Written By: Julie St. Pierre, OT Reg. (Ont.), COTO
When we think of sensory challenges, we often think of the senses that are familiar, such as vision, hearing, touch, taste, or smell. You might have also heard of proprioception: the sense of where our body is in space, and the vestibular system: the sense that tells our brain where our head is in relation to our body and gravity. This is the sense that alerts us when we fall or makes us feel dizzy.
Lately more and more publications have identified an 8th sense: Interoception.
What is Interoception?
Basically it is the signals that our internal organs send to our brain to alert us to what our body needs, and what our body perceives. Our organs such as our stomach, heart, lungs and tissues such as the muscles, and tendons all have receptors that send messages to our brain to alert us the constant multitudes of events happening in and around our body.
For example when we get a message from our stomach, it may tell our brain that we are hungry or full. A butterfly feeling in the stomach might also indicate we are nervous. A fast beating heart could be an indication that we just ran up the stairs too fast, that we are excited or that we are scared.
When all our sensory systems work well together, we can quickly perceive the information from our body, and make a decision to meet its need. For example, if we are hungry, we will eat, if we are full we will stop eating, if we feel nervous we might do some deep breathing or seek support. If our heart is beating fast because we ran up the stairs, we might take a quick break and decide to join a gym to work on our cardio. If we are excited we will express it with laughter and squeals. If we are scared we will address the cause of the fear.
When we have difficulties with interoception, the system can fail in two areas. The first is at the sensation level. For example some people may not feel right away that they are full, and continue eating, resulting in feeling bloated later. Others may not feel they are hungry, forget to eat, and find their oatmeal still in the microwave at the end of the day.
The other area of break down can result when we actually feel the sensation, but do know what it means, or misinterpret it. In the case of the stomach we might think that the sensation is always hunger and eat every time we feel anything from our stomach, when in reality we might be nervous or excited. This causes problems in the long run as our bodies are not getting what it needs and our emotional needs are not met. For children, this constant feeling of needs not being met can sometimes present as behaviour or tantrums.
While it may not be possible to rewire the nervous system itself, there are strategies to support interoception.
These can be done with any individual who may have difficulties with interoception and children can also be coached by caregivers with these activities.
1) Mindfulness: Paying attention to our body sensations will help us with awareness. Doing body scans once in awhile might alert us to sensations we did not know we had.
2) Slowing down: When possible, taking a few moments to decide what the sensation indicates before meeting it needs may help us clarify our needs: Are my palms sweaty because I am too hot and need to take a layer off or am I nervous and need to walk to calm down.
3) Assessing after the need is met: Did eating make the stomach sensation go away? Do I feel better or worse?
For children (or adults for that matter) who have great difficulties feeling the sensations at the body level , mindfulness only may not be enough and a more direct approach may be necessary to help them cue into what they are experiencing. Naming and identifying what the caregiver is noticing may help them realize they are experiencing something. Here are a few examples:
1) I am noticing that your eyes are wet, and that your shoulders are slumped. What do you think this could mean? Are you sad ? Disappointed?
2) I am noticing that your muscles are tight, and that your voice is loud. What do you think this means ? Are you excited? Mad? Restless?
3) I am noticing that you are moving from foot to foot rapidly. What do you think this means? Are you cold? Do you need to go to washroom?
It is important to keep in mind that addressing interoception is a long process as we learn to first identify the sensations then interpret them. It is also very important to note that everybody feels things in different ways and that there are not right or wrong answers. One person might feel hungry as a mild emptiness in the stomach another will feel it more as a cramp. One person will feel nervousness in their gut and palms while another will feel it in their stomach.
The important issue, is that we learn to correctly sense our body, interpret its messages clearly and meet our needs. Mistakes will be part or the process and help fine tune our abilities to support interoception.
If you would like support with this process, there are several articles online on the subject.
You may also want to consult with an Occupational Therapist, as they could help you customize the process
References: Kelly Mahler, The Interoception Curriculum, Kelly-malher.com