This post is part of a series for Autism Acceptance Month in which I will be exploring various ideas and subjects relating to autism and being autistic.

As children, we are taught that there are five sense: taste, touch, hearing, sight, and smell. However, there are actually far more senses than just five such as proprioceptive and vestibular senses. Today we’re going to talk about one of the lesser known senses, interoception. Interoception is the sensory system that allows us to feel what is going on inside our bodies such as respiration, heart rate, hunger, and the need to use the bathroom. Just as with all of our other sensory systems, our interoceptive sense can be hypo- or hyper-reactive in autistic people.

While not experienced by all autistic people, many of us have sensory processing differences that affect how we perceive sensory input. This can affect any or all of our senses and can affect different senses in different ways. For instance, a person may be sound and light sensitive while also being hyposensitive to taste and smell. These sensitivities may also change from day to day or over time. A person may be hyposensitive to their proprioceptive sense one day and then be hypersensitive the next or may have been hypersensitive to sound as a child but over time has come to be hypersensitive. For those of us with SPD, senses can be a confusing mess.

When a person’s interoceptive sense is off, it can have wide-reaching effects. For those who are hyper-sensitive to interoception, body sensations can be distracting, irritating, or painful which can lead to sensory defensiveness. Hunger may be felt acutely leading to over-eating to avoid feeling hunger. Bowel and bladder sensations may be painful leading to a person using the bathroom more frequently to avoid these sensations or the sensations of voiding may be unpleasant leading to infrequent use of the bathroom. A pounding heartbeat may be intolerable.

For those who are hyposensitive to interoception, body sensations may not be felt appropriately, quickly enough, or at all.  This can lead to all sorts of difficulties. A person may not feel the need to use the bathroom until it is urgent or may not sense it at all leading to the need to use diapers. Hunger and thirst may not be felt very much or at all which can lead to a person not eating or drinking enough. Further, a person may not feel the sensation of being full and as such may eat too much as they cannot tell when to stop. For those who are hyposensitive to interoception, body senses can quickly go from unnoticed to unbearable. I often don’t know I need to use the bathroom until very suddenly I have to go RIGHT NOW.

As we can see, interoception is important for keeping the body balanced. This sense is what allows us to sense imbalances and do something to fix the imbalance. Interoception also affects our perception of emotions. While not all emotions are connected to interoception, feeling hungry can lead to unpleasant emotions. If you can’t tell that you’re hungry, you may feel angry or upset and not understand why and not know how to fix it. For those of us with alexithymia, things can get even more complicated as emotions and body signals can become confused. For instance, the need to use the bathroom may be confused with anxiety (which has happened to me). This can make it very difficult to balance ourselves as we don’t know where to start not knowing what is wrong.

Though it may be a relatively unknown sense, our interoceptive sense is very important to our well-being. Being hyper or hyposenstive in this sense can have wide reaching effects for a person from their ability to stay well fed and hydrated to their emotional state. However, there are steps that can be taken to help mitigate the effects. For those who are hyposensitive, scheduling their body needs can be useful. For instance, having set times to use the restroom whether or not a need is felt or scheduling meal times to ensure that food is consumed regularly enough. For those who are hypersensitive, similar things may help as well. For instance, scheduling times to eat frequently but small amounts can help to avoid the pain of hunger without eating too much. Scheduling frequent bathroom trips can also help to avoid painful sensations. Differences to interoception may present challenges, but there are ways we can work to mitigate the effects and live better lives.