Interoception: How This 8th Sense Impacts Child Behavior

Episode Transcript

​​Dr. Nicole Beurkens:

Hi everyone, welcome to the show. I’m Dr. Nicole, and on today’s episode, we’re talking about interoception, which you may or may not have heard of, but it’s actually really critical to our functioning and overall wellness. It’s basically the ability to be aware of and respond to internal sensations or information in the body. So we’re talking about things like hunger, fatigue, feeling hot or cold, needing to use the bathroom, those types of things. You can imagine the kinds of challenges that come up when a child or an adult is struggling with this sense. And that’s exactly what happens for many kids and adults who have things like autism spectrum disorder, ADHD, sensory processing anxiety, and lots of other neurodevelopmental or mental health challenges. This is an issue that I don’t think is understood or appreciated nearly enough, especially when we’re looking at underlying causes of behavior and other kinds of challenges for kids, so I’m excited to have Dr. Kelly Mahler with us today to help us understand more about it. Let me tell you a bit about her.

She has a doctorate in occupational therapy, and has been an occupational therapist for 18 years serving school aged children and adults. Kelly is the winner of multiple awards, including the 2020 American Occupational Therapy Association Emerging and Innovative Practice Award, and a Mom’s Choice Gold Medal. She’s an adjunct faculty member in the Department of Occupational Therapy at ElizabethTown College, and is actively involved in several research projects pertaining to topics like interoception, self-regulation, trauma, and autism. Kelly is an international speaker and presents frequently on topics related to a wide variety of resources she has authored. She’s got lots of great books and resources, like The Interoception Curriculum, Interoception Activity Cards, Sensory Issues and High-Functioning Autism, lots of amazing things that Kelly has done, and we’ll make sure that she tells us more about that. But let’s dive in, and Kelly, welcome to the show!

 Kelly Mahler:

Thanks Dr. Nicole for having me. I’m so excited to be here and talk about interoception.

 Dr. Nicole Beurkens:

This is, as I said, something that I don’t think is talked about enough. Usually when I use this word, parents look at me like “Okay, I’ve heard a lot of strange words in my journey of having my kid evaluated and treated, but what is this that you speak of?” And yet, it’s something that is so key to every aspect of our functioning and being in the world, so I’m excited that you have sort of specialized in this with what you do. I think it’s going to really lead to a lot of a-ha’s for our listeners today. Let’s dive right in. Let’s start with really laying a foundation for people of what is interoception? When we say this, what are we really talking about?

Kelly Mahler:

Okay, you did a really great job of defining it, but what we know about interoception is that it is a sensory system just like vision or hearing. Instead of pulling in information from the world outside of our bodies, interoception’s job is to pull information from the inside of our bodies. So you have receptors for interoception located extensively throughout the inside of your body. So in your heart, your lungs, your stomach, your bladder, your colon, your skin, your muscles, even the lining of your mouth, the whites of your eyeballs, and these little receptors for interoception are pulling in information about how all of these different body parts are feeling. Like the receptors in the lining of your stomach pulling in information about “How is your stomach feeling? Is it empty and has a growly feeling? Or is it full? Is it nauseous? Is it gassy? Do you have that tingly butterfly feeling in there?” So, many of us feel these sensations from the inside of our bodies because of the sense called interoception, and like you said, interoception has such a wide influence on all of our lives. So it’s really important to know about. I wish it was given a different name because it’s not a very sexy word, right? Like, no one wants to know what interoception is, but once you learn about it, it gives everyone including myself a-ha moments, because it relates to so many aspects of our lives.

Dr. Nicole Beurkens:

Absolutely. And it’s sort of like proprioception, all these words. It’s like could we come up with more, I don’t know, tangible or less sort of scary or big sounding words for these things? It’s interesting because we teach kids from an early age, part of the preschool and kindergarten curriculum is our five senses, right? And as most parents know who are listening, if you’ve been in the realm of sensory processing or integration work, where you’ve got a kid with some challenges, you’ve probably been exposed to things like the proprioceptive sense, the vestibular sense, where are we in space, those types of things. But what we’re talking about here with interoception is an eighth sense. It’s even another one to add to it, and it’s so interesting because our senses are just not limited to those five that we learn about.

