Lost in Translation: Interoception and Neurodivergent Experiences
What is Interoceptive Awareness?
Interoceptive Awareness (IA) refers to how well we notice and interpret internal signals, such as hunger, thirst, pain and emotions. Everyone’s interoceptive sensitivity exists on a spectrum - it’s highly variable, especially for neurodivergent individuals. Some experience heightened sensitivity, experiencing intense and potentially distressing sensations, while others have reduced sensitivity, and so find it hard to notice or identify bodily cues accurately. Neurodivergent individuals often experience a mix of both, with responses that may vary over time or in different contexts.
When IA functions well, it helps us maintain balance in life. For example, hunger prompts us to eat, thirst reminds us to hydrate, feeling cold leads us to seek warmth and feeling too hot will drive us to cool off. Beyond physical needs, IA also influences emotional regulation and social connection, helping us recognise and respond to our feelings and those of others. However, for those with interoceptive differences, this finely tuned system can become unpredictable and unreliable, making it difficult to meet even our most basic needs.
The Interoceptive Brain: The Role of the Insula
The insula, located deep within the brain, is the hub for interoception. It receives and processes all sorts of sensory information created by monitoring our internal body state, and ultimately determines whether any action is needed. Research suggests the insula integrates these internal signals with external stimuli, explaining phenomena like turning down the car radio to “see better” or needing to doodle or move about to improve concentration.
Understanding the insula’s role has helped clarify why interoception differences can lead to the unique challenges neurodivergent individuals can face in managing physical and emotional well-being.
Low and High Interoceptive Awareness: A Double-Edged Sword
Low IA: The Struggles of Missing Signals
For individuals with low interoceptive sensitivity, internal signals may feel faint, abstract, or entirely absent. This can result in:
Hunger blindness: Hunger cues might be ignored or confused with other sensations, like anxiety, leading to delayed eating, fatigue, and emotional dysregulation.
Thirst misinterpretation: Thirst might be mistaken for hunger or overlooked altogether, causing dehydration symptoms like headaches, mood swings, or forgetfulness.
Missed signs of fatigue or pain: Overworking, burnout, or delayed medical care may occur when tiredness, discomfort, or illness goes unrecognised.
Low IA can also make it harder to recognise emotions, a condition known as alexithymia. For example, an increased heart rate might feel ambiguous - is it excitement, fear, or physical exertion? Without clarity, emotional regulation becomes more challenging.
High IA: When Sensations Become Overwhelming
High sensitivity to internal states isn’t necessarily better. For some, intense awareness of bodily sensations can be distracting or distressing, leading to:
Overwhelming hunger or fullness: Some individuals feel intense discomfort with hunger, prompting them to overeat or restrict their intake to avoid the sensation. Similarly, fullness may feel so unpleasant that eating is avoided.
Temperature sensitivity: Difficulty regulating body temperature can make small changes in warmth or cold feel unbearable, increasing stress and overstimulation.
Hyperawareness of body sounds: Quiet settings can heighten focus on internal noises, like a heartbeat, rumbling stomach or ear ringing, which can feel distressing.
Interestingly, individuals can experience both low sensitivity and high sensitivity simultaneously. For example, they might detect a sensation acutely but struggle to interpret its cause or meaning, a phenomenon linked to low interoceptive accuracy. This creates a paradoxical state of intense feelings paired with confusion, further fueling anxiety (read more here).
Supporting Interoceptive Differences
Improving IA isn’t about “fixing” these challenges but creating systems of support and learning strategies to connect with bodily needs. Here’s how:
1. Accommodations and Adaptations
Support begins by addressing the practical barriers caused by interoceptive challenges. Strategies include:
Using reminders: Alarms or visual prompts for meals, hydration, and rest can bypass low IA and ensure basic needs are met more regularly.
Simplifying decisions: A list of meal options can reduce decision fatigue, while small cues - like asking whether you want something hot or cold, spicy or plain - can clarify preferences.
Adapting frameworks like Intuitive Eating (IE): While originally designed for neurotypical individuals, IE can be helpful when tailored for neurodivergent needs. Its focus on food neutrality and self-compassion can reduce food-related anxiety, though it must account for interoceptive and executive function challenges. You can read about this in another blog here).
2. Interoceptive Awareness Builders
Building IA is a gradual process that involves reconnecting with internal signals in non-judgmental ways. Practices include:
Gentle sensory activities: Focus on small, manageable sensations, like feeling the texture of fabric or noting the temperature of a drink.
Movement practices: Yoga, stretching, or low-intensity movement can help foster awareness of bodily signals. However, be mindful of potential trauma responses; breathwork and body scans may feel triggering for some.
Exploration through play: Games or activities that involve noticing changes in the body (e.g., when exercising or resting) can make interoception feel less intimidating and more engaging.
I highly recommend Kelly Mahler for further information and resources on building interoception.
3. Patience and Compassion
Above all, supporting interoceptive differences requires patience and kindness. Recognise that every individual’s experience is unique, and progress may be slow. Emphasising safety, anxiety reduction, and allowing space for exploration without expectations are key to creating a supportive environment.
Interoception is a powerful, complex system that influences how we meet our needs and connect with ourselves. For neurodivergent individuals, interoceptive challenges can create unique hurdles in daily life, but these difficulties are not insurmountable. By embracing accommodations, fostering gentle awareness, and prioritising compassion, we can help bridge the gap between internal signals and actionable self-care. Remember, interoception isn’t about achieving perfection- it’s about building understanding and finding what works for each unique individual.
Looking for more support?
If you’d like to learn more to help you better understand your own experiences, I welcome you to book a free 30 minute chat online.