Interoception: Improving your internal body awareness - Kellie Jennings, Jigsaw Occupational Therapy

Your stomach is grumbling, your mouth is dry, your heart is racing, you're sweating hot. This is your internal system communicating to your brain that you are hungry, thirsty, nervous and too hot. Your interoceptive system is working to send messages to your brain about how your body is feeling and what it needs from inside, also known as your internal body awareness.

Until a couple of years ago, I had never heard about interoception. When I attended my Sensory Integration training course, interoception was mentioned, it intrigued me and I decided to research more. The problem is, not a lot of research has been done around interoception. So I wanted to share with you my experiences of supporting children and young people who experience difficulties registering their internal body signals.

Interoception is the signalling and perception of internal body sensations and emotions. The receptors inside our body, organs, muscles and skin send signals to the brain. The brain then interprets these messages so we can feel different body states such as; hunger, thirst, pain, temperature and emotions. Receiving these messages allows us to respond to these feeling and give our body what it needs. For example, we'll get ourselves something to eat or drink when we're feeling hungry or thirsty, we'd put a jumper on if we were feeling cold and we'd go to the toilet if we knew our bladder was full. If only it was as easy as that for all of us. Some, particularly those with sensory processing difficulties, do not always receive these messages in time, or they're just too faint that they go unnoticed. Therefore the body's needs are not always met as quickly or efficiently as it'd like.

I meet many children and young people who articulate a lack of understanding for what their body is asking for. Many parents explain that their child is not successfully toileting independently and for some reason they just seem to be completely oblivious to the fact that they need to go to the toilet until the very last minute, or may not even make it on time. Many never seem to notice when they're sweating hot and never seem to think to take off their jumper to cool down. I meet many children on the autistic spectrum and those with sensory processing difficulties who are described to have an unusually high tolerate to pain. When it comes to your interoceptive processing you can experience both over and under responsive reactions. Often the problems occur when a person is under-responsive and they're failing to effectively receive the internal signals their body is attempting to communicate.

An under-responsive interoceptive system is closely linked to emotional regulation. We've probably all heard of the term "hangry" by now, otherwise know as being angry because you're hungry. It is very typical to have an emotional response to what we are feeling inside our bodies. Some people may become angry or moody when they are hungry. When you begin to feel this way, most of the time you know you need to get something to eat and your mood improves. Imagine you have to go to the bathroom but you can't find a place to go. You most likely become anxious, frantically looking for the nearest options out of fear that you may not make it in time. For those that have difficulty registering the signals from their interoceptive system, they may not know why they're feeling a level of discomfort and this could present itself in meltdowns, feeling low in mood, tired and frustrated. They just can't seem to identify the real source of their discomfort.

Over the years despite the limited amount of research that currently exists around interoception I have discovered many sensory strategies that have successfully enabled a child to better understand their internal body awareness. Firstly 'heavy' work activities have proved extremely valuable in improving our sense of body awareness, not only externally, but also internally. The Southpaw Body Sox provides fantastic resistant across the whole body. Along with the Southpaw Resistance Tunnel they have the ability to create a resistance that forces the body to engage its muscles and joints when moving that in turn channels a stronger signal to the brain, ultimately improving the accuracy of the signals received. The Sensory Weight and Resistance Kit includes a Kitty Cuddle, Therapy Putty Soft and Firm, Light resistance band and a Softmed weighted ball. This kit includes some of the most popular resistance items that can be used at home, in the classroom and in therapy. Outside of the therapy room the Southpaw Weighted Lap Blanket is perfect to use at home whilst sitting watching television, eating dinner or doing homework. It provides consistent input to the brain about where the body is in space allowing the child to feel grounded and therefore transfer their concentration to the task in hand. Deep pressure feedback is another effective way to enhance our sense of body awareness. Many feel a regular massage is needed in order to feel relaxed and in touch with our bodies again. This is why the handheld Mini Massager is a great way to gain vibratory input all over the body. Vibration offers and intense sensation that is hard for the body to ignore, this therefore provides a more intense way to get the body to start responding to what it is feeling and sending stronger messages to the brain about the sensations are the parts of the body that are involved. In addition, the Vibraflex Massager is a long vibrating tube can be wound around arms, legs and neck. The flexible device holds it's shape and features two massage speeds.

Along with heavy work activities, deep pressure and resistance equipment. Vestibular stimulation can also enable a better sense of body awareness. The vestibular system controls our sense of balance which works on a constant feedback and adjustment process using communication between the internal sensory systems such as the inner ear, eyes, muscles, joints and the brain to achieve and maintain balance. As the vestibular system targets a range of the internal organs, muscles and joints, improved vestibular processing is likely to result in improved interoceptive processing. Southpaw offer many items of equipment that can safely be used in the home environment to provide intense movement feedback. The Home Therapy System Trapeze Bar for example is a very efficient way to interpret both movement and heavy work into one. The heavy work element also helps to reduce the risks of over-stimulation from too much movement as well, an added bonus. The Trapeze Bar fits securely and safely into doorways at home to enable easy and regular access to movement stimulation. The Southpaw Cuddle Swing available in both child and adult sizes provides a more relaxing way to receive both movement and deep pressure input.

Whilst I have found that all of these activities and items of equipment can support improvements in registering signals from the interoceptive system, these activity ideas also enable improved sensory and emotional regulation. If you recognise some of the behaviours mentioned above then give some of these activities a try and see if they can make an impact!