Kelly Mahler:

Yes, and thankfully there is a lot more knowledge spreading about the lesser-known senses, like you mentioned, like our vestibular and proprioceptive senses, but interoception is definitely lagging, and it is the newest sense to be discovered and studied. I mean, it’s been defined for over 100 years, but people just didn’t realize how important it was until the last 20 years. And now there are thousands of research studies. Neuroscientists are scrambling to learn more about interoception, the National Institute of Health in the U.S. has devoted millions and millions and millions of dollars to research just this year and figuring out interoception, because what research is revealing is that interoception underlies a lot of areas, but most importantly our mental health, because you have to be clearly aware of how your body is feeling. Those body signals provide us with really important clues to our emotional experience. So if you really think about, say, how do you know when you’re hungry? For many of us, it’s based on the way our body feels. It’s different for all of us, but for me I notice a growing feeling in my stomach, and I feel sluggish, and I know “I’m hungry, I need to eat.” Or I know that I’m anxious based on the way my body feels. The interoceptive signals coming from my body. I get super tense in my neck muscles, and I have a tight feeling in my chest. Those interoceptive signals are providing me with clues like something’s off in my body, I’m feeling anxious, and I need to do something to take care of my body and my mental wellbeing. So interoception is very, very important, especially to our mental well-being.

Dr. Nicole Beurkens:

Well, I want to dive into the ways that we can see problems with this show up, but what I hear you saying is that really, this is about that awareness of those internal signals, which we know, some kids, some adults seem to really lack connectivity to that sense, right? They’re not picking up on those cues, they’re not aware of that. Or it takes a lot of intensity for them to become aware of those sensations, and then would it be fair to say, because as you’re talking about the mental health piece, particularly as it relates to anxiety, there can be people on the other end of that spectrum, who sort of are hyper aware, overly aware, constantly aware of and analyzing every little interoceptive twinge, signal, and that can exacerbate anxiety? So just like any other sense that we might be dealing with, it sounds like we’ve got this spectrum of responses from under-responsive to super over-responsive. Does that sound right?

Kelly Mahler:

Yes, you’re absolutely correct, and within the general population we all have varying degrees of how aware we are of certain sensations. Some days we might be more in tune with our bodies, other days, we might not be. So that fluctuation is very typical, but there are people that live more at the extreme ends of that awareness level, like you say, and some people tend to be more overly aware of their internal sensations. So they are feeling so many different things happening on the inside of their body at once. I worked with a client that every time he ate, he could feel his meal digesting through his body. So imagine trying to — if you’re a child, a student in school, and you’re eating lunch, and then expected to go to math class and pay attention, but all you feel is that digestive process in your body, that is highly, highly distracting. Or when we talk about pain: Pain is an interoceptive function. We feel pain because of interoception. And for a lot of people, they can be overly responsive to pain sensation. So they might have chronic pain, or they may be the child that’s constantly running to the nurse’s office or complaining of a lot of different symptoms in their body, but it is a real experience. It’s not that they’re being overly dramatic, or sometimes these people get labeled as attention seeking, which I really don’t like that term, but it is a real sensory experience for them. They are overly feeling. Then we have people that we know are on the other end of that, where they’re unresponsive, and they might completely miss important clues coming from their body. They might not ever notice that growling stomach cuing them in that they’re hungry, and they’re relying on people in their life to remind them to eat, or they might not notice the feelings of thirst or needing the bathroom. So they’re relying on other people to help them to ensure that they’re drinking or getting to the bathroom in a timely fashion. Or like you said, for these individuals, sometimes they do pick up on body signals, but only the really intense one. So these are the kids that don’t notice they’re in a meltdown or approaching meltdown until they are at the height of it, right? And these kids are labeled since their emotions go from 0 to 100 in a seeming blink of an eye, but really what’s happening a lot of times is that there are some subtle inner sensations, but they’re missing those clues. say, like, some of us have these subtle signals saying, “Hmm, something’s feeling off in my body,” and our bodies are designed to be uncomfortable, like that discomfort gives us a lot of important information, like, “Hmm, something’s going on, I should do something to help my body feel a little bit more comfortable.” But for these individuals, they miss those subtle sensations. And then they’re like, bam, they’re in shutdown or they’re in meltdown, and at that point, it’s too late to have any rational thought, right? You need someone in your life to step in and help you co-regulate.

