What on Earth is...Interoception?

One of the key functions of Trauma Center Trauma Sensitive Yoga is to provide opportunities to practice interoception, something which clients with complex trauma might find particularly challening. But what on earth is it?

What do the academics say?

There is no complete agreement on what exactly we're talking about when we use the word interoception. Broadly speaking we could refer to interoception as ‘the perception of the state of the body’ (Ceunen et al., 2016). This perception is a product of the central nervous system. Information about changes of internal state are picked up by sensory receptors, passed to neurons and sent to the spinal cord and/or the brain. The central nervous system then makes a decision about what action is to be taken and this information is relayed to ‘effectors’ in either the visceral or somatic systems.

Huh?

Basically, we could boil it down to interoception being the fancy word for being able to notice internal sensations and translate them into action if necessary. So we're talking about things like

• Touch
• Muscle dynamics
• Hunger
• Thirst
• Satiation
• Sexual arousal
• Pain
• Safety and fear

So what?

As helpless babies we are entirely dependent on a relationship to meet our every need. We're depending on well-attuned and attentive adults for our survival. Hopefully, our world as a newborn looks something like this:

• My body needs food, I feel this as hunger, I do not want this feeling, I cry to be fed, I am fed.

In this narrative the newborn's internal experience has been mirrored by the adult caring for them and their need has been met; they are reassured that they know what they feel and thus who they are and they are reassured that the world is generally a safe place to be.

As humans, we are hard wired to survive.

So what happens if we feel hungry, we cry but we get no response? Well, once or twice or even every now and again we'd be fine, but what would happen if we got no response over and over and over again? One of the things that might happen is that our body might look for ways to tolerate this intolerable situation, ways to survive. One useful way to survive might be to switch off the messages that are telling us that we are hungry, or thirsty, or dirty or scared. We might learn to switch off interoception.

We know now that, the insular cortex, which is an important region in the brain for interoception, shows dysregulated activity in brain scans of traumatized people. The signals in this area might be overactive or underactive, resulting in internal messages that have become muddled. That might translate into symptoms like

• Difficulty localising skin contact
• 'Numbness'
• Sensory bombardment
• Not recognising internal states like hunger or thirst

fMRI van der Kolk's lab, Trauma Center, Boston: Insular Cortex in purple

A confused picture of the internal state of the body might lead to disturbances in the registering of ‘feelings’ necessary for basic survival i.e. hunger, thirst, pain etc. and also has links to self-harm, substance misuse and problematic dissocation (floating away).

Some neurologists think that our ability to know what's going on inside our bodies is a key way that we form our own identities and make sense of our existence. So maybe life is not so much 'I think therefore I am', but

I feel therefore I am

For someone whose experiences of relationships have been traumatic, TCTSY provides a safe relational environment in which interoception can be practised. The key TCTSY principles of non-coercion and choice-making might lead to an ability to have an interoceptive experience and take action to change the external environment (i.e. move out of a shape), or allow a client to engage in a wider range of interoceptive experiences and rewire their evaluation of their internal state as a result of these experiences.