Interoception With Kelly Mahler: What It Is & How To Enhance It
Interoception, maybe the most overlooked sense in neuroscience occupational therapy, has slid into the spotlight in recent years. This sense affects everything from stress to decision-making, to behavior.
But how?
I reached out to the leading expert in the field to find and learn how to use it to our advantage.
Kelly Mahler OTD, OTR/L, has been an occupational therapist for 20 years, serving school-aged children and adults. Kelly is the winner of multiple awards, including the 2020 American Occupational Therapy Association Emerging and Innovative Practice Award and a Mom’s Choice Gold Medal. She is an adjunct faculty member at Elizabethtown College and Misericordia University and she’s the co-principal investigator in several research projects pertaining to topics such as interoception, self-regulation, trauma, and autism.
5 Questions on Interoception with Kelly Mahler
1. What is interoception and why does it matter?
Interoception is a sense within all our bodies. Its biggest job is to help us experience our inner sensations, like a racing heart, full bladder, loose muscles, aching head, etc. These inner sensations provide us with important clues to how we are feeling and what our body needs for health, comfort, and regulation.
We all have very different inner feels. So, our inner sensations are different for each one of us. For example, when I notice my stomach feeling empty, it provides me with a clue that I need to eat. Or when I have a tight feeling in my chest and my brain feels slow, it’s a clue that I am feeling overwhelmed or anxious, and need to go for a walk.
2. What are some of the common signs of someone who has above-average interoception and someone who is below average? Are there any tools or methods you use to assess this?
There is really no wrong way to feel. So average, above average, below average, doesn’t really apply when we talk about interoception. We all have a different range of how aware we are of our internal sensations. Some people might be more aware of their internal sensations, others might be less aware, so we all fall on this range of awareness. The endpoints of his range of awareness are what we call interoceptive awareness extremes.
For some people, they might have an inner experience that’s muted. These people might completely miss body signals, like the feeling of thirst or needing the bathroom or getting overwhelmed. Or sometimes, for people that have a muted inner experience, they notice certain body signals but only when those body signals get to a very big place. So, they don’t notice getting hungry until they are angry. It’s an emergency feeling like, “I need to eat right now”. Or they don’t notice they’re getting overwhelmed until they’re in a meltdown or shut down.
On the other hand, some people can experience the opposite extreme, which is when their inner experience is intense. They might notice a lot of different body sensations all at once. Their inner experience may be chaotic, so they’re not sure what to pay attention to. For some people that have an intense inner experience, they might notice one or two body signals that are really overpowering. For example, people that experience panic attacks describe their inner experience to be very intense during a panic attack. Maybe it’s the feeling of a racing heart or the feeling of breathlessness.
3. Could you offer practical advice to parents seeking to support and enhance their children's interoception (e.g. scripts, types of statements)? What proactive measures can parents implement within daily routines or interactions?
I think one of the best pieces of advice we can give parents (notice I didn’t say easy!) would be to encourage parents to start talking out loud about the way their own body feels during different daily activities, or when they’re playing with their child.
There’s often such a mystery around interoception.
Many of us, including myself, are talking out loud about the way our body feels. So, for example, when you’re holding a cold drink, say out loud how your hands feel while you’re holding that cold drink.
Or when you’re running around chasing your child, take a moment to talk out loud about the way your body feels when you’re doing that. Maybe you noticed your heart… how does your heart feel? How about your muscles? What’s happening with your muscles?
Thinking about the bathroom. Talking out loud about the way your body feels right before you know you need to get to the bathroom.
So, it really helps to get that interoception vocabulary out there. It’s modeling that there are these important sensations to pay attention to in our bodies. And then eventually, the parents can work on shifting the curiosity to the child’s body and invite their child to notice how their body is feeling.
Avoid labeling what we think is going on inside their body, and instead invite them to discover their own inner experience.
We can use “I wonder…” statements. For example, I wonder how your hands feel while you’re holding that cold drink, I wonder how your heart feels after I’m chasing you. If your child can’t answer, that’s okay. We want to offer this curiosity and body noticing in a way that’s validating to their own inner experience. If we label that, we risk being wrong and mislabeling, which leads to inner confusion.
If your child seems to be noticing something, but they might be having a hard time describing that to you, you could offer a couple choices for a response. But know that the choices that you’re providing might not be a match for their experience and that’s okay.
Previous approaches that I was trained in really emphasize teaching someone how their body should feel. For example, angry means that your muscles are tight, your heart is racing, your voice is loud. But interoception science is showing us that this is not true for every single person. What your body feels like when you’re angry is completely different than what my body feels like when I am angry. So, if we can set up a process starting with our body signals, we can help our child to notice their own body signals and begin to understand their own body. We can then teach them to use these body signals as clues to their emotions or what their body needs in that moment.
4. Over the last decade or so it seems like there is more of a push to label children's emotions aloud in order to help them develop a language and awareness of these emotions. More recently, however, it seems like the science is shifting away from this. Can you talk about this as a relates to interoception?
Simply speaking, interoception science is showing us that when we label someone else’s emotions, we are at high risk of being wrong. When we label someone else’s emotions, it’s based upon a guess. And that’s just it; it’s a guess. And often times it’s wrong.
When we are labeling another person’s emotions, and are wrong, we can set off a cascade of inner doubt for them.
So, if we say that they’re feeling one way that’s not a match their experience, they might start to question themselves. Like, “Kelly just said I look sad. I don’t think I’m sad. But maybe I’m wrong. Maybe I’m the flawed one here. Maybe my inner experience is incorrect.” So, we’re trying to use a process where each person discovers their own body signals and uses these body signals as clues to their own emotional experience.
5. Some of the biggest challenges with raising kids involve the fundamental skills that we address as occupational therapists: feeding, toileting, sleep, and behaviors. How can we harness the power of interoception to address these challenges with children? Can you provide examples?
Interoception has a vast influence on our daily lives. For example, if you stop to think for a moment: How do you know when you need to use the toilet? It involves a lot of interoception. Maybe it’s a feeling coming from a certain part of your body that lets you know “I have to pee”. Or, “Nope, this time I have to poop”. That’s probably a different sensation.
So, interoception provides us with so many clues to what our body needs. Whether our body needs food, a toilet, sleep, a cozy cuddle, a quiet break, we come to understand how our body feels and what it uniquely needs for regulation. And this is true across our life span from day one of life all the way until we die. Interoception provides this information about our body that allows us to take care of our body’s needs. As occupational therapists, if we are supporting any aspects of daily living, we need to be interoception informed.
Want to lIf you want to learn more about interception, find Kelly:
Facebook Group: Interoception: The Eighth Sensory System
Instagram: kelly_mahler
Website: www.kelly-mahler.com
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