Dr. Nicole Beurkens:

Absolutely, and I think it’s interesting because we tend to look at as we do with all behaviors, but particularly thinking about these interoceptive kinds of signals, we look at it through the lens of our experience. If you’re a parent or a teacher, or a therapist, or whoever, with an intact, well-honed, well-regulated interoceptive system, we just automatically assume that the child or the person we’re dealing with, it’s the same thing for them. And so this idea that they may not even be registering or recognizing these internal sensations doesn’t even occur to us because we just take it for granted that that happens, and yet, there are so many places where this plays a role and shows up in creating some real problems. You just mentioned one of them being in regulating your emotional and behavioral states, recognizing the mounting signals, the mounting stress, so that you can do something before you hit that meltdown point. I’m thinking too, about toileting and toilet training. So often parents will come in to the clinic, whether they have a neurotypical kid who’s just really struggling to toilet train, where it’s common, they’ll say, “They wait until they’re absolutely going to have an emergency and wet their pants, when you asked them 10 minutes before, ‘Do you have to go to the bathroom?’ ‘No, I don’t’, but now we leave the house and now it’s like an emergency and they’re flooding everywhere.” It’s like, right, they’re not cued into those signals. And I think a lot of people start developmentally before their kid is ready, whether their child is neurotypical or has a neurodevelopmental issue. If they’re not registering those signals, they’re not going to truly be able to independently use the bathroom appropriately, because they truly aren’t picking up on those signals. Right? So that’s another area where this really plays a functional role.

Kelly Mahler:

Absolutely, yes. And a lot of our toileting programs are behavior-based or modes of external methods of teaching toileting, when actually one of the biggest components of toileting is that internal experience and noticing that feeling. That is what motivates all of us to get to the bathroom, right? And so yes, kids need to have that interoceptive foundation to be successful in toileting. And of course, there’s a lot of other factors, but interoception is a huge missing piece in most of our toileting approaches.

Dr. Nicole Beurkens:

Yeah. And you mentioned a great example with how it plays a role in attention. If somebody is absorbed with the feelings of what’s going on in their body, it’s difficult to attend. What are some other areas that you see? Because I want to really help listeners to connect this to maybe some things that they’re seeing with their child. What are some other areas where interoceptive differences or challenges show up or play a role in the kinds of issues that kids are having?

Kelly Mahler:

So some things that come to mind are: Toileting is a number one thing that we hear a lot. Needing to be reminded to eat, to drink, those are some big signs. Body temperature, so not being really aware of if you’re getting overheated or you’re cold. We see a lot of kids mismatch. They insist on not wearing a winter jacket, even though it’s really cold outside, but they’re not really picking up on the way their body feels when they’re hot or cold. One of the biggest areas that we get most of our referrals for is what some people could term “challenging behaviors”, and just being able to regulate your emotions, such as frustration and anxiety for a lot of these kids. And our approach is “We’re going to teach you all the coping skills you need”. But one of the biggest signs is that a lot of our kids can memorize coping skills but they can’t use them at the moment. And it’s not that they’re being oppositional or refusing to do what you’re teaching. It’s because they don’t have those clues coming from their bodies saying “Something’s off. Now’s a good time for me to use a coping strategy”. So that’s one of the biggest signs is that we hear so many times that a lot of these kids and adults can memorize all of these strategies and emotion regulation programs, and they can’t put it into place at the moment. And many times, it’s because of this interoceptive piece. So we really need to rewind some of what we’re doing and set that foundation. That interoception piece is the foundation of emotion regulation. You need to be clearly aware of how you are feeling in order to manage it effectively. We throw around all these emotion words at these kids and adults, and if you really take a step back and ask them, “What does frustrated mean to you? What does sad mean to you?” Many times, they are memorizing these words, and they don’t really have a concrete understanding of what these things mean, because interoception gives us concrete meaning behind each of our emotions. So we throw these things out, like “When you’re frustrated, take three deep breaths,” and they don’t concretely understand what frustrated means to them. So interoception is really shedding a light on how we can better support the emotion regulation needs in many different-aged people.

