This post is a transcript for a webinar. The webinar/video can be found here.
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In a lot of parenting spaces that I see on the internet, I hear the word “regulate” used as if it is a fancy way to say “calm down”. Dysregulation is sometimes used as a synonym for “grumpiness” or “sadness”, when in fact it’s much more complex than either of those things.
When I’m trying my best to use a non-jargony sounding term, the one that I typically find myself reaching for to substitute for “dysregulated” is the phrase “out of whack”. Of course, that’s not perfect but it’s as close as I can get in slang terms. Another way of saying it could be that there’s an energy mismatch between the person and the activity or environment, or that they’re out of sync. So then it’s important to realize that “regulated” doesn’t mean “happy”, either. Someone can be regulated and contented, calm, serious, even sad or angry if the situation is actually calling for those things and the person is in control of themselves.
Dysregulation could be affected by emotions like grumpiness or sadness, and it can be exacerbated by physical causes like hunger or discomfort. When someone is dysregulated, it means that their nervous system is not able to react appropriately to the situation that they’re in.
From a technical standpoint, dysregulated could mean too HIGH of reactions as well as too LOW of reactions. But, 95% of the time when laypeople use it, they mean TOO HIGH, so that’s generally what I’m also referring to throughout this presentation. I’ll try to clarify if I’m talking about too LOW of reactions instead, and otherwise assume that I mean too HIGH.
Regulated means your energy levels match the task.
Dysregulated means your energy levels do not match the task.
A child laughing hysterically and kicking and squealing and playfighting is not regulated to go to sleep.
A child laughing hysterically and running enthusiastically through an open field outside is perfectly regulated to play outside in a big open field.
Sometimes helping a child regulate means putting them into an environment where their level of energy matches the environment. Sometimes helping a child regulate means helping their body get its needs met so that their energy can match the task that’s up next.
A dysregulated brain has lost access to higher brain functions, like logic, paying attention, self-control, or use of language. When someone is dysregulated, their “logic brain” is not functioning in that moment. That means that trying to reason, lecture, or punish them out of it is not going to help. Their brain is not reacting out of logic.
The fastest way for someone who is DYSregulated to become regulated, is called co-regulation. Co- meaning “with someone else”…like co-operate or co-worker.
Humans are inherently social creatures. We are so social that being around someone who is regulated in their body, plus enough time, is all it takes to get regulated in our own body.
Our body will unconsciously match their breathing/heart rate. Our brain realizes that it is not in danger or under threat, and stops putting out panic hormones that make us want to fight or run away.
Have you ever been very upset and then had a person you love just hold space for you until your body has had time to calm? Maybe they physically hugged or held you; maybe they just sat beside you; maybe they held your hand.
Maybe you cried, or maybe you raged, or maybe you just sat there in shock. But with time, the emotion passed, and you were able to think logically again. Maybe you were able to do something to try to address the situation. Maybe it wasn’t a situation that could be fixed, but you were able to choose to go get some food or a drink of water because you had to keep existing.
Kids are not the only ones who co-regulate, although they often need it as their PRIMARY coping strategy, where for adults it is just one of many.
This starts out at birth, when a child is born and placed with loving and responsive caregivers. When a baby becomes dysregulated, they cry. They react with every fiber of their being to a state of something being wrong, because they don’t know how to tone down their reactions at all yet, or how to measure a situation and determine what kind of reaction it needs. They pretty much only know how to scream with every bit of air in their lungs when anything feels wrong in their body at all.
Then, a caregiver who can better assess the situation than the baby can, takes care of the need that was causing them to cry. The caregiver’s calm presence also co-regulates with their nervous system. Their brain learns, for the first or second or third time, that it is possible to move from a dysregulated state to a regulated state. Before that process happens, how would they know? It is all inward — it’s not like they could watch it happen. They must co-regulate in order to learn that it’s even possible for those feelings to pass and the storm to calm. If they don’t have anyone with them to co-regulate with them, the feelings still eventually pass, the storm still eventually calms…but rather than learning that they were safe with another person, they begin learning that they are all alone in those feelings, and maybe eventually even that suppressing those feelings is important in order to earn the right to not be alone.
Anything we do in life at all — walking, talking, riding a bike, memorizing a telephone number, reacting to our kids — anything we ever do is done by neurons in your brain “firing”. Imagine that the neuron has to travel from one place to another, and then the next neuron does the next part of the action, like a relay race where they hand off a baton.
