Adolphs R, Cameron OG, Critchley HD, Davenport PW, Feinstein JS, et al. (2018) Interoception and mental health: a roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3(6), 501-513.
Lubianiker, N., Koren, T., Djerasi, M. et al. Upregulation of reward mesolimbic activity and immune response to vaccination: a randomized controlled trial. Nat Med 32, 572–581 (2026). https://doi.org/10.1038/s41591-025-04140-5
Schneider E, Hernández C, Brock R, Eckstein M, Bodenmann G, Heinrichs M, Ehlert U, Läuchli S, Ditzen B. Intranasal Oxytocin and Physical Intimacy for Dermatological Wound Healing and Neuroendocrine Stress: A Randomized Clinical Trial. JAMA Psychiatry. 2026 Feb 1;83(2):118-127.
Trachtenberg E. Oxytocin and affection: does intimacy help wounds heal faster? The Mental Elf. 25 Feb 2026.
Trachtenberg E. Can positive expectations tune the immune system? The Mental Elf. 20 Apr 2026.