Dr. Nicole Beurkens:

It’s so interesting, because the thing that got me interested in this and looking into this years and years ago was that I had a young adult patient diagnosed on the autism spectrum, but — I don’t like terms, like high-functioning and low-functioning, but cognitively very intact, had good insight, was taking steps to move forward in her life, but she said to me one day, “I don’t have any sense of what it feels like to feel joy or happiness.” And it was interesting because she had good insight, had really been pondering this, we had such a good conversation about it, and I started connecting it to other things with her too, like body temperature kinds of things, like her getting so upset with herself, because even as an adult who was trying really hard to use the strategy she had learned, she would find herself in a very, what she would call over-reactive behavior mode to little things. And I started connecting those pieces, and it’s really what got me interested in this because I thought, “Oh, all these things go together. These higher-level things that she’s talking about with, “I don’t even know what it means to say that I’m joyful about something.” That’s connected to the same type of thing that’s making it difficult for her to regulate her behavior in situations, for her to regulate what’s going on temperature-wise and activity-wise. So her ability to put some of that into words helped me then get a much better perspective on what’s going on for so many of the kids and people that we work with, who aren’t aware of that, who can’t put that into words. And so I love that you brought up the emotions piece, because I think that’s so true. And again, it’s like we start from an assumption that this foundation is there, that kids, that people — “Of course you understand what that feels like”, and it’s like, no, they absolutely may not have any sense of that. Then they’re just memorizing and going through the steps.

Kelly Mahler:

Yeah. And I have to be the first to admit. I was one of those people. Until learning about interoception, I did assume that most people understood their emotions, and they just had a hard time managing them. Interoception has definitely helped me to support my clients in a much more effective and kinder way, because it’s helping me to understand their perspective, instead of me infusing my view of the world on how you should regulate your emotions. Our interoception work is all about nurturing their curiosity and learning about their own unique interoceptive experience. That’s what I really love about interoception is that each one of us has a unique inner experience. What you feel like when you’re anxious is different from me, so it’s not about teaching someone this blanket approach of “This is anxiety, your heart races, your palms sweat.” It’s like discovering what anxiety feels like for you. Like one of my clients, it’s a buzzing feeling in the back of his tongue. That’s not something I would have taught him. He discovered that on his own, and that’s so incredibly empowering because it gives him a clue as to when he needs to do something for self-care. So interoception is really shifting, and if this is the first time you’re learning about it, I just want to reassure people, you’re not alone. This was me 10 years ago. Every single day, we’re learning new stuff about it.

Dr. Nicole Beurkens:

Yeah, you and I have advanced graduate degrees, and this was not part of our training. So yeah, don’t be feeling bad, even if you’re specialists, like “I never heard of it.” Yeah, right there with you. That’s why I’m so excited to talk about this. I want to I want to get into some tools and some strategies, but I want to touch on the social piece while we’re talking about the emotional piece because I think this is another area where we just don’t even realize how much our inner experience and our connection to our inner sensations and our body signals impacts our ability to communicate socially, to relate with others. So can you touch on that?