Doing anything *again* makes the same set of neurons fire as it did the first time. Then as we do it more and more, that set of neurons firing in that way becomes like a “pathway”. Imagine that the neurons have to race in exactly that way each time, and they create a path because they run in the same place every time. Like how running in a grassy field will eventually create a path, if enough people keep walking through the same broken/trodden grass over and over.
The more times that “path” is traveled, the more well-worn and easily accessible the path becomes.
Regulation is the same way. With time and maturity, the regulation pathway becomes easier to access, even without the help of someone to co-regulate. This learning process is called “self-regulation”. Co-regulation taught the brain of that baby that it was possible to do, and eventually they learn to do it themself. They learn coping strategies, and how to ask for help.
But this is a complex process with many components, and learning this skill may not just be a straight-line pathway.
I think that one place where parents start to get burnt out is in the idea that co-regulation means that they, the parent or the adult, have to be dragged down fully into the bog of the child’s emotions every single time that the child has emotions, and that might be happening quite frequently depending on the child and their circumstances and their neurology and so on. Some kids just really, really feel things, and it seems rightly overwhelming to a parent or adult — especially if they’re the only one that kid has who’s going to do this with them in a healthy way — to imagine that they have to have their day interrupted 300 times while they be sad with their child over and over about them getting the wrong color bowl or whatever.
I think it’s really important to completely and totally rewrite that. I think that comes from a place of love and being absolutely well-meaning, the most possible well-meaning, but I don’t think it’s healthy for the child or their adult. Being empathetic does not mean getting sucked all the way down into a hole. You can be authentically empathetic and give your child as much time and space for their emotions as they need and still stay out of the hole. It takes time and practice and it’s harder to begin implementing when your kid is older and you change things than it is to lay the groundwork from the beginning, but both are possible.
I would say fully half, if not more, of the empathy I express for my kids during the day is little more than just “oh man, that really sucks” or “ugh, I’m sorry that happened to you.” And I’m saying it with an authentic tone right now — there’ll be written versions of this later and I don’t know if it’ll translate the same way — I’m saying that with genuine empathy. And I’m not saying that this is all I offer, or as deep as my empathy ever goes, I mean that half or more of the time this is all that’s needed. I don’t mean that I’m cutting off my kids after this point, I mean that they’re getting what they need from that interaction. Something doesn’t work just right and they want to be seen about it, for their struggle and their frustration or their disappointment to be seen, and I acknowledge it and fully see it. They might still flop around saying “that’s not fair” or “I don’t want to”. Now again, it’s important to note that I don’t mean that I empathize with them and then they snap right back to happiness, because that’s not what regulating means. But as they’re getting older they’re starting to have more and more experiences that help them learn the foundation of how to self-regulate. They might be able to do it halfway or 90% of the way with me and then walk away and get the rest of the way there by themselves. Those babies who didn’t know how to do anything else other than scream with their whole being have now had a lot of practice and a lot of examples of what it means to survive through the storm before.
Self-regulation is not just one thing. It is a big skill, made out of lots of little skills. These little skills might include differentiating between things such as, when it is helpful to distract ourselves (not processing the emotion, but postponing the processing for later), versus when do we need to talk it all out instead? Or who is the right person to “unload” or “vent” to, and who should we politely keep things back from? (It may not be best to emotionally unload on your cashier at the store, for example.)
We learn those things from going through this process over and over, from trial and error, and from the modeling of people around us. But one thing we can only learn ourselves by experiencing it over and over is that emotions are survivable. We live through anxiety, sadness, overwhelming excitement, fear, frustration… And we survive it. All of it.
Feelings are wonderful and powerful and huge. The process of learning to tolerate them, while still keeping hold of your ‘logic brain’, is challenging. And perhaps unsurprisingly, children do this a massive amount of the time…through play. It’s not just through their co-regulating with us that they learn to strengthen this skill. It is also through their repeated play over and over and over.
Now here’s the thing. A lot of public schools in the US, and at least some in the UK near where I live, and I truly think all over the world, have begun figuring out how they can outright, overtly, teach social-emotional skills and things like self-regulation and coping skills to children.
