All About Interoception: How You Sense Your Body From the Inside

Noticing internal body signals, like hunger, thirst, or pain, is something many adults don't think twice about. But for people with interoception differences, staying on top of these cues can be a daily challenge. 
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Lucy*, who identifies as a “late-diagnosed AuDHD-er” shares that anytime she hyperfixates on a task, paying attention to her body’s cues is almost impossible. She even had to set goals for herself in therapy to ensure she stayed hydrated and used the bathroom regularly. 
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If Lucy’s experiences sound familiar (perhaps you don’t always remember to grab a drink or something to eat until you’re ravenous!) then your body might also experience interoception differently from others. 
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This is a common trait in neurodivergent people, and the more it’s understood, the better equipped you’ll be to support yourself and others.

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In this article, we’re going to explore what exactly interoception is, how it works in the brain, how it shows up differently in autistic adults, and how to increase awareness of interoception differences.

Interoception is your understanding of what’s going on inside your body, and how the body interprets internal senses. For many people, it’s how they know they’re hungry, thirsty, hot, cold, or need to use the bathroom.

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‍When they’re hungry, their stomachs rumble. When they’re thirsty, their mouth or throat feels dry. When their bladder is full, they feel an urge to empty it. If they feel hot, they may remove a layer of clothing. If they feel cold, they might put on a sweater. These are all examples of interoception.
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Once these feelings are satisfied—they’ve eaten a snack, had a drink, gone to the bathroom, put on a sweater, etc.—that’s when the body should feel more balanced. This is known as homeostasis: Now that it’s regulated, the body is no longer sending signals that it needs rebalancing. 
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Considering that many autistic people experience challenges with interoception and with broader aspects of sensory processing, it is important to specify what interoception is before moving forward: Interoception is an awareness of the body's internal senses, rather than the body's reactions to external factors. 

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Nestled deep within the brain is the insular cortex, or insula. This structure serves as a key component of the brain’s interoception hub, influencing hunger pangs and heart rate. 

When interoception occurs within the insula, it follows a three-step process:
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1. Sensing (feeling a sensation): First, a sensor in a neuron (a nerve cell called an interoceptor) detects a signal like, say, a stomach rumble. The neuron then sends the signal to the brain, where it lands in another brain structure called the thalamus. 
2. Interpreting (determining what the feeling is): The thalamus sends the information to the insula, which then translates the stomach rumble into language you can understand. In this case, it means you’re feeling hungry. 
3. Integrating (taking action): Now that you understand your body is telling you you’re hungry, you can decide on a course of action, like having a snack. 

Interoception is also divided into two types, which describe a person’s ability to detect internal cues: attention and accuracy. In autistic people, these differences may show up as noticing body signals very strongly but finding them hard to interpret, or not noticing them until they become more intense.
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Attention interoception: How often people notice signals from their body
‍Accuracy interoception: How well people can understand the signals from their body.
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Some people are extremely attuned to their bodies’ signals, while others may have difficulty noticing them at all. Autistic people may experience both hyper- and hypo-awareness of internal signals.
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Since interoception varies by individual, measuring one’s interoceptive awareness remains a work in progress. Research on this topic is mixed, and there’s still a lack of agreement on how to correctly assess interoception.

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Some healthcare providers may ask patients to describe their heart rate or have them wear a heart-rate monitor, but other than conducting in-depth interviews about their eating, drinking, or toileting habits, there isn’t a solid way to quantifiably measure interoceptive sensitivity.

Assessing interoception differences as a specific trait of autism can be tricky because there is so much variability in experience. Research supports that interoceptive differences are generally considered a feature of autism rather than a diagnostic trait.

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What’s interesting about how interoception differences show up in autistic people, however, is that they often have low interoceptive accuracy and high interoceptive sensibility. This means that they are sensing a lot happening inside their bodies, but they have differences in how they interpret what those signals mean. 
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While not all autistic people experience challenges with interoception, it is a common enough characteristic to warrant deeper examination. 
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“Autistic people experience interoception differently than neurotypical people, but how it presents can vary widely across individuals,” observes Jacqueline Shinall, PsyD, a clinical psychologist at Prosper Health.

