Interoception
A post discussing what Interoception is and how it presents in my life as an autistic person.
Of course, all of the terms I’ve been reviewing in this recent series are things I wish I had learned earlier in life, but this particular one would have helped me immensely had I known it sooner. Interoception is the umbrella term used to describe the process in which your brain perceives your body’s internal state both consciously and unconsciously. The interoceptive signals sent to your brain should accurately allow you to determine how you feel both emotionally and physically within your body.
When there is a disconnect between your brain and your body, your brain will misinterpret the signals and inaccurately predict your internal state. Per Wikipedia, this impacts almost all of the things I’ve personally struggled with in life: anxiety, depression, panic disorder, anorexia nervosa, bulimia nervosa, posttraumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), alexithymia, somatic symptom disorder, and illness anxiety disorder. It is also associated with autism, schizophrenia, and substance abuse.
A study of people doing the interoceptive task of judging the timing of their own heartbeat showed that the neural activity within the insular cortex (also known as “insula” which is a portion of your brain’s cerebral cortex) aligned with the predicted subject’s accuracy in heartbeat detection. So that means they were able to show that the people with high interoceptive awareness had enhanced activity in the insula with more gray matter found there. The findings also showed that people with low interoceptive awareness had diminished activity in the insula with less gray matter.
You can do the heartbeat detection test on your own to get a general sense of whether your interoceptive awareness is high or low. Sit “in a safe and comfortable position, close your eyes, and try to feel your heart beating in your chest. Can you, without moving your hands to take your pulse, feel each movement and count its rhythm? Or do you struggle to detect anything at all?”
Interoception encompasses a variety of different systems within your body including: cardiovascular, gastrointestinal, endocrine & immune, nociceptive, respiratory, and thermoregulatory.
Cardiovascular: heartbeat
Gastrointestinal: hunger/thirst and fullness
Endocrine & Immune: regulating stress levels through allostasis (the active process of reestablishing homeostasis) and maintaining homeostasis (steady state of internal conditions required to maintain life) via multiple glands and hormones
Nociceptive: receiving and processing pain signals via the central nervous system
Respiratory: breathing, including dyspnea (difficulty breathing) during panic attacks, and/or constrictive breathing due to chronic stress or trauma
Thermoregulatory: regulating body temperature, sweating
Some people also include the Integumentary system (even though it is more external than internal) which includes your skin (including glands and nerves), hair, nails, and tactile receptors in your skin. There is an overlap in this system with your immune system, respiratory system, and thermoregulatory system.
In a healthy body, all your systems will be balanced and capable of maintaining homeostasis (stability) through their various functions. Interoceptive signals alert the brain to make changes to achieve homeostasis. For example, if you are hungry, someone with high interoceptive awareness will recognize the signal and realize it is time to eat to keep their blood sugar regulated. When you have low interoceptive awareness, it can keep your body imbalanced due to being unable to regulate your body’s needs in a timely fashion. An autistic person who hyperfocuses and forgets to eat would be an example of low interoceptive awareness.
Other studies have shown the connection between interoceptive awareness and emotions. The findings indicate that people who have higher interoceptive awareness are able to perceive and process their emotions easier than those with lower interoceptive awareness.
This is an overlap with alexithymia as “Those with alexithymia therefore not only struggle to recognize their own emotions (affective interoception) but also confuse these states with non-affective interoceptive states, such as hunger, tiredness and arousal. Alexithymia may, therefore, be characterized better by a general failure of interoception.”
In order to emotionally regulate, the first step is accurately recognizing your current emotional state. For people with alexithymia and low interoceptive awareness, it can be challenging to determine your emotion which makes it even more difficult to emotionally regulate yourself.
Personally, I have difficulties with interoceptive awareness in all my body’s systems. My anxiety/panic impacts my heart rate, breathing, and body temperature. My body naturally struggles to maintain a pleasant temp; I sweat both when I am hot and when I am cold. My IBS and previous eating disorders are directly related to my GI system. My fibromyalgia is connected to my nervous system, my immune system, and my integumentary system where pain, temperature, and touch signals present in non-standard ways.
Some of the ways I am adapting to the realization that I have low interoceptive awareness include:
Implementing a HALT check-in to see if I am Hungry, Angry, Lonely, or Tired when I realize I am having trouble thinking clearly.
Adhering to a fairly consistent schedule of eating and drinking water. I meal plan & meal prep at the start of the week for one week at a time, and I also fill up reusable water bottles to have ready-to-go to maintain hydration. I try to drink at minimum two 32oz bottles of water per day.
I started meditating last year, and while it was initially very triggering and troublesome to do some of the body scans and breathing-focused exercises, I am learning through my daily practice how to incorporate these into my life without the initial detriment they provoked. On my bad days, I know to avoid them.
Regular massage appointments help release my body tension, relax my muscles, and increase blood circulation. They keep some of my fibro symptoms at bay too!
While I’m still figuring out how to perceive my emotions through the various techniques described in the previous alexithymia post, I am also exploring somatic exercises to process trauma, help regulate stress, and emotionally regulate. (More on this topic in a future post!)
Some other things that I know would help but I haven’t been able to fully incorporate into my current routine (yet!):
A consistent sleep schedule.
Daily gua sha routine.
While it might not seem like these suggestions are directly related to interoceptive awareness, my theory is that they will help me care for my body while I learn the tools to recognize my emotional states & body states and practice techniques on how to regulate my emotions & body imbalances.
For further reading on this topic, I recommend this piece from Neurodivergent insights.
Do you experience low interoceptive awareness? If so, how does it present in your life?
Also, if you have further suggestions on how to adapt, I would love to hear those in the comments too!
~The Overstimulated