I need to say outright that I am not *against* that. I think that it’s great that kids’ mental health is being recognised as an important factor in their success in school and that it’s important enough for people to even prioritise over academics, or at least in tandem with academics. I think that it makes perfect sense that this is a “figuring out process” and wasn’t perfect from the get-go, because most things aren’t — they take time to figure out. I think that it’s CRUCIALLY important that in the wake of covid, with the amount of trauma that students have experienced and many are ongoingly experiencing, that schools be aware of the power they have to be able to equip kids with emotional skills like these and figure out how to use that power wisely and helpfully, and I think there are many many many therapists and school counsellors and other supporting staff out there in the world right now who are trying their utmost to do exactly that.
There is a problem on a systemic level with this plan. By “systemic” I mean that I would never point to any single counsellor and be like “you’re the problem here” and I would never blame a teacher for doing everything they can within this system, but that the system is still set up for failure anyway—or if not quite so drastic a word as “for failure”, then for a struggle if nothing else. And the reason for that is that in my experience, many schools and therapists and teachers, and even parents and caregivers who are taking their lead from the schools and educators, are trying to get their child to buy in to a system of overt, artificial, self-regulation tools while systemically, the natural self-regulation skill-building activities are almost entirely, if not entirely, suppressed.
Here’s what I mean by that: Wrestling, rough-and-tumble play, builds self-regulation. Playing with risky tools and materials builds self-regulation. Playing freely with sensory-rich materials builds self-regulation. Playing socially with others, fighting, arguing, bickering, builds self-regulation. Getting loud and yelling and moving through a range of volumes builds self-regulation. Trying to do hard things that you can’t do yet that you yourself chose and are motivated to do builds self-regulation.
Sensory-rich stims and fidgeting and play and self-soothing techniques are self-regulation tools. Picking things apart is a self-regulation tool. Sucking and chewing on and mouthing things is a self-regulation tool. Stomping your feet is a self-regulation tool. Yelling is a self-regulation tool. Crying is a self-regulation tool. Picking up heavy things and flipping them over or throwing them is a self-regulation tool. Throwing yourself on the ground and feeling a hard impact is a self-regulation tool. Running around, rolling, flipping, somersaulting, wiggling is a self-regulation tool.
Almost every single one of those things I just named comes naturally to a child or a group of children left to their own devices. Almost every single one of those things I just named are utterly policed to the maximum degree by school and childcare professionals and well-meaning parents and caregivers, too.
Some of that is necessary. I understand why there can’t be a class of thirty kids and they’re all freely allowed to wrestle one another or outright fight without any adult support. That’s why I called this a systemic issue. This is an issue in the way that our systems have built. We’ve built systems that can’t support children being children and then we blame the children for the fact that it’s not working.
We have tried to replace all of the collective of these things with, like, “A counsellor will come into your classroom and teach you all how to do deep breaths and maybe a yoga pose,” and we wonder why it’s not working sufficiently for them. It’s like taking a plant and saying “well, we won’t let it have any water, sunshine, or soil, but we’ve put it under an artificial bulb and given it a sort of scientifically engineered jelly, and we can’t tell why it’s not working.”
The ingredients you’re using to replace the natural ones don’t do the same thing. 20 minutes of recess, 40 minutes of recess, with monitors around to boss kids about all the things they can’t play, and strict rules about how kids can move their bodies, and only peers available who are exactly the same age as you, and a highly artificial environment socially and in terms of materials around, does not replace 6-8 hours of unstructured free play according to one’s own brain and own ideas. It’s almost laughable to think that it possibly could. And adding in practice with deep breathing and “brain breaks” where everybody dances to a YouTube video for 3 minutes (which is incidentally also trying to cram more literacy information into your brain) into the day doesn’t make up for that lack either.
It’s like the system is going, “Hey, our kids are stressed out. Let’s teach them factual information about bodily stress and some prepackaged solutions for de-stressing,” rather than realizing that the reason the kids are stressed in the first place is because they’re spending all day every day in a box designed to produce stress in them.
