Understanding Interoception: Why Some People Can’t “Just Calm Down”

Interoception is our sense of the internal state of the body. It's not just about noticing hunger or needing to pee. It's how we perceive our heartbeat, breath, body temperature, gut sensations, and even subtle shifts in mood or energy. For many people, these signals are clear and coherent. But for others, interoception is distorted, blunted, or overwhelming. And that can dramatically impact their ability to regulate emotions or respond to stress.

So when someone says “just take a deep breath,” but your nervous system is already in overdrive, or you feel nothing at all, it’s not a failure of willpower. It’s often a failure of interoceptive processing.

What Is Interoception, Really?

Interoception is the process by which our brain receives, interprets, and regulates signals from inside the body. These signals include heartbeat, breathing rate, blood pressure, gut tension, temperature, hormonal fluctuations, immune responses, and more. Essentially, it's the body’s internal communication network that lets the brain know how things are going beneath the surface (Khalsa et al., 2018).

Traditionally, psychology focused more on what we perceive outside our bodies: what we see, hear, and touch. But interoception is all about what’s happening inside. And it’s far more complex than just a one-way channel of data. The brain doesn’t passively receive interoceptive signals. It predicts them, compares them to reality, and adjusts accordingly (Barrett & Simmons, 2015; Chen et al., 2021). That prediction system can get thrown off by things such as trauma, stress or neurodivergence. When this happens the result can be emotional dysregulation, anxiety, dissociation, or a deep sense of “not feeling like myself.”

Why Interoception Matters in Mental Health

Many psychiatric conditions, such as anxiety, depression, PTSD, eating disorders, autism, and schizophrenia, have been linked to problems with interoceptive processing (Nayok et al., 2023; Khoury et al., 2018). That means people with these conditions might struggle to detect their bodily sensations accurately, or they might feel them too intensely.

In anxiety disorders, for example, the body’s normal stress signals (like a racing heart or muscle tension) might be misread as signs of danger, leading to panic or avoidance. This over-sensitivity to bodily signals can fuel a feedback loop of fear (Craig, 2002).

On the other hand, in conditions like depression or anorexia nervosa, people may be under-sensitive to interoceptive signals. They might not notice hunger, fatigue, or even emotional cues. This blunting can contribute to numbness, lack of motivation, or difficulty accessing pleasure or safety.

One 2023 review noted that disrupted interoception plays a core role in emotional regulation difficulties, poor decision-making, and breakdowns in self-awareness (Nayok et al., 2023). It's not about overreacting or being “too sensitive”, rather, it's about the brain and body being out of sync.

The Science Behind “Feeling Your Feelings”

Interoception doesn’t just happen in the gut or heart. It’s mapped across multiple brain regions. The insula is a key player, acting as the hub where signals from the body are interpreted and compared with expectations (Quadt et al., 2018). If the brain’s prediction doesn’t match the body’s reality, it recalibrates. Or at least, that’s the idea.

In people with trauma histories or neurodevelopmental differences, this predictive system can be disrupted. The Embodied Predictive Interoception Coding (EPIC) model explains this by showing how chronic stress alters the brain’s ability to update internal expectations based on bodily feedback (Barrett & Simmons, 2015).

When the brain doesn’t trust the body (or vice versa) it becomes harder to regulate emotions, make decisions, or even identify what you’re feeling.

This is why some people may swing between emotional shutdown and overwhelm. The body's warning systems have been thrown off course.

Why “Just Breathe” Doesn’t Always Work

Have you ever tried to use a calming technique—like deep breathing or mindfulness—and found it made things worse? That’s not failure. That’s interoceptive mismatch.

For people with trauma or dysregulated interoception, focusing on the body can actually heighten anxiety or dissociation. Being asked to “just calm down” is like asking someone to use a broken compass to find their way out of a forest.

Therapies that respect interoception don’t demand immediate connection with the body. For example, Somatic Experiencing, trauma-informed yoga, or certain forms of neurofeedback are designed to slowly build capacity to tolerate, interpret, and eventually integrate bodily sensations. Over time, this can rebuild the brain’s ability to predict and respond to internal cues with accuracy and safety.

Who Struggles With Interoception?

Some people are born with heightened or dulled interoceptive awareness. Others develop interoceptive dysfunction due to trauma, chronic stress, sensory processing differences, or developmental conditions like autism.

In fact, recent research suggests that alexithymia (the inability to describe internal emotional states) is deeply linked with interoceptive dysfunction and may underlie many co-occurring mental health symptoms across diagnoses (Murphy et al., 2019).

In autism, for instance, interoceptive confusion may explain both emotional dysregulation and difficulty understanding social cues. In PTSD, it may be tied to flashbacks or body-based trauma memories. In anorexia, it’s often connected to distorted perceptions of hunger, fullness, and body image.

Understanding these interoceptive differences isn’t about labelling people as disordered. It’s about finding compassionate, body-based ways to support them.

Rebuilding the Brain-Body Bridge

The good news is that interoception can be strengthened. Just as the nervous system can be dysregulated, it can also be rewired.

Practices that involve gentle, non-judgmental body awareness can help re-establish the brain-body connection. Some examples of this include mindfulness, breathwork, interoceptive exposure, and somatic therapies. Newer technologies, like vagus nerve stimulation and biofeedback, are also being studied for their ability to modulate interoceptive processing at the neurological level (Chen et al., 2021).

But for most people, it starts with one simple truth: if your body feels like an unsafe place to be, the first step isn’t to push harder. It’s to create conditions where your body can feel safe enough to notice again.

Putting It Into Practice: Support for Reconnecting With Your Body

Understanding interoception is one thing, working with it is something else entirely. Shifting how your body and brain relate takes time, support, and a safe environment where there’s no pressure to “get it right.”

At Balance Centre for Mental Health, we work with interoceptive challenges a lot. Whether you’ve experienced trauma, live with anxiety or dissociation, or identify as neurodivergent, our team offers body-informed therapy that honours your pace. We don’t rush you into overwhelming awareness or ask you to sit in stillness when that doesn’t feel safe. Instead, we support you to notice and connect the signals accurately at a pace that your body and brain can handle. 

From Somatic Experiencing and EMDR to nervous system education and sensory-informed approaches, our clinicians are here to walk with you as you rebuild trust in your body and learn to respond to its signals with more clarity, compassion, and choice.

When you’re ready, we’re here. You don’t have to figure it out alone

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References:

• Nayok, S.B. et al. (2023). A Primer on Interoception and its Importance in Psychiatry. Clinical Psychopharmacology and Neuroscience.

• Khalsa, S.S. et al. (2018). Interoception and Mental Health: A Roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

• Barrett, L.F. & Simmons, W.K. (2015). Interoceptive predictions in the brain. Nature Reviews Neuroscience.

• Chen, W.G. et al. (2021). The Emerging Science of Interoception. Trends in Neurosciences.

Murphy, J. et al. (2019). Interoception and psychopathology: A developmental neuroscience perspective. Developmental Cognitive Neuroscience.