Interoception: The foundation for Emotional Regulation
Interoception is often referred to as the “8th sense” ; it is your internal cues of what is going on inside of your body. It can include hunger, heart rate, breathing, pain, and many other internal body signals. These internal cues then help us determine what actions we need to take to feel regulated and help us determine our emotional state. When individuals struggle to identify their needs it can lead to issues in regulating their emotional state.
As we continue to learn more about interoception we are finding that there is a large co-occurrence between Autism and low interoceptive awareness. This often presents as poor emotional regulation, sensory regulation, and difficulty with participation in daily activities.
Some reasons that autistic individuals can experience low interoceptive awareness include:
Alexithymia: Alexithymia is a term used to describe difficulty with identifying and describing emotions experienced by oneself. Studies have shown a high incidence of Alexithymia in autistic individuals.
Sensory Differences: Autistic individuals experience the sensory world differently than neurotypical individuals and this difference is often not validated or acknowledged. When we try to help by saying things like “it’s not that loud! You’re going to be ok!” or “It’s not yucky! You’ll like it if you try it!”, we are invalidating their sensory experience and telling them what they are experiencing is wrong
Exposure to behavioral strategies: Autistic individuals are often exposed to behavioral strategies in school, therapy, or at home. These strategies will often encourage them to ignore their feelings of anxiety or frustration and push through the activity to earn their “reward”. This is seen with the use of reward or token boards or when they are instructed that they can take a sensory break only when a task has been completed.
Social differences: Autistic individuals often show emotions differently than neurotypical peers. We can then mislabel their emotions by incorrectly guessing how they are feeling. This can look like a parent saying “I know you’re sad we’re not going to the park today” or “Why are you mad? What’s wrong?”
Low interoception can lead to emotional dysregulation and meltdowns when cues are missed about how an individual is feeling inside. Small warning signs or discomfort are missed until the issue becomes too big to ignore and becomes a meltdown. This can look like when an individual is gradually overwhelmed by background noise in a classroom or similar setting. Instead of taking a sensory break or using their noise canceling headphones, they fail to recognize their discomfort and this leads to a sensory meltdown. Another example would be when someone misses their initial internal cues for anxiety and instead of utilizing those coping strategies the anxiety continues to build and we might see self injurious behaviors, elopement or meltdowns.
The good news is research has shown that interoception awareness can be improved.
You can start by bringing awareness to your own interoception by labeling what you are feeling and how you are responding. It is important to only label your own feelings and not try to label your child’s feelings. We do not want to add confusion by mislabeling how they are actually feeling.
Some examples of bringing attention to your own interoception:
“I’m feeling tired, my eyes are heavy”
“My heart is beating fast after running with you. I’m going to rest and take some deep breaths”
“My arms feel cold, I’m going to put a sweater on”
“My mouth feels dry, I should drink some water”.
All of these are ways to acknowledge how you are feeling and help label your internal cues.
The impact of interoception is a newly talked about aspect of self regulation. If you would like additional support on this topic please reach out.
