What is interoception and why does it matter for healing?

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Interoception is the perception of the body's internal state: the ability to sense and interpret signals from within the body, including heartbeat, breathing, hunger, temperature, pain, and the subtle sensations associated with emotional states. It matters for healing because trauma systematically disrupts interoception, leaving survivors either flooded by bodily sensation or cut off from it, and healing requires restoring the capacity to accurately read and respond to the body's signals. Dr. A.D. (Bud) Craig at the Barrow Neurological Institute has mapped the neural substrates of interoception, particularly the role of the insula cortex in integrating bodily signals into conscious awareness. The insula receives signals from every organ and tissue in the body and synthesizes them into the felt sense of one's current state. Dr. Craig's work has shown that the insula is also critical for emotional processing, since emotions are fundamentally bodily states with cognitive labels added. Dr. Bessel van der Kolk's neuroimaging research found that trauma survivors showed altered interoceptive processing: in trauma-related states, the insula either became hyperactive (overwhelm, flooding, somatic symptoms) or hypoactive (numbing, disconnection from the body). Trauma literally changes the relationship between the mind and the body's signals. This is why survivors may be unable to identify what they are feeling, or why they feel sensations intensely but cannot label or contextualize them. Alexithymia, the clinical term for difficulty identifying and describing one's own emotional states, is strongly associated with trauma and is fundamentally an interoceptive deficit. When the translation pathway between bodily sensation and emotional labeling is disrupted, the person feels something in the body but cannot name what it is or understand what it means. Many trauma survivors experience this, making the standard therapeutic directive "what are you feeling?" confusing or impossible to answer. Developing interoceptive capacity is central to body-based healing approaches. Somatic Experiencing, mindfulness-based therapies, and yoga practices specifically designed for trauma all work on gradually restoring the person's ability to notice, tolerate, and accurately interpret bodily signals without being overwhelmed by them. The goal is not just symptom reduction but the rebuilding of a trusting relationship between the person and their body, which trauma has disrupted.