‘The Hidden Sense’ – Interoception and Neurodivergence

Does this sound familiar?

• You’ve gone hours without water, food, or a bathroom break and only noticed when it became urgent
• You pushed through a social event feeling fine, then got home and felt the exhaustion hit all at once
• Your emotions seem to arrive suddenly and at full intensity, with little warning beforehand

If you’re neurodivergent, these experiences may not be random. They may be connected to a sensory system called interoception, one that quietly shapes how we feel, function, and understand ourselves.

What Is Interoception?

Most of us learn about five senses growing up. But we actually have eight.

The three internal sensory systems are:

• Vestibular: balance and spatial orientation
• Proprioceptive: awareness of our body’s position and movement in space
• Interoceptive: awareness of our internal body and emotion states

Interoception refers to our awareness of both internal body states and emotional states. 

Internal body states: hunger, thirst, pain, energy levels, urge to urinate etc

Internal emotion states: initial anger, fear, happiness, sadness etc.

Studies have found that neurodivergent individuals may have challenges with interoceptive awareness.These internal signals can be more challenging to monitor when your brain is busy managing sensory input from the outside world.

Why Neurodivergent People May Struggle with Interoception

For many neurodivergent people, the external world is already a lot to manage. Loud environments, unexpected touch, busy spaces: these can keep the nervous system in a near-constant state of alert.

When the brain is working hard to process what’s coming in from outside, internal signals can get deprioritised. The body’s whispers get drowned out by the noise.

Reduced interoceptive awareness in this context can actually be a protective response, a way the brain manages overload. This is not a flaw. It is an adaptation.

Something similar can happen after trauma. When safety feels uncertain, the brain orients outward, scanning the environment rather than attending to internal experience. Over time, this can become a habitual pattern.

The Brain Behind the System

The key brain structure involved in interoception is the insular cortex (the insula). It helps us perceive:

• Pain and temperature
• Heartbeat and physical sensation
• Emotional states including happiness, anger, and disgust

Research into neurodivergent brains has found the insula may work differently:

• Hypo-connectivity (less connectivity) may mean reduced awareness of internal signals, missing hunger, emotion, or pain cues
• Hyper-connectivity may mean heightened or overwhelming awareness of those same signals

It’s important to note that findings are mixed, and people with autism and ADHD can have very different interoceptive profiles. There is no single pattern.

Two Different Interoceptive Profiles

Under-responsive

• Missing signals of hunger, thirst, or needing the bathroom until they become urgent
• Not noticing pain or physical discomfort until it’s significant
• Emotions arriving suddenly and at full intensity, because earlier signals went undetected

Over-responsive

• A heightened or confusing awareness of internal sensations
• Difficulty distinguishing between anxiety and hunger, as both produce similar physical feelings
• Emotions feeling amplified or overwhelming

Some people experience a mixed profile, with under-responsiveness in some areas and over-responsiveness in others. All are valid and recognised patterns.

Why This Matters: The Real-Life Impact

Emotional regulation
If you don’t notice that anger or anxiety is building until you’re already overwhelmed, regulating that emotion becomes much harder. The early physical signals of emotion are precisely the window in which regulation is most possible.

Interoception affects more than whether you remember to drink water.

Homeostasis
Hunger, thirst, fatigue, temperature: these are the body’s signals for staying in physical balance. Consistently missing them can affect energy levels, cognitive function, and physical health.

Sense of self
Knowing how we feel is a significant part of knowing who we are. For neurodivergent individuals who also mask, suppressing natural responses to fit neurotypical expectations, interoceptive difficulties can compound the challenge of developing a stable sense of self.

Alexithymia
Alexithymia describes difficulty identifying and describing emotional states. It occurs at higher rates in autistic individuals and is closely linked to interoception. When the body’s signals are unclear, finding words for feelings becomes genuinely difficult, not because of unwillingness, but because the information isn’t coming through clearly.