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“Some autistic people have heightened awareness of internal cues,” also known as hyper-interoception. Others, she explains, have reduced awareness, or hypo-interoception. A common profile among autistic people, she notes, is mixed interoception, where they may be more aware of certain internal cues, but less aware of others.
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Unfortunately, interoception differences don’t end at hunger and thirst. Missing critical body signals can potentially lead to emotional dysregulation, anxiety, and burnout. These differences, however, do not mean you are broken. There is support out there, and that starts with building your awareness about interoception and how it can affect autistic people.  
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Hypo-interoception 

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Autistic adults who have hypo-interoception, or a reduced awareness of cues, may experience the following, according to Dr. Shinall:

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• Not noticing hunger/thirst—either at all, or not until they are extremely hungry. Irritability or shakiness may develop as a result of how autistic people often have a different relationship to food. In the long term, some individuals may develop ARFID, an eating disorder closely associated with autism, or kidney problems due to chronic dehydration.

• Not noticing bathroom needs until they become urgent. Over time, this can lead to bladder problems, like UTIs.

• Differences in pain perception or awareness, which may delay reaction or response to injury or illness.

• Not being aware of emotions in the moment is a possible cause of meltdowns or shutdowns due to emotional overwhelm.

• Less awareness of fatigue and not resting when necessary can lead to burnout
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Hyper-interoception

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On the other hand, Dr. Shinall says autistic adults who have hyper-interoception, or a heightened awareness of cues, may experience the following: 
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• Increased awareness of temperature changes
• Raised awareness of anxiety-related sensations like a tight chest, nausea, dizziness, or increased heart rate
• Sensory overload from internal cues (raised temperature, muscle tension, feeling of fullness after eating)
• Small changes may feel much bigger or more worrisome
• Difficulty sleeping or relaxing due to increased awareness
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Mixed interoception

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A mixed interoceptive profile is very common in autistic adults, confirms Dr. Shinall, with the traits varying widely. “Someone may be more aware of certain internal cues,” she explains, “such as their heartbeat, while being less aware of other cues, such as hunger.”
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Interoception and emotional regulation

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Interoception plays a central role in emotional regulation, as emotions often come with physical sensations, like a racing heart when you’re anxious. For many autistic people, especially those with alexithymia, it can be hard to notice or interpret these internal cues, making it more difficult to understand or manage emotions. 
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People who have a hyper-interoception profile “often feel physical signs of emotions very strongly,” says Dr. Shinall. These people may be more aware of physical sensations commonly intertwined with emotions, such as increased heart rate, chest tightness, stomach discomfort, or muscle tension. 
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On the flip side, people who experience hypo-interception may not immediately notice internal emotional cues, like when their muscles feel tense, and their heart is beating faster. If these signals aren’t acknowledged, it could lead to delays in stress-reduction strategies. 
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For people with mixed interoceptive profiles, any emotional regulation challenges depend on which cues they’re able to acknowledge. “They may misattribute cues and therefore not understand or recognize how they are feeling, which may also lead to a spike in emotion,” warns Dr. Shinall. 
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Interoception and anxiety

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Anxiety is a common mental health challenge for autistic adults. Interoception differences can make it harder to catch early signs of anxiety, which may lead to overwhelm before you even realize you're anxious. It can also be challenging to distinguish between anxiety sensations—that require emotional interpretation—and interoceptive signals.
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“When internal sensations such as a racing heart, stomach discomfort, or muscle tension are noticed but not clearly understood, the brain may interpret them as signs of danger or threat,” explains Dr. Shinall. This uncertainty can not only trigger anxious thoughts but also intensify your body’s sensations. 

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If you have a hypo-interoceptive profile, then early signals of stress or emotional activation may go unnoticed until they suddenly feel overwhelming. “Without clear interoceptive cues to identify what the body needs, physical states like hunger, fatigue, or sensory overload can also be misinterpreted as anxiety,” says Dr. Shinall. When this happens, nervous system regulation becomes more difficult because body signals can’t reliably be used to anticipate or manage stress. 