Kelly Mahler:

Yeah. There is some really interesting research, and I promise not to get too technical, but what this research is showing is that in order to intuitively understand how someone else is feeling in the moment, we recreate our own interoceptive experiences. So we call upon our own interoception, how we would feel in that moment in order to intuitively understand how someone else is feeling. So it’s really kind of funny, because I’m primarily a school-based practitioner, and what I see in the schools is like, we’re teaching emotions with flashcards. It’s like, “Here’s a picture of a person smiling, this is happy.” And what this research is saying is that understanding and reading other emotions is a skill that comes from within, it’s a skill coming from understanding ourselves first, and then we are equipped to understand other people. But we are just so focused a lot of times, especially when we’re supporting neurodivergence, we’re so focused on social skills, which I think we should stop doing, personally. We need that social connection. That’s what we need to focus on: Meaningful social connection. But we’re so focused on teaching them to think about other people, and there’s not enough emphasis on helping them understand themselves. We need to rewind, again, rewind, and help each person understand themselves. Then that is what neurologically and developmentally equips them to be able to think about other people. If you’re so busy trying to figure out yourself and what’s going on, you don’t have the resources to think about other people, and it’s not a lack of caring, it’s not a lack of love and empathy. It’s a, “I’m trying to figure myself out here”. So if we can nurture that self-understanding, it goes a long way in that whole social connection piece.

Dr. Nicole Beurkens:

Yeah, it’s so, so critical. We could do a whole episode just on that, but I love what you said, we need to back up, as with so many things with the population of kids and individuals who are struggling with this stuff, we start, in my opinion, way too far up the developmental pyramid, and we leave these big gaps. We don’t recognize that, wait a second, we need to go back, and we need to address some of these things developmentally that absolutely formed the foundations for meaningful social engagement, not scripted social interactions, meaningful, true development of relationships, and engagement. So glad that you said that. I think we’ve got people hooked. They’re like, “Oh, this makes sense.” I think people are having so many a-ha’s. Let’s get into some tools, because I know parents are thinking, “Okay, so what do we do about this? How do we support the growth of this interoceptive sense? How do we nurture this for, really, any kid, but especially those who are struggling?” What are some ideas you have about that?

Kelly Mahler:

So I want to tell you about the evidence really quick, and then I’ll give you some practical strategies. So, the evidence clearly shows that you can improve interoceptive awareness, which is super exciting. The evidence-based intervention right now that is shown to improve interoceptive awareness is mindfulness, but don’t get scared, okay? It’s specifically body mindfulness and being able to pay attention to how your body is feeling in the present moment. So these studies are using different forms of body mindfulness to enhance the interoceptive awareness in the participants in the studies. So as an occupational therapist, I know this evidence, but I have a lot of clients that thought traditional forms of body mindfulness are not a match. If you’re out there listening and you’ve tried body mindfulness, we hear this from so many people: It is not easy. Body mindfulness is hard. It requires attention, it requires cognition, language. It assumes that you have a safe relationship with your body, which a lot of my clients don’t have, whether it’s because of a history of trauma, or they’re chronically dysregulated and their body feels scary. So what we’ve done, occupational therapists we’re really trained at adapting things to make them more accessible and successful. So we adapted body mindfulness, and we are using it very successfully for a wide variety of learners, whether they have a diagnosis or they don’t. We’re actually using it as a preventative model for all kids and adults. So that all being said, now that you know what the research is saying, some of the things you can do: I think one of the easiest things you can do as a parent is just to start doing what we call interoception talk or Body Talk, and just start talking out loud about how your own body is feeling in the moment. So maybe you’re holding a cold glass of water, and you say, “Oh, my goodness, my hands feel cold when I’m holding this glass of water,” or you’re getting a hug from your child, and you say, “Oh, my goodness, my, my heart feels slow when you give me a hug.” So just starting to talk out loud about how your body is feeling, and being that really good model for your child. And then you can start to shift your body talk, your interoception talk to your child, and start just inspiring their curiosity about their own body, like “How do your hands feel when you hold this glass of water?” And remember, their experience might be different than yours. Your hands might feel cold, but they might say their hands feel wet because there’s condensation, right? So we always validate and honor every single person’s experience. If your child doesn’t have the language to be able to label what it is they’re noticing, that’s okay. Still continue to do that body talk. If you have a cold glass of water, you could have them put their hands on it and say, “Oh, do your hands feel cold?” And just talking the body talk out loud as often as you can during your daily routines. You don’t have to do anything extra, it’s just a shift in seeing moments as interoception moments. I think that is really the biggest thing you can do as a parent, and I don’t know about you, but I was raised, I think our generation was raised in, and we’re in a society right now where we ignore our bodies. We push through, we stay busy, we are on our screens, we don’t take the time. So this is a huge shift, even for myself with my own kids, and just really talking about how my body is feeling and getting them to think about how their bodies are feeling can go a really long way.

