By Rachael Thompson
Disclaimer:
The material in this blog is not to be used by any commercial or personal entity without expressed written consent of the blog author. The statements in this blog are not intended to provide individual strategies or interventions. The author does not in any way guarantee or warrant the accuracy, completeness, or usefulness of any message and will not be held responsible for the content of any message. Always consult your personal Occupational Therapist for specific sensory processing advice.
What is Interoception?
Interoception is the perception and interpretation of the signals from the organs and tissues within our bodies. It is the sense that gives us information for example that we are tiered, feeling sick, hungry, thirsty, that we need to go to the toilet, that we are physically exerting ourselves that we are hot or that we are cold.
Interoception also provides us with the information that we need to work out our emotional state and how we are feeling. Emotion is derived from both the ability to perceive the physiological changes in our body and being able to label these using the additional information that we get from the context of our experience. If we think about some emotions most people can readily identify how it makes their bodies feel for example when we are angry we may feel hot and tense, when we are anxious we might feel the sensation that is commonly referred to as butterflies in our tummies. When we feel love we may get a sense of warmth and openness within our bodies. When we talk with each other about emotions we ask a person how they are ‘feeling’ rather than what they are ‘thinking’. Therefore it is reasonable to conclude that emotions are inherently linked with the sensations that we feel arising from our bodies.
Interoception and Awareness of Self
Psychologists, philosophers, and neurobiologists have for many years discussed how human experience is based on the embodied experience of sensations- the way an experience or interaction ‘feels’. Being able to sense the feelings arising from our body dictates our awareness of self, the world and others.
Understanding the mechanisms of interoception brings clarity to these hypotheses.
There is now a lot of research that identifies that interoceptive processing difficulties relate to difficulties with a sense of self, self-identity and being distinct from other people.
My interoceptive processing differences meant I could not readily identify and process the sensation that I got from my internal organs and tissues. As a child for example I found it difficult to know if I was hungry or thirsty. I also had difficulties identifying and communicating emotions. This was diagnosed alongside autism as alexithymia.
I remember in childhood a concept of myself being distinct from others was a particularly difficult concept for me and I would often spend hours looking at my reflection. My reflection gave me the sense of who I was and I was reliant on my visual system for this as I was not getting enough signals from my body to provide me with this information. Still now I will often look at my reflection to give me a clue as to how I am feeling. I look for the visual representations to inform how I might be feeling on the inside and whether this is an emotional state or a physical state. As a result of having difficulty sensing and interpreting the physiological signals from my body that would enable me to label emotional states, my vocabulary of emotional terms was very limited and I never really felt the need to express emotional information to others as most of the time I was not aware of an emotional response to a situation. I did however know what I thought of a situation and could express this readily.
Interoception and Social Interaction
If an individual has difficulties with self-awareness arising from difficulties with interoception it then becomes very difficult to maintain a sense of themselves whilst in conversation with others and their attention will often either be entirely on themselves or on the other person, it is difficult to move fluidly between awareness of self and awareness of other in a conversation.
This is further exasperated by our tendency to focus our attention on one singular sensory system or topic i.e. if I am looking at something I may shut of my auditory sense. If I am thinking I will not be ‘feeling’, if I am concentrating on your response I will not be attending to my own response.
The consequence of this is that it makes reciprocal conversation really difficult and impacts on our ability to express and communicate empathy in the moment and during interactions. This is not to say that autistic people do not have empathy, we do!
Interoception and Empathy
Empathy is an individual’s ability to relate to the experience of another person. You do this based on how you would feel in a similar situation. You also have a physiological reaction within you when you see another person in some form of distress and use this to understand the other persons feelings and you also feel to an extent what it is the other person is feeling. Because I struggled to perceive the interoceptive information that is used to identify emotion you can see how this would therefore make it difficult to respond in an emotionally empathetic way in the moment that the interaction takes place.
Autistic individuals understand and process the world and have very different experiences to most non-autistic individuals this makes it is hard to use own experience as a basis to understand the experience of another person. This does not mean however autistic individuals do not care or empathise with another persons situation or experience.
As one example of my own autistic experience, I can sense and use visual cues to identify when someone is upset or happy or excited or anxious however I experience this as an external sensation it is not perceived or processed based on how I would feel, as such I think that the way that I process empathy is perhaps also a truer identification of how the other person is feeling because it isn’t based on my feelings or my own emotional response.
I use this external sense along with other cognitive strategies to understand their context. If it is someone I know well I will also have previous experience of their reactions and patterns of their experience which I can use to interpret and understand how they are feeling. I know if someone's normal routines and patterns of interaction change. I sometimes identify that something is wrong even before anything is said. My response however is often from my thinking self rather than my feeling sense. I am typically solution focused and will be searching for a practical solution to ease the distress or discomfort of the individual rather than engaging in an emotional exchange that would support co-regulation for a non-autistic individual.
My ability to empathise with another autistic individual I think is much more straightforward and intuitive because I am able to draw on my own experience to some extent in order to relate to them and I intuitively have a much better understanding of their experience because our neuro-types are closer.
References
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