Children need to move through the range of feelings in order to figure out how to make sense of those feelings in their bodies. I feel like rather than trying to co-regulate, knowing how to give a child space to flop around on the ground and moan and cry and feel all the things they’re feeling, adults are focused on the meaning of “regulating” as meaning “rush to the end, skip to the part where they’re happy and quiet again”. I run into that quite a lot in public in England where I live, I think my kids are quite shocking to some of the English kids’ sensibilities sometimes. A huge part of the co-regulation and self-regulation IS the process, not fast-forwarding to the end. Whether that’s the process in terms of going through emotions when they come up in day to day life, or whether that’s the process in terms of practicing through it in all forms of play. But when adults try to skip kids to the end of their feelings in day to day life, and when adults try to sanitize and boss and police kids’ play, then they take away all of the tools that the kids could possibly have for learning to regulate themselves in healthy ways, and they wonder why teaching the kids to take deep breaths and count to 3 isn’t working.
Okay so. This may not help if you’re in the trenches with your kid right now, or you have a kid who’s burnt out after years of being crunched through the system, or you didn’t know about this until recently, or you’ve tried other parenting methods that have seemed to disconnect you guys’ relationship rather than build it, or the kid is subject to loads of adult control in other settings and you’re the only one trying to help them out, or you’re a foster parent or adoptive parent or other non-traditional caregiver route so you’re dealing with a kid who has preconceived notions about everything and you don’t get to start from square one… There’s a million reasons why you. might be listening to this and be like, this does not help me, I do not have six years of rapport with my kid and we’re both drowning RIGHT NOW and they don’t trust me and I’m not in a good headspace and they can’t self-regulate and I can’t co-regulate and nothing is working. Especially adults who did not have a safe person to co-regulate with as a child, or who were primarily parented by having their emotions shut down, rather than learning how to safely regulate.
I absolutely, 100% know that somebody is listening who feels this way right now and I get it. I absolutely get that. Your kid’s emotions are, in fact, dragging you all the way down. Every time that they have them it’s dragging you down and they’re having them 300 times a day. I get it.
It is going to be hard work to climb back out of that hole. AND, it is going to set the foundation for your kid knowing how to climb, supported, out of a hole. All of this work we do, all of this emotional regulation, all of this learning, all of this is teaching them how to do it in childhood so they can live healthy and well in their bodies in their childhood AND so they have it in their adulthood. I didn’t have any of this until my adulthood. I lived catastrophically badly in my body in childhood even as I was having a “good” childhood, I had loving parents and a safe home, I still had lots of things going on where my emotions were an absolute wreck and I didn’t start untangling the mess it had made until adulthood. So any of the holes I fell into in adulthood, I was learning as an adult how to survive the loss of a baby, having never been allowed to deeply feel any loss before or how to navigate that depth of grief. So when I say to you: if you are in the trenches with your child right now, and you’re disconnected and lost and both of you dysregulated, it is going to be hard work to climb out of that hole, AND it is going to be the best and most important thing you can possibly do for them because you will be teaching them the way out together, and they will see you learning that and navigating that, and that will set up that foundation for them forever. It is never too late to build trust with your child again. It is absolutely doable to climb out of the hole. It is hard and it is doable and things will be good and lovely and worthwhile again. It is never too late to learn how to regulate, and in so doing, become the person who can co-regulate with your child — their safe space, their foundation for a more emotionally healthy adulthood.
So how do we do it…
In the same way that lecturing/berating a child who’s dysregulated doesn’t fix the problem, neither does beating yourself up when you’re dysregulated. Your logic brain is turned off, and you just have to power through til you get to the other side, keeping everyone as safe as possible. If beating yourself up worked, it would have worked by now.
Did you know that yelling is, from a sensory perspective, a very regulating thing to do?
That might sound weird and it might make your brain jump to conclusions that aren’t the same as exactly what I’m saying. But think about it for a moment, from a mental perspective of thinking of the mechanics of the body.
Yelling requires you to take a deep breath, and usually to continue deep breathing as well. Yelling produces a sound which is entirely within your control, and usually drowns out many, if not all, of the surrounding sounds in the environment for you (the yeller). Yelling often goes along with opening your jaw to a degree to where you can feel a “stretch” as you forcefully yell whatever it is that you’re yelling.
Yelling is a powerful, energetic, emotional release.
Also, *of course*, you don’t need me to tell you, that yelling AT somebody in a negative or angry way can be harmful to your relationship with that person and to the emotions of both of you.
Adults who struggle with yelling when they’re in a challenging situation could be struggling with self-regulation or sensory needs just like children could. They could be struggling with one or many or all of these things:
-Meeting a sensory need to cover up the noise in the environment — e.g., kids are getting too loud so you suddenly snap and yell at them to stop. Your yell covers up the noise briefly and your body feels like that will help, even if your logical part of your brain knows it won’t.