Dr. Nicole Beurkens:

Yeah, I think it’s so true. And, you know, I’m thinking about those kids who don’t yet have verbal communication or struggle, maybe with some of those pieces. I find that being attuned and observing what they’re doing, and then using some labels with that. You can see, if they touch something super-cold, and they pull back from it, you say, “Oh, maybe that felt cold”, or “That felt uncomfortable”, or just having even that emotion-sharing moment around that experience, like honing in on that, helping bring their attention to that sensory experience that they just had, I think can be valuable too.

Kelly Mahler:

Absolutely, and that’s just another way of honoring someone’s experience. Maybe they’re jumping and you start jumping with them, and you say, “I see your feet are jumping!”, just being really attuned and honoring and validating their experience. I don’t think that’s done enough, and I think for a lot of these kids, they are subjected to quite the opposite in compliance-driven models, where these compliance-driven models are trying to make these kids fit into the way they think what typical is, So “Stop jumping, sit still. You’ll get your reward if you sit still”, instead of honoring and validating that child’s body needs and is telling them. These compliance-driven models are actually shutting interoceptive awareness down and teaching that child and adult over and over again, “Ignore what your body is telling you, you need, and listen to my demand. And if you listen to my demand, I will give you a reward.” That is very damaging, for a lot of reasons, but interoceptively, it is very damaging.

Dr. Nicole Beurkens:

Well, I think that’s one of the big things that more and more, is the argument against interventions like applied behavior analysis and those kinds of things. We’ve done some episodes on that, you can go back and listen to those for more insight on that. But this ties in really well, because the whole premise of those is, “Ignore what’s going on with you. What’s going on with you is not important. What’s important is what’s going on with me and the demand I’ve given you, and complying.” You’re right, it does teach this total shutting down and ignoring, and can really be traumatizing, even from that standpoint. That’s what so many adults now with Autism and related issues are saying. They’re able to communicate about the trauma they’ve had at the hands of those kinds of interventions, but I think it ties in really well with what we’re talking about here. You can’t help a person develop better interoceptive sense, better honoring and understanding of their own body and what’s going on within it, if you’re constantly rewarding shutting that down and ignoring that.

Kelly Mahler:

Exactly. Exactly right. Yeah.

Dr. Nicole Beurkens:

So being a model, this pausing and just taking time to be aware of our own interoceptive experiences, those of our kids’ sort of labeling that, being in those moments together, that’s a really important thing that we can do to support growth in this area. How about another tool or tip you have?

Kelly Mahler:

