The 8th Sense

Becca Olivo, MS, OTR/L

Somewhere along your educational journey, you likely learned about the 5 basic senses: auditory, vision, taste, olfactory (smell), and tactile (touch). However, there are actually three more “hidden” senses that are much less well-known. These include proprioceptive, which gives us information about our muscle and joint position, vestibular, which tells us about our body’s position in space (body awareness), and interoception. Interoception is the sense that allows us to feel internal body sensations, such as a growling stomach or tense muscles. Interoceptive awareness is the ability to notice one’s own body signals and connect them to an emotion.  These important body signals underlie both affective (e.g., happy, sad, nervous, annoyed) and homeostatic (e.g., hunger, fullness, need to go to the bathroom, sleepiness) emotions and help us to determine how we feel. 

Interoceptive awareness varies between individuals and is directly connected to our ability to identify our emotions. Some individuals have “typical” levels of interoceptive awareness, and therefore have a clearer emotional experience and can more easily identify distinct emotions. However, others have an “atypical” level of interoceptive awareness, which can lead to an unclear emotional experience and more difficulty determining various emotions with clarity. This can cause a variety of challenges, such as difficulty identifying exactly how you feel,  the ability to recognize a general feeling of comfort or discomfort but an inability to pinpoint any specific emotion, the ability to detect a basic emotion but an inability to determine the intensity of the emotion (e.g., a little angry or explosively angry) , or the ability to recognize a general feeling but an inability to detect the other emotions intertwined with that emotion (e.g., excited and nervous).  Interoception differences are common, and atypical interoceptive awareness has been found in people with a variety of conditions/disorders, including Autism, PTSD, ADHD, dementia, sensory processing disorder, depression, and obesity, among others. It is important to remember that recognizing an individual has an unclear emotional experience, does not imply that the person lacks emotions, but rather that they need extra support in making sense of their emotions. 

Interoception is a crucial foundation of independent self-regulation. We have to be able to understand how we are feeling in order to regulate our emotions. The three steps of independent self-regulation are Notice-Connect-Regulate. We must first be able to identify and describe body signals. Kelly Mahler’s Interoception curriculum begins with a series of experiments, targeting one of 15 body parts including the skin, muscles, stomach, brain, hands/fingers, and feet/toes.  To target these body parts, students held ice cubes, rolled, jumped, sat still like statues, and noticed all the ways these main body parts can feel using a word bank for each body part. The next step is to connect these body signals to emotions. For example, if you notice your muscles feel tight, hands feel sweaty, and your cheeks feel warm, you might be feeling nervous or embarrassed. After you connect the body signals to an emotion, you are able to take action to regulate by either continuing a comfortable feeling or using a strategy to restore comfort within your body. It is important to remember that all people have unique body-emotion-action connections, therefore the goal is not to tell an individual how we think he or she feels and what we think he or she should do to manage those feelings, but rather to provide a framework for an individual to explore and figure these things out for themselves. 

If you suspect that your child (or even you!) may have difficulties with interoceptive awareness, you should reach out to an occupational therapist to discuss ways to assess current skills and make a plan to develop better interoceptive awareness through explicit teaching. Here are some ways to reinforce interoceptive awareness at home:

• Make statements that provide observations and prompt attention to body signals (e.g., “I see sweat on your forehead, put your hand on your forehead, do you feel wet sweat?)
• Ask questions that call attention to a specific body part and provide choices for response (e.g., “Do your eyes feel heavy or light?”)
• Ask questions that call attention a specific body part and require an individual to provide a response without choices (e.g., “How do your muscles feel now?”)
• Ask questions that call attention to the entire body (e.g., “how does your body feel right now? You said your hands are fidgety, what else do you notice? What emotion is that?”)

Typically when a child struggles with interoceptive awareness, they also struggle with the ability to self-regulate. But when these skills are worked on both at school and at home, your child is more likely to develop the necessary skills to keep their bodies and minds regulated with tools and strategies that work for them!

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