We all learn about the five senses in elementary school, but did you know there are actually eight? In addition to the systems that process visual (sight), auditory (hearing), olfactory (smell), gustatory (taste), and tactile (touch) stimuli, there are the vestibular (balance), proprioception (the body’s position in space), and interoception (everything that is happening inside our skin) systems.

Despite the importance of interoception, many people are not aware of this sense or do not pay much attention to it. While much lesser known than its more popular counterparts, interoception profoundly impacts our daily experiences. 

Interoception allows us to perceive and understand the internal state of our bodies. It allows us to recognize when we are hungry, thirsty, or in pain, and to understand the feelings associated with those bodily states.

Interoception also impacts our ability to care for our physical health, regulate our emotions, participate in life socially, and manage many other areas of life that influence its quality.

We also know that neurodivergent people often have sensory systems that work differently than the majority of people due to differences in neurology. Each individual sense can be hypersensitive (more sensitive than the norm) or hyposensitive (less sensitive than the norm). This means their sensory experiences can be exaggerated one way or another, which often results in challenges.

What is Interoception?

Interoception is the sense that allows us to perceive and understand the internal state of our bodies. It includes sensations such as hunger, thirst, pain, temperature, and fatigue. Interoception is also involved in the ability to recognize and interpret emotions and feelings, such as anxiety, excitement, and sadness.

The term "interoception" comes from the Latin words "inter" meaning "within" and "ceptio" meaning "perception." The sense of interoception allows us to be aware of what is going on inside our bodies, which is important for maintaining physical and emotional well-being.

Interoception and Physical Health

A hypersensitive or hyposensitive sense of interoception can have a significant impact on your ability to care for yourself in various areas of daily life. Here are some examples of how differences in interoception can impact self-care.

Individuals with a hypersensitive interoceptive sense may struggle with the following:

Feeding/Eating: They may struggle to recognize when they are hungry or full, leading to difficulties with portion control.

Sleeping: They may struggle to fall asleep or stay asleep due to discomfort or pain associated with bodily sensations. They may also be more sensitive to changes in temperature, which can disrupt their sleep.

Dressing: They may also struggle to regulate their body temperature and may be more sensitive to changes in the weather, causing discomfort when clothing is too warm or not warm enough.

Pain Management: They may be more sensitive to pain and discomfort and may struggle with managing chronic pain conditions. They may also be more sensitive to certain medications and may experience more side effects.

Health Maintenance: They may overreact to changes in health and obsess over what is wrong to the point of distraction.
Body Temperature: They may struggle to regulate their body temperature and may be more sensitive to changes in the weather or indoor temperatures that fluctuate.

Seeking Medical Care: They may struggle to describe their symptoms accurately or may avoid seeking medical care altogether due to anxiety or discomfort associated with medical procedures.

Toileting: They may struggle with toileting due to discomfort or pain associated with bodily sensations. This can ultimately lead to encopresis, a serious medical issue that requires intervention.

Individuals with a hyposensitive interoceptive sense may struggle with the following:

Feeding/Eating: They may not recognize when they are hungry or thirsty, leading to dehydration and regularly becoming “hangry.” They may also struggle to recognize when they are full, which can lead to overeating and other health concerns.

Sleeping: They may not recognize when they are tired and stay up too late, leading to struggles to wake up in the morning.

Dressing: They may struggle to pair appropriate clothing choices with the weather and not be properly dressed for the temperature.

Pain Management: They may not recognize when they are in pain, leading to delays in seeking medical care or management of chronic pain conditions.

Health Maintenance: They may not recognize changes in their physical health, leading to delayed diagnoses or treatment of medical conditions.

Body Temperature: They may not recognize when they are too hot or too cold, leading to inappropriate clothing choices as well as health impact.

Seeking Medical Care: Individuals with a hyposensitive interoceptive sense may not recognize the severity of their symptoms, leading to delays in seeking medical care or receiving appropriate treatment. They are also likely to have trouble describing their symptoms to medical professionals.

Toileting: They may also struggle to recognize when they need to use the restroom until it’s an emergency. Like those with a hypersensitive interoceptive sense, this can also lead to encopresis.

Interoception and Emotional Regulation

Emotional regulation is the ability to manage and respond to your own emotions in an effective and adaptive way, which is essential to emotional well-being. 

Interoception plays a crucial role in emotional regulation, as it allows us to perceive and understand our own internal states, which is essential for effectively regulating our emotions. Individuals with hypersensitive or hyposensitive interoception may struggle with emotional regulation in several ways. 