Well, if you want to get a little bit more structured, one of the things that we’re doing with the work, we have the interoception curriculum. One of the things that we do in the curriculum, the way we adapt body mindfulness is we focus on one body part at a time. So instead of being able to pay attention to your entire body and notice how it’s feeling, that is a really high-level skill. Not many of us can do that very well, unless you have a very active mindfulness practice. So we’re chunking it down into one body part at a time. So you could do this in many different ways. Maybe as a parent, each week, you’re going to focus on one body part. So say week number one, it’s hands. And you’re just going to focus during your daily routines, again, on capturing moments where your child’s hands might be feeling a certain way, and then cueing them in and helping them to notice what that feeling is. If they’re at a level where they can, they can match their own interoceptive language to what it is they’re noticing. On my website we actually have a lot of free resources. One is an interoception daily activity list, and it breaks it down into a lot of different things that you’re probably already doing with your child and really good times to tune them into how their hands are feeling, and then we have a menu for feet and activities that could be a good time to tune them into how their feet are feeling, because what we’re finding is chunking it into one body part at a time and then nurturing interoception during times when they’re probably feeling a stronger sensation within that body part helps trigger their attention to that body part. So if you go back to that example of holding a cold glass of water, that’s probably evoking a stronger feeling in your child’s hand, and it kind of helps to capture like, “Oh, my hands feel”, whatever it is: cold, wet, freezing, numb, tingly, whatever it is. So we’re always trying to catch those moments that are evoking a stronger feeling, then giving practice noticing, and labeling that feeling. So chunking down into one body part at a time, and then watching for moments that evoke a stronger sensation can be really helpful at developing and nurturing this interoceptive awareness in all people. We’re doing the same thing with adults as well, but I know we’re talking to lots of parents right now. We’re trying to get really good at, “How do we embed this into things you’re already doing?” I have a daughter that had a long stretch of different therapists coming into our homes, and they’re all giving us different things to do, and I’m a therapist, I know I should be doing these things, but my gosh, it is hard! The one therapist that had such an impact on our lives was because she helped me to see how to embed things into things I was already doing with my family. That is when the work got done. That is when the supports got used. So that is what we’re trying really hard to do.

Dr. Nicole Beurkens:

Which I love about all of you who exist in the wonderful field of occupational therapy, because that’s really your lens and your perspective, right? It’s how do we improve function within the context of functional daily life stuff? And I think you’re right, especially for parents who were like, “Oh, my gosh, this is one more thing to work on.” It’s like, no, this is something that’s happening all the time. So I love that you’re giving people tools and resources to embed it into those experiences. And I think it’s really about slowing down, isn’t it? It’s about slowing down and allowing for those connections to be made in kids, but you can’t do that in a fast-paced, quick “Do this, do that, do that.” They can’t process those sensations, and then they can’t form those connections. So there really is a case to be made here as for so many other things that we might work on with these kids, is that we need to slow things down.

Kelly Mahler:

Yeah, I think that’s good for us as parents too. There’s a lesson here for me too, but you have to just really slow down and I think too, to consider all the work that we’re doing is always in periods of calm and regulation, because nobody wants to tune in when your body feels overwhelmed. So I think that’s something else that goes along with slowing down, and really considering how regulated your child is, and how comfortable they’re feeling. To think about the environment too, because what some of the emerging research is showing is that if you are sensitive to the outer senses, so say you are really sensitive to sounds in your environment, we know that that can be a painful stimulus, sounds in your environment. It causes a stress response. So for these individuals, they are hyper vigilant to their outer world out of protection of their nervous system. They’re always waiting for that next insult to their neurology, that next loud sound that creates that stress response. So their attention is pulled outward, constantly monitoring the environment. So they have no attentional resources left to pay attention to their internal signals. So you really want to think about where you’re, you’re doing your interoception work, and making sure that it’s a place where your child feels safe and they’re feeling regulated, and we’re always doing this in playful and engaging ways. It’s never a demand, that we’re saying, “You must notice how your hands are feeling,” we’re trying to do it in an invitation, and making it really playful and feel safe. I think that felt safety is really important for consideration.

Dr. Nicole Beurkens:

So critical, I’m glad that you raised that. Do you find it’s also the case that these are things that take some time? These kinds of connections between the brain and the body don’t happen instantly. So I imagine that you probably spend a lot of time helping parents and professionals understand that this is work that builds over time. You don’t do one session on how your hands feel and then expect that the kid’s going to have that. It’s over time that the connections get made, and then the efficiency of those brain-body connections kick in. So it’s something that we don’t necessarily see instant payoff with. But don’t stop, we need to continue exposing it, putting language to it and working on it to help those connections form. Is that your experience?