-Meeting a sensory need to have strong, self-regulating proprioceptive (deep body pressure) sensory input through the throat, jaw, tongue, lungs, and abdomen. Deep body pressure is one of the fastest and most dependable ways to self-regulate, so your body gets pushed to a point where a switch flips and it goes, “I need a burst of regulating sensory input NOW!”
-Meeting a self-regulation need to take a deep breath and soothe a nervous system that is crying out for a deep breath — but coupled with the triggers in the environment, the person yelled in addition to the breath instead of just taking a breath.
-Meeting an anxiety-based need to assure themself that they do have “control” over the situation, or that they have power and are not in fact powerless — yelling is big and powerful and feels like it’ll be reassuring to the body to do such a big, powerful move (even if your logic brain knows it won’t help anything.)
-Meeting an anxiety-based need to suddenly do “something” rather than do “nothing” — getting pushed past the point where you feel like you must take action NOW, so the action comes out of you quick and strong rather than being a measured action.
-Meeting a need for conflict resolution but only knowing how to copy the patterns that were modelled for them — they never saw anyone or learned any way to deal with conflict other than escalating to yelling.
-Meeting a need for conflict resolution and doing their absolute best to be an improvement on the patterns that were modelled for them that were even *more* harmful than yelling, but this is as best as they know how to do it.
That’s just one example of reframing what it is that you’re doing when you’re dysregulated to help try to find the root and help grow something different from that root instead. If you can take stock of your body and figure out that you, the adult, are yelling because you need to take a deep breath, then you know you can try to begin replacing it with taking a deep breath – but if it has nothing to do with your breath and more to do with you unconsciously copying a pattern, then you might need to start immersing yourself in reading or watching videos of other people’s scripts and suggestions and teaching ideas so that you can start feeding your brain new patterns.
The key here is that outside of that already-out-of-whack moment, we can learn and practice coping tools. Some popular ones include deep breathing, or doing body check-ins where you unclench tension in your jaw and shoulders and fists and focus on relaxing your muscles. This forces your body to consciously release its nervous tension that it was using to prepare for a fight or to flee. Strategically distracting yourself can be another tool, although it should be used appropriately. You can’t always “check out” of every situation, but you might be able to use distraction to get through a moment of crisis into a moment where you will have more resources to handle something.
The most powerful thing for me has been practicing pausing. Almost every parenting mistake I regret has been when I snap-reacted and did not pause. I try to sit and remind myself: “This is not an emergency. There is time to figure out how to react.” And just like my kids practice self-regulation through play, I do it too. I practice pausing in times when I don’t actually need to pause, when I’m not on the brink of becoming dysregulated. My kid says “Can we have some grapes?” And I practice pausing and think to myself “Grapes…yes…good idea” and then I say out loud “Grapes, yes, good idea” and then I get the grapes. Or whatever. Practicing taking a whole conscious thought and having it before I say the thought out loud, so my body gets used to the fact that I can think a whole thing through, not just start responding or reacting it and only find out what it is as I do it on impulse.
The more we practice, the stronger the regulation pathway becomes. That makes it ever easier for us to access. That models for our children how they can do it: first as they co-regulate in time with us, and then later as they copy what they’ve seen us do.
If you are all the way in the trenches with your child, I think the first thing you do is drop everything that you possibly can that you expect of your child and mega prioritize as hard as you possibly can doing whatever it would take to get yourself to a place of at least short bursts of regulation. Maybe you can’t get your whole life back on track in a day when you are all the way burnt out and everything is terrible, but maybe you can get to the point where you feel like you can manage things for the first hour of the morning before things start going terrible, or maybe there’s an hour from 5-6 pm after everybody’s eaten dinner that everybody is doing okay before you roll into bedtime struggles, or whatever it is. And then start building relationship-connecting things with your child into that brief moment of time where you are regulated and you have yourself pulled together. Offer them ice lollies for breakfast and ask them no questions at all and tell them that you think they’re a lovely person to be around. Say nothing at all about the thing they dropped on the floor that’s supposed to go somewhere else and don’t ask them anything at all about how school was, just tell them as softly and genuinely as you can “I was thinking about you today.” Play a videogame alongside them. Build them something silly in minecraft. Think about what their love language is and if there’s a way you could meet them in that.
