Interoception: Supporting emotional regulation and self-awareness

What is interoception?

Interoception is an internal sensory system that allows us to notice, identify and respond to how we feel, both physically and emotionally. In the same way that our eyes help us make sense of the visual world or our ears tell us what the world sounds like, our interoception helps us to make sense of what’s happening inside our own bodies. Interoception is the ability to spot changes in our own bodies that tell us when we are getting hungry, cold, thirsty, or that we are feeling angry, upset or excited.

Why does interoception matter?

Being aware of how and what we feel is an important first step in knowing what we can do, or what we need to do, to keep ourselves safe and looked after. Interoception helps us to look after our bodies – telling us when we need to eat or drink, or when we are too cold and need to put a jumper on – but it also helps us to identify, regulate and manage our emotions before they become overwhelming.

What does poor interoception mean?

Children with poorly developed or atypical interoception skills can really struggle with managing and regulating their emotions. This is because, where most of us notice the physical signs that we are getting cross or frustrated, such as our muscles becoming tense or our heads feeling ‘hot’, children with poor interoception don’t. If a child or young person doesn’t recognise the signals for an emotion, they aren’t able to respond to it, so anger can become rage and sadness can become distress. And while an outburst or meltdown may seem to the class teacher to have come out of nowhere, it is equally surprising for the child or young person. They literally haven’t felt their emotions until it becomes too late to do anything about it.  

What does poor interoception look like in the classroom?

Because interoception informs so much of self-awareness and self-regulation, the way it presents in classrooms can be as difficult-to-manage or unusual behaviour, which the young person (and the adults around them) can make little sense of. For example, I am often called in to support schools with ‘challenging behaviours’ such as angry outbursts, shouting, screaming, and meltdowns, and in many of these cases poor or atypical interoception is a contributing factor. 

Is poor interoception related to autism?

In my experience, many children and young people with social communication difficulties, including autism, also present with poor or atypical interoception. 

Can we manage challenging behaviour in children with poor interoception?

Traditional behaviour management strategies generally try to deal with the problematic behaviour and rarely the underlying cause. Many also presume that a young person has a typically developing awareness of their internal state. For example, they might ask the young person to rate where they are on an emotions thermometer (to then choose a strategy that might help them) without appreciating that the young person doesn’t have the mindful body awareness to be able to do that. Children and young people with interoceptive difficulties aren’t always aware of the early warning signs of an outburst, and we therefore need to work on developing interoceptive abilities and understanding within the young person. 

The good news is, there are lots of simple and effective activities that can help not just the individual, but the setting as a whole:

• In individual classes
• Across the whole setting
• For small groups

What is an interoceptive activity?

An interoception activity is one that focuses on creating an internal change, and then helping the child or young person to notice and label that change. We can think of it as ‘mindful body awareness’. These activities are designed to be short and repeatable, and can focus on:

• Muscles 
• Breathing
• Temperature
• Heartrate 
• Touch

By helping children and young people with poor interoception to recognise what it feels like when their muscles go tight or their heartrate speeds up, we can help them link these to their emotions. This then gives us a basis for developing and applying self-regulation strategies. 

What does an interoception activity look like?

Interoception activities focus on a particular part of the body for at least 30 seconds.

• You might ask the class to sit with their hands clenched tight for 30 seconds.
• After the 30 seconds, tell them they are going to do that again, and that you want them to notice the differences in their bodies between now, when they are relaxed, and when they clench their fists again. Name the parts of their bodies where they might notice a change. Do they feel their nails digging into their palm? Do they feel the skin go tight across their knuckles? Do they feel a change in their biceps too?
• Get them to repeat the activity for another 30 seconds and try to really notice where they feel a change. When the 30 seconds is up, ask them what they felt. 

What are the benefits of teaching interoception across the setting?

Research (Goodall, E. 2020) has shown that settings where interoception is proactively taught as part of the daily timetable see decreased behavioural challenges as a whole. It can:

• Foster a calmer learning environment
• Support self-regulation of emotions among all pupils
• Decrease incidences of challenging behaviour and outbursts
• Get pupils ready for learning
• Foster understanding, kindness and compassion among pupils
• Support a sense of responsibility
• Help develop problem-solving and working memory skills
• Promote higher levels of learning, health, and social-emotional development
• Lead to increased overall wellbeing across the setting

How can we incorporate interoception activities into our setting?

All children will benefit from whole-class interoception activities that can be delivered by class teachers with no additional resourcing needed. 

These will be most effective when done in:

• Two or three short sessions a day, ideally first thing in the morning, after break and again after lunch. Each session should cover 1 or 2 interoception activities.
• Multiple short sessions a day, ideally after a transition period and/or when children and young people need refocusing. Again, each session should include 1 or 2 activities.

• One or two long sessions a day, in classrooms where there are high levels of dysregulation and disruption all day. Each session should last 15-20 minutes, and activities should be directed as a sequence of movements or actions that focus on specific muscles, breathing, temperature or heartrate.

Some children will require more targeted support in this area. Support for these children might include:

• Small group work looking at applying what they are learning in real time situations 
• Developing a bespoke toolbox of strategies that links explicitly with their growing mindful body awareness
• Behaviour support plans that make explicit reference to their interoceptive needs and how to support them 

Useful resources

Ready to Learn: Interoception kit – from the Government of South Australia. Directions for interoception activities start on page 33.