Interoception: Feeling Your Feelings

What do you think of interoception? No, really, how do you feel about it? There are ways to get in touch with your mind, body and emotions. Learn how they’re connected and whether interoception is an issue for you.

Transcript

Interoception

A disclaimer: Nothing here is intended to be medical advice. If you have a medical or mental condition please seek help from a professional.

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Most of us learned about the five senses in school – sight, hearing, smell, taste and touch. There are more than 5! The sixth and seventh sense are called vestibular which is related to balance and proprioception which is related to posture and movement. 

There is also a lesser-known sense, the eighth sense, called interoception. This sense keeps a person in touch with what is going on inside of the body like hunger, thirst, feeling hot or cold, fatigue, or a full bladder.

Interoception is also the sensory system that gives us information about BODY-EMOTION connections.

Interoceptive awareness makes it possible to:

• NOTICE body signals
• CONNECT body signals to the emotion

Body signals in autistics can be:

• Strong and Overpowering

• There may be too many body signals noticed all at

once

• They may be muted

• The might not be noticed until they are

intense OR

• They might go completely unnoticed, or

• A person might notice body signals but not be able to give details about the location or feeling

Interoception plays a role in potty or toilet training. In essence the child learns to notice their body signals and to understand what they mean.

Most autistics can learn to:

Notice what’s going on in the body;

Connect with it

Regulate it

We can notice how our body feels when we’re:

Angry

Sleepy

Hungry

Tired

Sad

Hurt

Stressed

Upset

To notice something going on in your body think of it this way. When you’re feeling your muscle tense up you can learn it’s from stress, tension, etc. What do you feel in your body if you are:

Excited

Disgusted

Embarrassed

When you are angry how does your body feel?

It’s okay 

• Not to know what you feel

• Not to be in the mood for sharing your feelings

Interoception might be different based on culture. Some cultures don’t encourage expressions of emotion. This might lead to ignoring emotions and the bodily feelings associated with them.

Interoception involves receptors throughout our bodies that send information about our muscles, skin, bones, and internal organs to our brains. The brain interprets the information and we feel hunger, our heartbeat, pain, body temperature, nausea, need for the bathroom etc. 

When the interoceptive system is properly working, the sensations alert us that our internal balance is off and motivates us to take action, to do something that will restore the balance and help us feel more comfortable. 

For example, if a person feels hungry they eat, if they feel full they stop. They drink water when they’re thirsty. 

I recently saw a video of an autistic woman drinking a huge glass of water within seconds. I hadn’t realized that was an autistic thing as I do that and family has commented on how quickly I can gulp down a pint of water.

Interoception is what urges us to take action. When we feel uncomfortable, due to hunger, thirst, etc., we want to relieve that discomfort.

Interoception also plays a role in allowing us to feel emotions. Being autistic means that sometimes you may not notice these things. Issues with interoception make it hard to recognize and regulate emotions.

Usually each emotion feels differently in the body. For example, a person facing a job interview is going to have some anxiety. If you’re in the situation you can understand to expect that you will feel anxious. 

There are physical symptoms that tell us we’re having anxiety. Is your heart racing? Do you feel like you can’t easily catch your breath or are you breathing rapidly? Are you sweating more than usual? If a person doesn’t clearly feel these sensations, it’s difficult to identify emotions. If we can’t identify them we can’t take action that our body needs.

In addition to self-regulation, interoception is clearly linked to many other important skill areas including:

Self-awareness

Flexibility of thought

Problem solving

Social understanding

Intuition

Perspective taking

I find this interesting in particular because some autistics seem to have a keen intuition, are great problem solvers and at times are flexible in thinking particularly about a subject of interest.

The interoceptive system often is negatively impacted in individuals with autism. Generally speaking autistics have lower awareness of their interoceptive signals. There are some who are overly aware of their physical bodies and have a lot of anxiety about how well it functions. This can lead to rumination and fear. Ruminating over whether you need to see the doctor, afraid of what she will find if you do and on and on.

You may already know that as you get older things start to break down physically. Fortunately it’s a long process and often a person doesn’t know how those wrinkles got there.

I remember when I first reached 60 there were little annoying things that would happen. A knee would ache, I might notice a rash, or it would get harder to open bottles and jars. Of course my first thought was that it was serious and I better go to the doctor. I didn’t want to, I’m autistic after all. I procrastinated.