Individuals with a hypersensitive interoceptive sense may struggle with the following:

Naming Their Emotions: One of the key aspects of emotional regulation is the ability to accurately identify and label one's own emotions. Tuning into your interoceptive signals, such as an elevated heart rate or flushing skin, helps identify what you are feeling, but when you are overwhelmed by sensations, it may become harder to decode what is happening. This can make it challenging to effectively regulate your emotions.

Emotional Well-Being: Emotional well-being refers to an overall sense of positive emotions and life satisfaction. Individuals with hypersensitive interoception may struggle with emotional well-being, as they may be more prone to experiencing intense emotions and may find it difficult to regulate their emotions effectively. It can also lead to more anxiety.

Resilience: Resilience refers to the ability to bounce back from stress and adversity. Individuals with hypersensitive interoception may struggle with resilience, as they may become easily overwhelmed by stress and may have difficulty regulating their emotions in response to stressful situations.
Urge to Use Coping Skills: Effective emotional regulation often involves the use of coping skills. Individuals with hypersensitive interoception may have a heightened urge to use coping skills in response to intense emotions but may struggle to find coping strategies that are effective for them.

Individuals with a hyposensitive interoceptive sense may struggle with the following:

Naming Their Emotions: Individuals with hyposensitive interoception may also struggle with identifying emotions in themselves, as their brains may experience fewer interoceptive signals to decode. This can lead to being less attuned to their internal states as well as to difficulty recognizing when they are experiencing certain emotions. It may also take longer to process what they are feeling.

Emotional Well-being: Individuals with hyposensitive interoception may also struggle with emotional well-being, as their decreased awareness of what they are feeling can result in their not understanding what they need. It may also impact their ability to experience pleasure, which can contribute to feelings of apathy, hopelessness, and low mood.

Resilience: Individuals with hyposensitive interoception may also struggle with resilience, as they may not recognize the impact of stress on their internal states and may not respond to stress in adaptive ways.

Urge to Use Coping Skills: Individuals with hyposensitive interoception may not recognize the need to use coping skills in response to stressful situations and may not actively seek out coping strategies to regulate their emotions.

Generally speaking, research has shown that individuals with poor interoceptive awareness may be at higher risk for certain mental health conditions, such as anxiety and depression.

Interoception and Social Participation

Interoception plays a crucial role in social participation. Individuals with hypersensitive or hyposensitive interoception may struggle with social participation in several ways. 

People with a hypersensitive interoceptive sense can be so overwhelmed by their internal sensations that they miss chances or lack the bandwidth to tune into, identify, and respond to the internal states of others.

Individuals with a hypersensitive interoceptive sense may struggle with the following:

Perspective Taking: They may be so overwhelmed by their own internal sensations that they struggle to tune into the perspectives of others.

Communication: Overwhelm caused by internal sensations may make it impossible to process and respond to verbal and nonverbal cues from others.

Empathy: They may be so overwhelmed by their own emotions that it is more difficult to identify and share the emotions of others.

Attunement: When overwhelmed by their own emotional experiences, it may be more difficult to tune in and respond to the internal states of others.

Social Touch: Social touch is another important aspect of social participation that can be impacted by interoception. Individuals with hypersensitive interoception may find certain types of touch uncomfortable or even painful, leading them to avoid social touch altogether.

Attachment: This is another area that can be impacted by differences in interoception. Individuals with hypersensitive interoception may struggle with attachment, as they may find it challenging to regulate their own internal states and may become overwhelmed by the emotional intensity of close relationships.

Individuals with a hyposensitive interoceptive sense may struggle with the following:

Misreading Others' Emotions: A person with hyposensitive interoception may have difficulty understanding their own emotions, which can make it challenging to read and respond appropriately to the emotions of others. This can lead to misunderstandings, conflicts, and difficulty forming close relationships.

Empathy: If you struggle to identify your own emotional state, it’s harder to identify emotional states in others. This is sometimes mistaken as a lack of empathy. You may experience really deep emotions about other people’s experiences, but struggle with how to express them in a way that others can understand.
Social Touch: Individuals with hyposensitive interoception may not recognize the subtle nuances of social touch and may miss important social cues conveyed through touch.

Attachment: Individuals with hyposensitive interoception may also struggle with attachment, as they may not recognize the emotional nuances of close relationships and may struggle to form deep emotional connections with others.

Final Thoughts

For neurodivergent individuals, differences in interoception can be even more pronounced, resulting in unique challenges that impact quality of life. Hypersensitivity or hyposensitivity to interoception can cause problems in feeding, sleeping, dressing, pain management, health maintenance, body temperature regulation, and seeking medical care, among other areas. It can also lead to difficulties in recognizing and interpreting emotions and feelings, resulting in challenges with emotional regulation and relationships. By understanding and paying attention to interoception, we can improve our physical health, emotional well-being, and overall quality of life.