Set yourself a mental goal and do this once a week, or twice a month, or whatever you think you can do without burning yourself back out. And then try to pepper the rest of the time with little one-sentence moments if you possibly can. Just make a conscious effort to tell them you love them, why you love them, that you think they’re cool. Not making such a huge deal out of it that you’re trying to embarrass them or make them react, just like it’s such an obvious fact of life that it’s going to come out in conversation sometimes.
In addition to the relationship building, I urge you to ask yourself what you can accept. The hardest times in my entire parenting journey have been when I simply refused to accept how things would be for a little while, or maybe even a long while, and these things shifted the most imaginable when the only thing that changed was that I accepted them. For awhile, my son would have a screaming, throwing things, raging meltdown at bedtime every single day. I had moved his bedtime as early as felt like it could be humanly reasonable and he was still doing it. I was not asking him to do one single thing in the entire afternoon and evening other than let me put bedtime underwear on him so he didn’t wet the bed and let me brush his teeth for him, and sometimes we even skipped teeth, and sometimes we even skipped underwear and I just snuck in after he was asleep and put down a bedtime pad or changed his clothes…and yet even with as few demands as I possibly could think of, he was still raging and melting down every single day. I took this as a sign of my own failing, I questioned myself, I felt like an impostor for doing these types of talks and writing on my Facebook page if I couldn’t even help “fix” my own kid…and then it took a conversation with a friend for me to realize that that’s how I was seeing it. And once I fixed my own framework to realize “Maybe this is just how it is right now,” the whole thing became so different. Nothing changed about my son at all. I just went into bedtime thinking “I will tuck my daughter in and then I will go sit with my son with my arms open in case he wants cuddles while he cries and lets all his feelings out,” rather than thinking, “I sure hope he doesn’t pop off today,” when all evidence was that he had done it daily for weeks! And then he grew right out of that phase. I didn’t even notice when he did. I wasn’t desperate for the end of it anymore. I had totally accepted that he needed to cry for a bit in order to process the day and in order to fall asleep, and that I’d be there with him to keep him safe through it, and we got through it.
So: drop everything you can possibly drop. Accept anything that you can possibly accept. Regulate yourself as much as you can possibly regulate yourself. Start looking for short bursts where you are regulated enough to connect with your child and start building a foundation of connection. Ask yourself where, if anywhere, you might be able to let them practice regulation in ways that are play-based or otherwise “just practice” and don’t have actual emotional precursors involved. Can you guys listen to rock music in the car and shout the lyrics to them together? Can you roughhouse and practice getting your energy up and then back down? Can you spend more time climbing something or lifting heavy things or building something or working on a physical, heavy, involved project together like digging, pushing, pulling, climbing, building, creating…?
My child has a tendency to go for long periods of time where he’s happy to play at his own level of ability, and then for some reason he’ll get completely obsessed with something just a little bit too hard for him and he’ll hyperfocus on it to the point of rage when he can’t do it and just do it over and over and over and over until he can. I’ve talked about him doing this at playgrounds before. He got himself completely stuck in a spiral ladder when he was like 3; he got himself stranded on a (walled, safe) bridge sobbing and looking down at the ground when he was 4; he spent time screaming at the top of his lungs at a skateboard quarter-pipe he wanted to climb when he was 5. And I always take it as an opportunity to sit with my own feelings of discomfort and work on my empathy tone of voice when he comes to me to tell me he still can’t do it and I have to tell him that I won’t just pick him up and do it with his body for him, and then he goes back to it again and again and then suddenly, somehow, he does it. I always wonder if the crying and screaming and raging is going to distract him, is going to defeat his own purpose and stop him from reaching his goal. And then I watch him figure it out.
Okay, and then the last thing that I would suggest – whether you’re coming at this new regulation learning from “in the trenches” or whether you’re just coming at it from a more informed place no matter what your family is feeling like lately – is to learn about interoception, about the sense of your inner body. You, the adult, the caregiver, learn about it, and also model that and teach that for your children.
Interoception, the sense of what’s going on inside of your body, can be broken into two parts: emotional feelings and biological feelings. Biological feelings can be a little more straightforward to understand, they might be your need to use the toilet, your feeling of hunger, your feeling of thirst, sleepiness, etc. And then emotional feelings of course are your emotions, but the way that they’re tied to physical sensations too.
