Autism and Interoception: When You Can’t Feel What Your Body Needs
Author: Mokshvi Shah, BS Northeastern University Student
Published: August 2025
Many autistic individuals experience a disconnect between their body and mind, especially when it comes to interoception, the internal sense that helps us understand hunger, thirst, pain, temperature, or the need to use the restroom. Interoception is the brain's way of interpreting signals from within the body, and when that system is out of sync, it can make basic self-care feel confusing, inaccessible, or overwhelming.
For example, someone might not notice they’re thirsty until they feel dizzy, or they may miss cues of anxiety until they’re already in meltdown. Others might struggle to differentiate emotional states from physical ones, like misinterpreting sadness for nausea, or hunger for anger. This overlap between emotional and physical experiences is often confusing, especially in environments that don't validate or accommodate neurodivergence.
In neurotypical populations, interoception tends to be automatic and intuitive. For many autistic people, it’s a skill that requires active, intentional effort. This difference can result in misunderstandings: others may assume someone is ignoring their needs or being avoidant, when in reality, the internal signal simply isn’t coming through clearly.
Here’s how poor interoception can impact everyday life:
Disrupted routines: Skipping meals or holding urine too long, not from choice, but from not recognizing the urge.
Emotional dysregulation: Difficulty identifying when overstimulation is building up, leading to sudden shutdowns or outbursts.
Miscommunication: Trouble explaining bodily discomfort or emotions, especially in medical or social contexts.
Self-doubt: Questioning one’s perception of pain or need because others don’t believe or validate it.
Supporting someone with interoceptive differences isn’t about pushing them to "tune in better." It’s about understanding their sensory and cognitive style, and offering tools that bridge the gap between internal sensations and daily choices. These tools might include:
Visual schedules for meals, hydration, and rest
Body scans or guided check-ins throughout the day
Tracking moods alongside physical symptoms to build self-awareness
Accessible language to describe physical and emotional states
In therapy, interoception work can be gently integrated through psychoeducation, mindfulness practices adapted for sensory needs, and collaborative strategies to decode emotional-physical experiences. Importantly, the goal isn’t to “fix” someone’s interoception, but to empower them to understand their body on their own terms. For many autistic adults who grew up feeling like their needs were invisible or wrong, naming interoception as a difference, not a defect, can be incredibly healing.
Honoring these needs without shame creates room for autonomy, self-trust, and improved wellbeing. It also challenges the assumption that everyone navigates their body in the same way, which makes the world just a little more inclusive.
