You may have heard the term interoception before and know what it means, or maybe this is a completely new concept for you to understand. Many neurodivergent individuals with Autism and/or ADHD struggle with interoception skills which, as a result, can negatively impact mental and physical health. I didn’t really learn about interoception until years after my doctoral program and through loads of additional training, personal research, and most importantly, through my work and hearing stories of countless neurodivergent individuals, couples, and families. Interestingly enough, interoception sounds complicated but it really makes a lot of sense when you break its important nervous system role down. I hope to increase your knowledge and understanding of what interoception means, and how it’s impacted by the neurodivergent brain.
What Is Interoception & The Felt Sense?
Interoception (otherwise known as the “eighth sense” or “felt sense”) is the ability to perceive and maintain awareness of our physiological state. It is a felt sense of one’s own internal process and learning how to pay attention and be sensitive to the feedback from one’s body. Interoception plays an important and key role in the ability to self-regulate and keep our body in a state of homeostasis and balance (both emotionally and physically). Our bodies have automatic, built-in, and regulatory processes that keep us in balance and are necessary for survival. You may think of this like a thermostat that kicks into gear to heat or cool a room when the temperature changes. With interoception, our body gets a signal to regulate to maintain a sense of well-being, survival, and balance.
Self-Regulation 101 & Neurodivergence
By self-regulate, I am referring here to both the ability to regulate physical needs (e.g., hungry, tired, thirst, pain) and emotional needs (e.g., anxiety, anger, frustration, sadness, excitement, and happiness). For example, if you are hungry, you may feel the sensation of a hollow stomach, hear a loud grumble, or experience the physical symptoms of low blood sugar. This prompts you to take action and get something to eat to stay in homeostasis. With emotions, you may be cued into the heart racing or feeling shaky, which sends the important message that you are experiencing some anxiety, which can prompt you to self-regulate with soothing strategies such as stimming, breathwork, grounding activities, and/or physical movement. As a result of your engagement in self-regulatory strategies, your body reduces the anxiety symptoms and homeostasis is restored.
Once I learned about interoception awareness, and through my work with neurodivergent clients (Autism, ADHD, PTSD, C-PTSD), I began to realize why typical emotional regulation skills and interventions used by many therapists weren’t as effective for most of my clients in my private practice. The role of self-regulation and emotional regulation are vital skills for well-being and trauma healing, yet it’s a bit harder to access this self-regulatory process as a Neurogivegent individual. Therefore, it is important to find a clinician who is skilled in adapting sessions, individualizing, and allowing for space to build the skill of interoception in sessions before doing any deeper or more meaningful work in therapy and trauma healing.
Interoception and Trauma Healing
What we have learned about interoception and self-regulation is that we can’t rely on cognitive strategies or “top-down” approaches alone. We have to pay attention to the somatic body cues and use “bottom-up approaches”. As a result, interoception skills plus self-regulation help with trauma resolution and moving through healing.
Bessel van der Kolk, M.D., in his book The Body Keeps the Score, writes:
“Agency starts with what scientists call interoception, our awareness of our subtle sensory, body-based feelings: the greater that awareness, the greater our potential to control our lives. Knowing what we feel is the first step to knowing why we feel that way. If we are aware of the constant changes in our inner and outer environment, we can mobilize to manage them.”
So essentially, interoception and the ability to tune into our body cues and respond with self-regulation and emotional regulation skills are vital for well-being and trauma healing.
Important Considerations for Interoception & Neurodivergence in the Therapy Room
- It’s important to find a therapist who understands the impact of interoception and how to support learning these important regulation skills. Adapting therapy sessions to accommodate individualized needs and going at the own pace of the client is essential.
- When we don’t have good interoceptive awareness or the skills to self-regulate, we can’t access therapy in the most beneficial way. Your therapist should start by teaching you how to access these skills at the beginning of sessions so that you can learn to self-regulate in therapy first and then out in the real world where it matters the most.
- Interoception is connected to alexithymia, which also makes accessing self-regulation skills a bit more difficult. Your therapist should understand alexithymia and how to incorporate that need into your therapy sessions.
- Your therapist should explore masking and help you learn how to de-mask. De-masking allows you to better understand and connect with your own internal experiences and needs.
- The therapist should be supportive of teaching self-regulation skills
- Learning how to track your heart rate to identify flooding and deep physiological arousal. In general, a heart rate over 100 indicates you are in a heightened emotional state and your nervous system is dysregulated
- Teaching relaxation techniques that accommodate any physical or sensory needs
- Teaching mindfulness techniques that are also individualized and based on client feedback around what feels supportive and helpful
- Slowing down the process and learning how to do a body scan to tune into physical and emotional cues
- Grounding and sensory-friendly activities
- Breathing strategies
- Tapping and Bi-lateral Stimulation
- Preferred activities and materials in the therapy room to pair with learning new skills (e.g., doodling, coloring, fidgets, music, weighted blankets, and visual aids).
What Can be Done?
Clearly, finding ways to tune into the eighth felt sense and to regulate with interoceptive skills is essential in moving through healing and personal growth. Knowing what your needs are is a key factor in de-masking, trauma healing, setting important boundaries, and getting your own needs met in a way that feels sustainable and healthy. A compassionate therapist, who is skilled in understanding interoception, trauma, and neurodiversity can help you feel seen, and empowered instead of misunderstood or alienated. Please consider seeking support in an encouraging environment, I’m here to help. Contact me soon for a free phone consultation.