At its most basic, interoception is “inner body sense”. But there are a lot of inner body sensations, and ascribing them *meaning* is a whole other piece of the puzzle. Are you able to notice the sensation itself? Are you able to take the sensation and interpret meaning from it? That’s interoception. It’s an intensely personal study/understanding, because people’s interpretations might be different, because people’s bodies communicate in different ways.
Maybe when I notice my hands getting hot and sweaty, I realize I’m anxious about something — but maybe when your hands get hot and sweaty, it means you’re angry, and when some other person’s do it, it just means they need to take off their jacket. These are vastly different interpretations and they can all be right!
This all obviously ties in with your regulation too. I can tell I’m starting to get dysregulated when it feels like my throat has swelled up and I can’t speak. I can tell that I’m starting to get dysregulated when it feels like my ears are on fire or that something making contact with my skin is making it burn and I need to get it off. These are all physical sensations. I don’t have to name the emotion associated with it. That can be super important for our kids who are neurodivergent in some way or even just for kids who are young or struggle with language or for any reason. It would be impossible for me to stand in your body, so it is really impossible for me to tell you exactly what emotion you are feeling. I might be able to make a reasonable guess but it’s not guaranteed to be right, and people do a lot of things that don’t fit the mold – like a child laughing because their body is nervously dysregulated and out of whack but somebody interpreting it to mean they’re feeling defiant and rude because they just did something wrong. So rather than project the emotional word onto what thing it is I’m observing, in myself or in others, I can just identify exactly what the feelings are, however those feel. There are a few resources like Autism Level Up that are working on creating alternate feeling words that aren’t things like sad, mad, happy but are things like buzz, flame, too much, blub blub. I’ve seen the speech therapist Tera Sumpter suggest modeling use of colors or characters or descriptions, like, “It feels like a river in my chest” or “It feels like Bluey in my heart” or “It feels red in my throat”, that would be personal and explained between the caregiver and the child more than anyone else. My own son used to tell me “it will hurt my eyes” when he meant that something was taking too long and making him feel, I would put my best guess as, impatient or full of longing for the future. He’s not old enough or articulate enough to explain to me WHY it meant it would hurt his eyes, but he came up with it on his own and expressed it and that language meant exactly what it needed to mean for him.
So when schools and teachers and caregivers and parents try to teach kids self-regulation, this is another reason that it may miss the mark. Not that their work isn’t important or isn’t good, but it’s so generalized that it may be meaningless if a child is missing interoceptive cues. That’s another key piece of the puzzle: interoception can be too strong, too weak, or distorted…oh, and it may not be the same across body parts. Maybe you’re REALLY sensitive to noticing when you’re hungry and you know the exact minute of the day at which you need to have your first snack so you don’t become a raging hangry monster, but you don’t notice you need to urinate until about 4 seconds before you’re going to burst.
So if we’re looking at a child who goes into a rage all the time and their school and their caregivers are all trying to teach them how to self-regulate with coping strategies – take deep breaths when you’re mad. Go for a walk. Listen to music – All of those things *might be* fine. But we only know they *might be*, because we’re guessing what will work for them, what will feel good for them. They’re not necessarily the child’s natural choices, they’re just ones that society says are good ones. AND, all of those things rely on the child being able to notice when they’re getting angry.
We might think “well of course you notice when you’re getting angry…it’s when stuff makes you feel, well, angry.” But you can see how vague that is! Maybe the child doesn’t actually notice at all. Interoception is *so* intensely personal. And it can be a much more challenging learning experience for autistic and, in a greater sense, for all neurodiverse people. Being aware of its existence as one of the body senses, and making intentional efforts to learn it, can help, regardless of what age you are. Kelly Mahler is another OT who’s got loads of resources about interoception, she’s the leading expert in the field.
I know that this has been a lot of theory and not a ton of case studies, just a few personal stories. I have many many more in my mind but the theory is what feels like it applies to everyone and sometimes it’s hard to pull the right things out of the case studies or the highly specific answers. But I tried to leave a lot of time at the end of this so that I can get through some questions because I know there are lots of you here, there must be people who have some specific questions about how this should look in practice, and so we can jump into that right now.