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While they may appear the same, it’s important to remember that interoceptive differences are not the same as an anxiety disorder. An anxiety disorder is a distinctive mental health condition characterized by excessive, difficult-to-control fear or worry, not body-signal misinterpretation.

Masking, burnout, and disconnection from the body

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The connection between interoception and autism can also be intensified when common autistic behaviors like masking come into play. Masking, or the concealment of autistic traits, suppresses internal cues by placing prolonged demands on the nervous system, which can lead to negative long-term effects. 
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“When engaging in masking behaviors, so much attention is directed outward toward managing social performance, that less attention is available to notice internal sensations, such as hunger, fatigue, emotional shifts, or rising stress,” explains Dr. Shinall. “Over time, this outward focus can make internal cues feel faint, delayed, or difficult to interpret.”
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Chronic stress—which can arise from long-term masking—also impacts interoception because a constantly activated nervous system “can drown out more subtle body cues due to the heightened state of arousal,” says Dr. Shinall. If left unaddressed, this chronic stress could potentially lead to autistic burnout.

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The level of significant fatigue and exhaustion brought on by burnout makes recognizing internal body cues even more difficult: “[Burnout] weakens the signal between brain and body,” continues Dr. Shinall, “which causes internal signals to be overlooked or misinterpreted.”

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As challenging as they may be for autistic adults, interoceptive differences are not a personal failing—even if others find these traits frustrating.

There are, however, several supportive strategies that can help individuals better understand their internal body cues. 
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Quick daily check-ins and routines

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• Keeping snacks on your desk allows you to eat immediately whenever you notice hunger signs

• Building in regular breaks throughout your day to stay connected to your body and respond to your needs

Body-based awareness practices

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Dr. Shinall recommends the following body-based awareness practices to help build up your interoception skills: 

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• Body check-ins and body scanning: Pause several times throughout the day to ask yourself questions like, “Am I hungry?” “How tense are my muscles?” Consider using a visual scale to identify the intensity of those cues during a check-in (e.g., scale of 1 to 5). 

• Predicting and testing: Once people begin to recognize cues, they can try to figure out what they mean. This method encourages you to notice differences in your body and then test methods to determine their intention. So if you have a stomachache and then eat a snack, did your stomachache go away? If so, then that indicates your body is telling you you were hungry. If not, then you may have been experiencing a different sensation.

• Breathing and heartbeat awareness exercises: Take the time to feel your pulse, count breaths, and see how your pulse changes before and after those breaths. This can also include tracking breathing patterns throughout the day to determine if they change based on your level of distress.

Emotional awareness exercises

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• Body mapping: This exercise can help you connect body sensations to emotions or needs. Throughout the day, check in with yourself and identify your bodily sensations. But this practice goes beyond body scans as you’re trying to pinpoint exactly where these signs appear and what they might mean. If your chest is tight, are you feeling anxious? It can help to map these sensations on a picture of a body to identify where the cues occur.

• Interoceptive journaling: Keep a log of what anxiety feels like in your body, such as increased heart rate, muscle tension, or nausea. Over time, you’ll learn to connect those sensations with emotional patterns.

• Grounding through routine: Having consistent daily routines can reduce uncertainty and support emotional regulation. Routines also create natural opportunities to practice tuning into body signals.

• Sensory grounding: Use your senses to anchor yourself in the present when emotions feel overwhelming. Try bringing attention to your senses using the 5-4-3-2-1 technique, where you identify 5 things you see, 4 things you feel, 3 things you hear, 2 things you smell, and 1 thing you taste.

Sensory diet supports

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While a sensory diet has nothing to do with food, it can still provide excellent health benefits for autistic adults. A sensory diet is a set of planned sensory activities that you can use throughout the day, specifically designed to help regulate the nervous system and improve how you process sensory information. 