Interoception and ADHD Specifically

Some ADHD traits are also linked to interoceptive differences and activity in the insula cortex:

• Attention and inhibition difficulties
• Time blindness: difficulty sensing how much time has passed or how long something will take
• Missing basic physical needs during periods of hyperfocus

Building Interoceptive Awareness

Like any skill, interoceptive awareness responds to practice. Small, consistent changes can make a real difference over time.

Body scans
Moving attention slowly through different parts of the body, noticing what’s present without judgment. Even two minutes at your desk counts. A guided option: headspace.com/meditation/body-scan

Progressive muscle relaxation
Deliberately tensing and releasing muscle groups helps build awareness of what physical relaxation actually feels like. This is particularly useful for people who struggle to distinguish baseline tension from distress.

External reminders
Visual prompts reduce the cognitive load of monitoring internal states. Try:

• A large water bottle on your desk
• Sticky notes or phone alarms
• Apps designed for this purpose. The Tiimo app (tiimoapp.com) is built with neurodivergent users in mind

Sensory tools
Fidget items, textured mats, and weighted accessories can help keep the body grounded and support awareness of internal states. Kaiko Fidgets (kaikofidgets.com) offers a range of options designed with sensory needs in mind.

Emotion check-ins
Noting how you’re feeling at set points in the day, even briefly and without much detail, gradually builds the habit of internal attention. Emotion wheels or feeling charts can offer useful scaffolding if identifying feelings is difficult.

What This Might Mean for You

If you have recognised yourself in any of this, that recognition matters.

Understanding that the disconnect between your body and your awareness is not carelessness or a personal failing, but a documented neurological pattern with a name, can be genuinely relieving.

It can also open up new directions. Approaches that work with the body directly, whether through movement, somatic awareness, sensory tools, or therapeutic work that attends to the body alongside the mind, may be more useful than strategies that assume internal signals are already accessible.

At Seed Psychology, we work with neurodivergent adults who are navigating exactly this kind of thing. If this resonates and you’d like to explore it further, we are here to support you. 

Book at seedpsychology.com.au/book-an-appointment/ or call 03 9388 8113.

Frequently Asked Questions

What is the difference between interoception and proprioception?
Proprioception is our sense of where our body is in space and how it’s moving. Interoception is our awareness of what’s happening inside the body, covering physical states like hunger and thirst, and emotional states as they build. Both are internal sensory systems but they serve different functions.

Can interoceptive difficulties be part of ADHD, not just autism?
Yes. Both conditions show differences in insular cortex function. In ADHD, interoceptive difficulties are often connected to attention and time perception. In autism, they are more commonly linked to emotional awareness and alexithymia. Many people are autistic and have ADHD, and may experience elements of both.

I don’t know how I’m feeling until I’m already overwhelmed. Is that interoception?
Very likely, yes. This is a common experience with an under-responsive interoceptive profile. The earlier, quieter signals of emotion go unnoticed, and the feeling only becomes apparent once it has escalated. Building earlier awareness of those signals is exactly what interoceptive practice aims to support.

Can therapy help with this?
Yes. Approaches that attend to the body alongside the mind, including somatic therapies, mindfulness-based approaches, and sensory-informed practice, can help build interoceptive awareness over time. A psychologist who understands neurodivergence can help you identify your profile and develop strategies tailored to how your system actually works.

References

Craig, A. D. (2009). Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 364(1525), 1933-1942.

Critchley, H. D., Wiens, S., Rotshtein, P., Ohman, A., & Dolan, R. J. (2004). Nature Neuroscience, 7(2), 189-195.

Lopez-Larson, M. P., et al. (2012). Psychiatry Research, 204(1), 32-39.

Radeloff, D., et al. (2014). PloS One, 9(9), e106539.

Uddin, L. Q., & Menon, V. (2009). Neuroscience and Biobehavioral Reviews, 33(8), 1198-1203.