I was recently involved in a discussion surrounding neurodivergence and disordered eating, something that impacts many neurodivergent people. One thing that really stuck out to me was the number of people saying they had a limited ability or inability to determine the internal sensations they feel, which is related to interoception.
I briefly discussed interoception in my article on meeting sensory needs, but wanted to examine it in more detail. Essentially, interoception involves our sensitivity and ability to pinpoint bodily sensations such as hunger, thirst, temperature, pain, itchiness, organ sensations, sensual touch, sensations related to our breathing, and more.
Interoceptive feedback is essential for keeping our bodies running smoothly. It allows us to know whether we’re becoming overheated, if we’re overly hungry, if we need to go to the bathroom, or if we’ve pushed ourselves past our physical limits to the point of pain or injury. Interoceptive sensations provide us with feedback necessary for obtaining bodily balance.
I’ve discussed alexithymia and how difficult it can be for neurodivergent people to decipher what we’re feeling or what others are feeling. Difficulties with interoception can be likened to difficulties related to alexithymia, but in regards to physical sensations rather than emotional ones. Our emotions can be heavily intertwined with our interoception. If we don’t know how we’re feeling in our physical bodies, then it can be that much more difficult to determine how we’re feeling emotionally.
If one person asks another how they’re feeling and they don’t have the interoception to know how they’re feeling physically, then they might not know how to relay an emotion to go along with it. If someone knows they’re hungry or in pain, they might say they aren’t doing great or that they could be better. Conversely, if someone has all of their physical needs met, they might relay that they’re feeling well or happy. If their interoception is imbalanced, they might not be able to discern any of those things, and as such, they might not be able to describe their experience.
That’s not to say that all emotions are linked to interoception, but it’s not uncommon to feel short-tempered when tired or hungry, and it can be difficult to feel content when you’re in pain or are physically uncomfortable. These difficulties can be magnified for those of us who experience alexithymia, as we can struggle to know whether what we’re feeling is due to a physical need going unmet or an emotional state.
For instance, many neurodivergent people often have gastrointestinal issues and anxiety, so it may be hard for a neurodivergent person who has a stomach ache or nausea to determine whether they’re feeling badly because of anxiety, gastrointestinal upset, or hunger. This is one of the many scenarios I have to run through regularly to determine what I’m actually feeling. It’s like I need a checklist to monitor my own feelings, and I sometimes have to go through them one by one before figuring out what my body needs.
This is the case for many neurodivergent people. We often don’t know what our bodies are trying to tell us until we’re well past the threshold of what would be a typical sensation for most neurotypical people. It’s like we go from being in an unmoving vehicle to full throttle instantly. This means that we’re often left with things like severe injuries or infections or hunger or pain that lead us to pass out, simply because we’ve waited so long to address them before finally being able to notice something is amiss. It doesn’t take long for us to go from noticing something isn’t right to being in a physically uncomfortable or intolerable situation.
This can get really tricky, especially when dealing with medical needs, because medical professionals tend to be reliant upon self-reported levels of discomfort or symptoms, and if a neurodivergent person doesn’t realize that something is actually wrong within their body, they might report their discomfort as being really minor, when their body is saying otherwise.
One of the main purposes of interoception is to direct behavior. I personally need someone to tell me that I need to see a doctor or that it has been too long since I’ve eaten, or I simply won’t until I’m really uncomfortable. Not doing those things isn’t me being stubborn, it’s me simply not knowing they need to be done because my body hasn’t reached that full throttle level yet. Having a neurodivergent brain means I may miss out on the warning signs leading up to reaching that level and I may not know when to act in a distressing situation.
This isn’t the case for all neurodivergent people though, and many neurodivergent people do experience hypersensitive interoception, feeling bodily sensations at an acute level. Even when that’s the case though, it can be difficult for a neurodivergent person to understand what’s going on in their body if they’re feeling a ton of sensations at once.
Just as with any other sensory information, interoception varies widely from person to person and even sometimes from day to day. Recognizing that neurodivergent people may have atypical responses to pain, distress, or general bodily sensations is vital for ensuring proper support.