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Below, Dr. Shinall provides several activities that can be used in a sensory diet: 

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• Proprioceptive input: Proprioception is the sense of one’s body parts and how they move in space. Engaging in exercises that strengthen the muscles and joints—weight lifting, using resistance bands, climbing, push-ups, or yoga—can help increase your overall body awareness. 

• Movement breaks: Setting movement breaks throughout the day can help regulate the nervous system and, again, increase your body awareness. This can be something as simple as stretching, walking, or even a quick dance break! 

• Temperature awareness: Some people who have difficulty recognizing internal cues may not notice temperature changes or may have challenges regulating their bodies. Some exercises could include taking a hot shower, holding ice cubes or rubbing them on your wrists, and alternating hot and cold input.

• Scheduling regular supports: Since it can be hard to recognize cues, it’s essential that individuals who experience differences in interoception schedule regular breaks, meals, drinks, etc., to reduce reliance on those cues. It can also help to sit and check in with how you feel based on the activity on the schedule (e.g., “My lunch alarm went off, what do I notice in my body?”). 

When therapy may help

Cognitive behavioral therapy (CBT) is a therapeutic approach that helps you identify and change unhelpful thoughts and behaviors. For autistic adults, especially those with interoceptive challenges, CBT “is most helpful to address body-signal interpretation,” says Dr. Shinall, “often taking it beyond just recognizing cues, but also knowing how to interpret them and respond to them.” 
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Some of the benefits of CBT include: 

• Help with reframing misinterpreted body signals (e.g., “My stomach hurts. Am I hungry or anxious?”)
• Support with breaking the anxiety-body feedback loop (e.g., not feeling anxious any time they notice an internal cue)
• Learning how to label those sensations and incorporate coping and regulation strategies

Dr. Shinall also recommends mindfulness-based approaches like body scans, noticing cues without judgment, and breathing exercises. Occupational therapy can also help address interoceptive differences through several of the body-based awareness exercises listed above. 

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Interoception varies from person to person, and these differences can shape how the body and emotions are experienced—something many autistic people notice in their daily lives. Building awareness of these patterns can make it easier to understand your needs and respond to them in ways that work for you. 
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“While interoception differences are common, they are highly variable,” reiterates Dr. Shinall. “Not all autistic people will have differences in interoception; some are more aware while others are less aware, and they can become less aware during times of high stress, burnout, or fatigue.”
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If you're an autistic adult trying to better understand your body’s signals or manage emotional and sensory overwhelm, Prosper Health is here to help. Our 100% virtual therapy and evaluations are designed with autistic and neurodivergent adults in mind. Our clinicians specialize in autism spectrum disorder, and many are neurodivergent themselves.
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Through evidence-based care, we can help you build interoceptive attention, reduce anxiety, and strengthen emotional regulation. Click here to get started today. 
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*Name changed to protect the contributor’s privacy

What is an example of interoception?

An example of interoception is any internal body cue: A stomach rumble might signal that you’re hungry. A dry mouth or throat signals that you’re thirsty. A full bladder urges you to go to the bathroom. A raised body temperature signals you to remove a layer of clothing. A lowered body temperature signals you to put on a layer of clothing.
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What is the role of interoception in mental health? 

Interoception plays a significant role in mental health because impaired awareness of internal body cues can make it harder to catch early signs of anxiety, a common challenge for autistic people. Not noticing signs of anxiety or other forms of emotional dysregulation (racing heart, stomachache, etc.) early on may lead to overwhelm or burnout before you even realize you’re anxious or dysregulated. 
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Is interoception the same as alexithymia?

No, interoception is not the same as alexithymia. Alexithymia is a difficulty with naming, recognizing, or expressing emotions. However, since many autistic people do have alexithymia, interoception differences can make it even more challenging to understand their emotions because they can’t necessarily notice or interpret their internal cues. 
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Can therapy help with interoception?

Yes, therapy can help with interoception. Specifically, cognitive behavioral therapy (CBT), an approach that helps people identify and change unhelpful thoughts and behaviors, addresses body-signal interpretation. Not only does this treatment help people recognize body cues, it also helps them interpret and respond to them.