Then something interesting happened. I found that if I waited a few days or a week the symptoms often resolved themselves. 

This is so different from when I was younger and a painful whatever meant there was something wrong. Now it means I’m older and my body overdid something and I just need to let it reset. I’m noticing the aches and pain more I just have to ignore them unless they last or get worse! A conundrum.

I have a friend who waited several days to go to the hospital for extreme pain she had in her leg from a blood clot. Her family said she had a high pain tolerance. I thought maybe she feels the same amount of pain but just doesn’t complain about it. Is that possible or do you think most autistics can actually tolerate pain?

There’s a study from this year that looked at pain perception in autistic people.  The study found that autistics experience pain at a higher intensity than the general population and are less able to adapt to it. This is contrary to the belief that people with autism are supposedly 'indifferent to pain’.

I appreciate the study because I feel pain intensely yet I often won’t say anything about it.

Interoception is on a spectrum. Some autistics can learn to be more perceptive while others’ brains don’t.

We know that a common co-occurring condition in autistics is alexithymia which is a difficulty identifying and describing feelings. Approximately 50% of autistics may be alexithymic. There may be an association with alexithymia and interoception.

I read a book which approached interoception in a different way from how we typically look at emotions and the body. The book suggested that symptoms of an underlying disease or illness and emotions are related. For example, a sore throat might be from angry words that you aren’t expressing. 

I get that this might sound a bit new-agey. I’m not saying I believe there is a correlation like this. Emotions may be a contributing factor to injuries and illness. I used the book to help me become more aware of my emotions and lear to connect them to my body. 

This is definitely a skill that takes time to learn. If I had a sore throat I would ask myself “am I holding in angry words?” It was a starting point to noticing, inquiring and solving what felt uncomfortable. I emphasize “starting point.”

There are times when our bodies are speaking to us even before we get a particular illness. For example, some people who are prone to migraine headaches may see spots or sometimes they’re called “lights” in connection with the migraines.

It’s referred to as a prodrome to a migraine. A prodrome is an early symptom at the onset of a disease or illness. 

Often people don’t notice symptoms until the illness gets worse. If a person notices a prodrome it’s possible to take action early, like taking medication.

For an autistic person it can be difficult to recognize our symptoms of any illness let alone a prodrome, right? It’s taken a long time for me to understand prodromes and how they relate to illness. It has taken years to put the two together. It helps to write down symptoms and notice if  there’s a pattern.

Some autistics will notice a mild sore throat and wonder if they need to see a doctor. The next day they may notice more symptoms and the illness, in this case a cold, may become more obvious. We may learn that the next time we have a mild sore throat we may be getting a cold. It can help us avoid exposing someone else.

These prodromes vary from person to person particularly when it comes to colds but you can get to know yours with observation.

I referred to the book I read when I was having extreme shoulder and arm pain. I didn’t do anything physical that would have caused it. The book said the pain was “holding in a punch” in other words being extremely angry.

That led me to question whether I was very angry about something. I was although I hadn’t realized it. Sometimes an autistic person may dislike a situation yet not realize how strongly they feel about it or how it’s affecting them physically.

Sure enough it turned out there was a situation at work involving an individual who continuously went out of her way to frustrate my work and I was pretty angry about it. 

Once I understood what was underlying the pain it was a bit easier to deal with both the emotional issue and the physical. I had to do physical therapy for my arm - noticing physical pain and it’s possible underlying emotion doesn’t mean it goes away on its own.

You can experiment with this yourself. As you notice something in your body see if there is a correlation with an emotion. 

Most of us have learned that when a person is experiencing anxiety their heart rate increases and they may be short of breath. I think it’s possible to start out by understanding what is a common, related reaction under certain circumstances.

Sometimes when I’m driving I realize I’m not enjoying it. I may complain to myself about the traffic, the roads, etc. I’m not stressed, I think. Then I notice my hands are clenching the steering wheel and I’m holding my breath and that tells me I am feeling stressed. 

Deep breathing can be a way to lessen feelings of stress and anxiety and that’s something easy to do even when driving.

It takes practice and learning and not everyone will be able to do it. As I said, interoception is on a spectrum. It took me a very long time to put emotions and physical symptoms together and there are still times when I can’t do it. 

