Interoception

What is interoception?

Interoception is awareness of your body’s internal senses or signals. It identifies how you feel.

You can consciously or unconsciously respond to these signals. For example, if your stomach rumbles, you know you’re hungry. You can go have a snack. Once you’ve satisfied your hunger, you’ve reached a state of balance — your body stops sending you hunger signals. This is called homeostasis.

As you grow and develop, you learn more about what important interoception skills are necessary, like feeling the need to pee or poop and knowing when to use the toilet.

It can also have a significant impact on your behavior and emotions. For example, if you’re in a dark room and your heart is beating fast, you might feel scared. By identifying how you feel, interoception helps you make a decision. In this example, you can decide to turn on a light.

Interoception may be more difficult for some to recognize and interpret than others. There are ways you can practice and improve your interoception skills. A healthcare provider may help you with this.

Examples of interoception

Examples of interoception include the following feelings:

• A full bladder
• Anxiety or nervousness
• Hot or cold temperatures
• Hunger
• Itchy skin
• Muscle tension
• Nausea
• Thirst
• Pain
• Your heartbeat

How does interoception work?

There are three steps to the interoception process:

1. Sensing (you feel a sensation). An interoceptor (sensor in a neuron/nerve cell) detects a signal. A neuron sends it along a nerve fiber pathway to your brain. It lands in a region called your thalamus. (Your stomach rumbles).
2. Interpreting (you determine what the feeling is). Your thalamus sends the information to the insula to decode it. Your insula rewrites the message into a language that you can understand. (You feel hungry).
3. Integrating (you take action). You read the message with your conscious mind and determine whether or not you need to take action. (You eat some food).

Your understanding of the sensation may be:

• Benign. It’s harmless.
• Ambiguous. Not sure about all the details.
• Threatening. It will cause harm.

Certain mental health conditions like anxiety disorders may make you perceive benign sensations as threatening ones. This could potentially cause you to have more symptoms and stress. The opposite is true for depression, which may make it difficult for you to clearly identify a threatening sensation, like pain from an injury.

What are the types of interoception?

There are two types of interoception. They describe your ability to detect internal signals

• Attention: How often you notice signals from your body
• Accuracy: How correct you are at understanding signals from your body

You may be highly in tune with these signals, while others may not notice them. It varies significantly from person to person.

A healthcare provider might use different techniques to measure interoception functionality, like having you:

• Answer questions about what you feel, like do you feel your heartbeat right now?
• Perform a task, like count how many times you feel your heartbeat in a minute or does the beat of this song match your heartbeat?
• Use a device-assisted task performance. For example, while wearing a heart rate monitor to confirm the accuracy, how many times can you feel your heart beat in a minute?

What are the signs and symptoms of interoception?

Your body tries to communicate these signals through signs and symptoms. Common signs of interoception include:

• Dilated pupils
• Fast breathing
• Fast heartbeat
• Flushing
• Goosebumps (piloerection)
• Sweating

Common symptoms of interoception may include:

• Discomfort after an injury (nociceptive pain)
• Dry mouth
• Muscle stiffness
• Nausea
• Abdominal pain

What are the symptoms of poor interoception?

You might notice your interoception skills may not be working as well as expected if you experience any of the following common symptoms:

• Difficulty knowing when your bladder is full (when you need to pee)
• Difficulty managing emotions
• Feeling easily anxious
• Having a high or low pain tolerance
• Not feeling hungry or thirsty or not feeling full after a meal

Many different conditions can affect how well interoception works. In some cases, interoception skills may not be fully developed.

What conditions affect interoception?

The following conditions may affect how well you’re able to process interoception:

• Anxiety disorders
• Attention-deficit/hyperactivity disorder (ADHD)
• Autism
• Depersonalization-derealization disorder
• Depression
• Eating disorders
• Panic disorder
• Post-traumatic stress disorder
• Somatic symptom disorder
• Substance use disorder

How does interoception relate to neurodivergence?

“Neurodivergence” is a term to describe brain functionality that differs from the norm. Interoception, or your ability to detect your body’s internal signals, may be heightened or not working as expected with neurodivergence.

Two examples of neurodivergent conditions that can affect your interoception include:

• Autism. Interoception accuracy (how correct you are at identifying feelings) is low. For example, it might be hard for you to regulate or express your emotions. You might also have trouble identifying bodily needs, like hunger.
• ADHD. Interoception attention (how often you notice signals) is strong but you may have trouble acting on those signals. For example, you feel thirsty but can’t decide what you want to drink.

How to improve interoception?

You can improve your interoception skills by:

• Performing deep breathing exercises (like diaphragmatic breathing or box breathing)
• Practicing mindfulness
• Practicing yoga
• Meditating
• Participating in cognitive behavioral therapy

A mental health professional or healthcare provider will discuss different ways you can meet your goals. These vary from person to person and may be unique to your situation. For example, electrical stimulation (like vagus nerve stimulation) may target areas of your brain to make communication between your body and brain easier.