When Greek philosopher Aristotle said, “Knowing yourself is the beginning of all wisdom”, he didn’t imagine how challenging this could be for some people. Delhi-based visual artist Gauri Chawla is one of them. The 47-year-old thought her body was failing her when her multiple attempts at reducing weight went in vain. She had been overweight for eight years but felt its strongest impact when her type 2 diabetes got worse because of it. Despite eating home-cooked nutritious food, her irregular eating pattern— skipping meals often and eating when not hungry—made things unfavourable. The more weight she gained, the worse her condition became as she developed resistance to insulin.
Overwhelmed, she saw a doctor only to find out that food wasn’t the problem, impaired interoception—the subtle inner awareness of bodily processes—was. Besides being put on a rigorous diet and exercise plan, she started working with a mindfulness coach, who helped her gain a better understanding of the body’s needs.
The lesser-known inner world Not only in matters of hunger, but interoception awareness also bears relevance in perceiving other important bodily functions, too, such as heart rate, temperature, thirst, sleep, pain and the need to urinate, in addition to emotional regulation. “It gives agency over one’s body, to understand its needs and make decisions that serve, not disrupt it,” says Mumbai-based holistic health coach, Dr Mickey Mehta.
That’s easier said than done, he admits. Interoception is silent, unlike external senses such as hearing and seeing, which can be measured. It is because of its interpretational challenge that the study of inner sensations was left out of the ambit of scientific examination. “The growing interest in interoception within the scientific community and among medical practitioners germinates from successive advancements in psychophysiology and the role it plays in cognitive, emotional and physical health. Its misrepresentation can lead to health conditions or worsen existing ones, especially anxiety and depression, anorexia, obsessive-compulsive disorder (OCD), cognition, somatic symptom disorders, sleep issues among others,” says Chhaya Singh Goel, co-head, of psychological services, Mental Health and Behavioural Sciences unit, Artemis Hospitals. She adds, “Interoception signals emanate from deep within the central nervous system and are sent to the brain through a vast web of neural pathways, particularly from the lamina I of the spinal cord. It’s responsible for processing pain and temperature, along the spinothalamic sensory tract, through the connections of the solitary nucleus, (a part of the brainstem) to the other areas of the brain. It helps us understand what’s happening inside our body and respond to it effectively.” Even though interoception operates within a framework of individualised factors such as genetics, environment and lifestyle, there are a few ways to harness this subtle power.
Body scan: Mindfulness practices such as controlled breathing, meditation, stretching or practising stillness can help build attention towards the body. “In that moment of awareness, mentally scan each part of the body, starting at the top of the head and ending at your toes. Observe whatever comes up and name the emotion or sensation. Is it disgust, surprise, guilt, worry, itch, warm, tight, fluttery, fidgety, sweaty? Sit with it in conscious awareness and breathe through it. Techniques like rebirthing breathwork, which involves taking deep, continuous breaths without pausing between inhales and exhales, have been found to be particularly effective while doing a body scan,” says Mehta.
Daily check-in: By inculcating a habit of pausing and checking how you’re feeling through the day, even for 15-30 seconds, can significantly build interoception. “There are three types of check-ins: an external one, wherein you observe the activity you’re doing on the outside—writing, eating, walking, driving. Next is an internal check-in, in which you slow down whatever you’re doing for a few seconds, taking your focus inwards. Notice the physical sensations inside such as a grumbling stomach, a parched throat, and dry lips, using ‘I’ statements. For example, I am feeling hungry/thirsty/drowsy. The last is an emotional check-in, wherein you examine the thoughts or emotions. Unprocessed emotional energy is typically stored in the neck, jaw, chest, shoulders and hips. The Buteyko breathing technique (deep, gentle breaths, opening up your chest and releasing the strain) is helpful while doing this. Practice will make this routine automatic,” says Goel.
Record-keeping: An effective way to build interoception awareness is through cardiac biofeedback. “Begin by noting your resting heart rate. Then, undertake a high-intensity activity such as jumping jacks, on-the-spot running or walking up a long flight of stairs. Once you’re done, sit still wherever you are. Start counting your heartbeat when it’s pounding, which is easier to detect. Continue this as the beats slow down. The more you do this, the more aware you’ll become of the softer heartbeats, building better interoceptive ability,” says Mehta. In fact, one of the best ways of developing inner awareness is by doing something fast-paced outside. “Engaging in mind- and body-based activities like yoga, tai chi or bushwalking can also provide positive sensory feedback to the brain, further enhancing interoceptive accuracy over time,” says Goel.