One thing I often ignore is drinking water. That’s not good when you live in a desert. There are days when I’d get sick to my stomach, have a headache and just feel awful.

In Arizona we hear a lot about drinking enough water. It’s said that if you’re thirsty you’re already dehydrated. 

Well, I get thirsty and I notice it but I ignore it if I’m focused on something. I pay attention to nausea though which is a sign of dehydration that has gone way past thirst. 

I don’t like to admit that I’m not in tune with my body. I tell myself that I’m just too busy and I can wait a bit longer. I’ve now learned that I can’t or I’ll pay for it.

There are some things you can do to improve interoception. They may not work for everyone.

Take a moment and notice what you feel in your body. Autistics are sensitive. We notice how our clothes feel, the temperature in a room, the hum of fluorescent lights among other things. 

What else do you feel? Several times a day take a moment to notice what you’re feeling and where in your body you feel it. If you’re not aware it’s okay. Try again another day.

Also notice your emotions. If you think you’re not feeling anything, ask yourself how others might feel in this situation. Sure, we don’t know what a particular person might feel, not even neurotypicals know that for sure. 

We already know some common things, like if your partner breaks up with you most likely you have strong feelings, if a dangerous animal is chasing someone most likely they’ll have physical and emotional feelings.

In a breakup where you know you’re feeling emotional, notice what your body feels like. Do you have pain in your chest or throat? Is your stomach tense? Have you lost your appetite? This can be sadness, grief, hurt, regret, guilt, anger or all of them.

Another thing I’d recommend is that you take your pulse while you’re resting on the couch or sitting in a chair so you know your normal heart rate. If later you’re in a situation that would raise a person’s heart rate you can check your own and see what results you get. Running is a physical reason for your heart rate to increase; stress would be an emotional reason.

 When you are at the doctor and they take your temperature or blood pressure or look in your ears, whatever it is, ask the doctor the results. Get to know these “black and white”numbers and you are getting to know your body. I find doctors often don’t tell me until I ask.

When you are not feeling well or get sick try to notice what came first before that terrible cough or high fever. Were you short of breath for a few days? Were you sleeping too much? Were you snapping at people?Anything else that seems subtle to you. Notice if it happens again and start to put together what the prodrome is for you. Autistics are good at pattern recognition, remember? 

I’m not saying that if you see an aura you’re going to have a migraine, we don’t want a self-fulfilling prophecy. Noticing it though can help you look for a pattern. 

Many of us have COVID tests at home or have taken one. What would make you want a test? Fear, anxiety? Not feeling well, high fever? This is interoception, you’re noticing how you feel and taking action to safeguard your health.

Another tip: for awhile notice when you say the word “think”. It can be a substitute for the word feel. “I think it’s going to be a good day” becomes “I feel like it’s going to be a good day.” Try using feel to replace the word “think” and see if it helps you see your emotions differently.

Autistics have a tendency to intellectualize feelings. It’s a way we deal with emotional discomfort. It’s not the healthiest way to approach life and isn’t good long term. Often it doesn’t work anyway.

I’ve heard that mindfulness or yoga can help. Mindfulness means noticing your body, your emotions, your surroundings in the moment. It’s letting go of thoughts about the past or future and just “being.” Mindfulness can help you practice understanding what’s going on in your body and with emotions.

Your body communicates with you. Some people say that if you ignore this communication, or don’t pick up on it due to interoception issues the brain will “speak” louder until it gets your attention. It’s kind of like your car I guess. If you don’t pay attention to something small that’s wrong with it, it will get worse until you have no choice. 

Most of us autistics love the way it feels when we’re learning. Notice it the next time you go down the research black hole. Notice your body. What about when you’re involved in your special interest? Has anyone ever told you that your face lights up when you talk about it? That’s happiness to a high degree. 

The goal is to notice how your body feels, notice your emotions and…use this information for your benefit. Let go of worry about little things that don’t feel right. Avoid ruminating. Improve your interoceptive sense if you can.

Now that we’ve reached the end of this episode I’m hoping you’re feeling happy that you’ve learned something new about interoception.

Listen to other episodes to learn more about how the autistic brain works. Reach out to me by email at info@theautisticwoman.com. Tell your family and friends about the podcast so others can learn what it’s like to be autistic. 

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