Interoception is the internal body sense, often referred to as the eighth sense, that gives us awareness of our body’s internal state. Specialized nerve receptors in internal organs, muscles, and skin continuously send signals to the brain, allowing us to answer the fundamental question, “How do I feel?”. Accurate interoception enables us to recognize internal changes and take corrective action, a process necessary for maintaining a stable internal environment, known as homeostasis. This awareness is foundational to survival and emotional regulation.
Defining Interoception and Its Role in Regulation
Interoception is the neurological process of integrating signals from the body into a coherent representation of our physiological state. This information travels along neural pathways, including the vagus nerve, to specific brain regions like the insula and the anterior cingulate cortex. The insula acts as a primary hub, decoding raw physical sensations and translating them into a language the conscious mind can understand. This brain-body loop allows us to connect physical sensations, such as a quickening heart rate or tense muscles, with emotional labels like anxiety or excitement.
The precise awareness of these internal signals is a prerequisite for emotional self-regulation and healthy decision-making. When a person accurately senses their heart pounding, they can interpret it as a sign of stress and choose to engage in calming strategies like deep breathing. This process is also involved in allostasis, the brain’s ability to proactively anticipate and prepare for internal needs. Accurate interoception allows for the predictive regulation of internal sensations, ensuring that needs like hunger, thirst, or temperature changes are met efficiently. Research suggests that different internal signals, such as those from the heart (cardiac) and the stomach (gastric), may even activate distinct regions within the insula.
Recognizing Manifestations of Interoceptive Dysfunction
Interoceptive dysfunction occurs when the brain does not accurately sense, interpret, or integrate signals from the body. This typically manifests in two primary ways: hyposensitivity or hypersensitivity.
Hyposensitivity (Under-Registration)
Hyposensitivity means internal signals are muted or delayed, making it difficult to notice internal changes until they become extreme. Individuals might consistently ignore bodily cues like the initial signs of hunger or thirst. This under-awareness can also extend to pain signals, leading a person to ignore minor injuries or delay seeking help for serious illness. A lack of awareness of bladder or bowel fullness until the last possible moment is a common manifestation. Emotional experiences are challenging because the underlying physical sensations are not registered until they escalate into a full-blown meltdown or emotional shutdown. The muted internal feedback loop prevents the person from taking timely action to regulate their emotional or physical state, leading to a state of constant imbalance.
Hypersensitivity (Over-Registration)
Hypersensitivity involves an intense perception of normal internal signals. For these individuals, a slight change in heart rate, a normal stomach gurgle, or a mild temperature shift can feel distracting or distressing. This heightened awareness can lead to chronic anxiety, where the person fixates on perceived bodily anomalies, misinterpreting natural physiological fluctuations as signs of danger or illness. A person might be acutely aware of their own breathing or pulse, finding these sensations intrusive and anxiety-provoking. This over-attunement often prompts avoidance behaviors or a constant need to suppress the perceived intensity of internal feelings. Both hyposensitivity and hypersensitivity disrupt the body’s self-regulatory mechanisms, making it challenging to maintain physical and emotional well-being.
Conditions Linked to Interoception Challenges
Interoception difficulties are frequently observed across a spectrum of mental health and neurodevelopmental conditions.
Autism Spectrum Disorder (ASD)
Atypical interoception is common in ASD, often contributing to challenges in self-care, emotional regulation, and difficulties with identifying emotions (alexithymia). Autistic individuals may struggle with interoceptive accuracy, having a hard time correctly identifying or interpreting the signals they receive.
Anxiety and Trauma
Anxiety disorders and depression show strong links to interoceptive dysfunction, often characterized by an altered perception of bodily threat signals. In anxiety, hypersensitivity to cardiac or respiratory sensations can fuel panic, such as misinterpreting a normal heart flutter as imminent danger. Trauma is also known to change the accuracy of interoception, sometimes leading to emotional numbness or a feeling of disconnect from the body.
Eating Disorders
Interoceptive issues play a significant role in eating disorders, such as Anorexia Nervosa (AN), where individuals report a disrupted perception of hunger and satiety. Some with AN experience hyposensitivity to hunger cues, making it easier to ignore the need for food. Others experience a hypersensitive perception of fullness after meals, leading to food restriction. This inability to correctly gauge internal signals contributes to the dysfunctional eating behaviors and difficulties in recognizing the severity of the illness.
Attention-Deficit/Hyperactivity Disorder (ADHD)
ADHD is associated with interoception challenges, particularly in the domain of attention, where individuals may notice signals strongly but have trouble acting on them effectively.
Strategies for Improving Interoceptive Awareness
Improving interoceptive awareness involves strengthening the communication pathway between the body and the brain through focused, mindful practices.
The systematic body scan is one of the most widely used techniques, where attention is deliberately directed to different parts of the body to observe sensations without judgment. This practice helps individuals become more familiar with the subtle, moment-to-moment changes within their physical self.
Mindful movement practices, such as yoga, gentle stretching, or Tai Chi, enhance awareness by focusing on the sensations generated during movement. These activities encourage noticing muscle tension, the rhythm of breath, and body position in space.
A practical strategy involves identifying and labeling emotions based on physical sensations, such as recognizing that “tightness in the chest” and “shallow breathing” correspond to feeling frustrated. Structured sensory activities, like bouncing a ball or dancing to feel the heart rate increase, can also be used to modulate internal input and draw attention to bodily experiences. The goal of these general strategies is not to achieve a heightened state of awareness, but rather to cultivate a more accurate, balanced, and trusting relationship with the body’s internal signals.