Kelly Mahler:

Yes, it is definitely not a quick fix. A couple of things come to mind. First of all, interoception work for all of us is a lifelong journey. So it’s not like you’re going to work, work, work, and you get to this certain goal or endpoint and you’ve achieved it, and it’s like all done! It’s something that we all need to work on, on a daily basis of listening to our bodies, tuning into what the messages our bodies are sending us are. So it is a lifelong journey. But for individuals that are really chronically out of touch with their interoceptive signals, and we’re doing this work in a clinical type of way, it does take some time. I’m always asked “What is the magic number?” We haven’t found it associated with anything. It’s not associated with faster changes with age. We have not found any relation there. Some of my older learners take a lot longer than my younger learners and vice versa. It’s not related to a communication style. I’ve had some clients that don’t speak to communicate that have made rapid progress, it’s not associated with IQ, so it really is all over the board, and we can’t figure out what the mix is that helps someone make connections faster than others. In some of the research studies that we’re doing, we are seeing gains in our participants in as little as seven weeks. But don’t say “I’ve been doing this for seven weeks, and I haven’t seen anything!”, because again, that is so variable. At the seven weeks into our studies, it’s not like that person achieved that gold standard. It’s still a lifelong process like I said in the beginning.

Dr. Nicole Beurkens:

Yeah, I think that’s so important and there are so many factors that play into that. I’m in my mind, even the nutrition, my mind goes to nutrient status and the role that a nutrient like zinc plays in registering and allowing some of those signals. And so a kid or an adult who is deficient in zinc, that may be an issue. There are so many factors, and throughout our life, those factors change. Depending on where our level of stress is or what’s going on, we may have, you know, more efficiency or less efficiency with this. So I think just recognizing all the variables is important, but the key is to recognize that it’s something to address, something to be thinking about and something to be embedding in what we’re doing with people. I think just the awareness, there’s so much benefit to that.

Kelly Mahler:

Absolutely, and it just helps us to get one step closer at understanding, and understanding some of these kids that can be hard to understand. And that is really what drives us, it’s just helping these kids to be better understood and better supported in kinder ways.

Dr. Nicole Beurkens:

I love it. You mentioned some great resources that you have. I want to make sure that people know where they can find out more about you, about your work, about your books, where are the best places online for them to go?

Kelly Mahler:

So there are two good places: The first is my website, and that’s kelly-mahler.com, and on my website, we have a lot of free resources. There’s a whole tab that’s called “Resources”, and we have free videos, a blog and printables. You name it, it’s there. And then we also have a Facebook group. If you search on Facebook for “Interoception: The Eighth Sensory System” , you’ll find us there, and I think we have 17,000 people from all over the world, and it is an incredibly supportive group. So if you are wanting more ideas, you can post there, you can just follow along. We have parents and caregivers, professionals, I mean, we even have lots of self-helpers in that group. So it’s an awesome place for resources, and we’re always posting updates there as well, when we have new research coming out, or we see other cool research, or resources, or free tips that we post them there.

Dr. Nicole Beurkens:

Wonderful. And your books and things are available at your website and other places as well, where books are sold online because I think people might be interested in checking out your curriculum and things like that.

Kelly Mahler:

Yeah, they’re all available on my website. 

Dr. Nicole Beurkens:

Fantastic. And Kelly’s last name is Mahler. We will of course, as always, put all of the links and things in the show notes so that you can easily click it, but for those of you listening, if you want to hop over to her site right now, that’s the spelling of her last name. Kelly, this was wonderful. So much valuable information, insight, great tips. Thank you so much for taking the time to spend with us today.

Kelly Mahler:

Thank you. It was a real honor to be here. Thanks for having me.

Dr. Nicole Beurkens:

Absolutely, and thanks, as always, to all of you for listening. We will catch you back here next week for our next episode of The Better Behavior Show.