Interoception and its Role in Emotional Regulation

Interoception is a complex mechanism that registers different internal sensations for homeostasis (such as registering hunger, bathroom needs, heart rate) as well as connecting us to our internal emotional landscape by registering associated feelings with the sensations. For example, if the sensation of a waistband on clothing is strongly perceived/felt, identifying that the accompanying emotion of annoyance is a big step to building interoception.  

Interoception works through a vast network of sensory receptors in the body: the skin, the muscles, the fascia, the bones, the internal organs, and the inner ears are all examples. Ideally, when our interoception is functioning sufficiently, we can feel our hunger cues and eat when hungry, stop eating when full, know when we have to use the bathroom, and know when we need to rest. With good interoception, we have a connection to our internal emotional landscape. We recognize our feelings when they arise, and can make necessary accommodations or take appropriate action steps. We can advocate for ourselves, and tend to our needs (or ask for help when we need to). 

Why do so many people have difficulties with interoception? Well, it has been identified that interoception is not well developed in neurodiverse individuals. It has also been identified that people who have experienced trauma can also have insufficient interoception. And if you think “I’ve not experienced trauma”, I think that we all have to some capacity–including living during a pandemic and also under uncertainty in the world. 

Here are some examples of poor or insufficient interoception that you might see with your child:

• bladder/bowel accidents due to lack of feeling the urge
• not registering hunger or fullness until too late (resulting in “hanger” or being “too full”)
• diminished ability to identify feelings/numbness
• being too sedentary
• needing a lot of movement
• needing a lot of muscle work
• not registering food on their face
• not noticing that shoes are on the wrong foot or if clothes are on backwards
• not being able to problem solve how to fix something or feel better if annoyed
• becoming explosive very quickly (not registering the build up of feelings)

Sometimes, we diminish our child’s interoception–with good intentions–by negating an experience for them. An example of this: “Wait, didn’t you just eat? You can’t be hungry again, it’s only 20 minutes later!” Even though this is a fairly innocent remark (and that when saying this, you are trying to help build your child’s interoception) it actually can backfire. It teaches your child that they don’t know what their body needs. That they should rely on an external cue, such as how much or little food they’ve eaten, versus the internal cues from their own body.

Kelly Mahler, OTD, OTR/L, has created a wonderful body of work called The Interoception Curriculum. This work encourages us to start paying attention to sensory sensations and link the sensations to emotions. You can use these simple steps to begin to help your child (and notice more about your own interoception). 

1. Pay attention to a sensation–start on the outside of the body, like the hands or feet, when washing hands or being barefoot, for example. Ask your child to describe the sensation of the experience. 
2. Get curious about how the sensation makes your child (or you) feel. It could be comfortable, fun, happy, sad, frustrated, uncomfortable, etc. 
3. Wonder, “is there anything that needs to be done right now?” For example, if there is an uncomfortable feeling, is there anything to do to help your child feel better?

A couple of things to consider when trying this with your child:

• Your child may not be able to do ANY of this….yet. If they cannot identify any (or any part) of these 3 things, model some things that YOU sense or feel. One example: “Oh, when I’m washing my hands, it feels warm/cold, and bubbly. That makes me feel relaxed, and I keep doing it until I have all of the soap off of my hands.”
• If your child gives an unexpected response, simply get curious. You can ask “Oh, wow. Tell me more about that.”
• It’s important to validate your child throughout the process. 
• When you model something for your child, make sure that you are sharing your experience, not what their experience should be. It will help to give them a clue. 
• Carve out a time to do this during daily routines: bath time, washing hands, or sensory play are good times to practice.

When practicing these ideas, know that this is a process, and not a quick fix. The more we can help build our children’s interoception through curiosity and validation, the more that they can effectively self-regulate, as interoception is a key building block for self regulation. Taking the time to notice, get curious, and validate your child’s experience will go a long way in getting them to trust themselves, and advocate for their needs.