Feelings and Body Signals in Autism

 [Plain Language for Lay Audience]

Alexithymia means having trouble recognizing and describing your own emotions. People with alexithymia often can't tell what they are feeling and find it hard to explain their emotions to others. This can make it difficult to connect with others and share feelings.

Interoception is the ability to sense and understand signals from inside your body. These signals include things like hunger, thirst, heartbeat, temperature, breathing, and the need to go to the bathroom. Interoception helps keep our bodies balanced and healthy by letting us know what we need and how we feel inside. It also plays a big role in how we experience and control our emotions by linking our body sensations to our feelings.

Both alexithymia and interoception issues can happen together in autism. 

Autistics might have unusual interoceptive awareness, meaning they can be more or less aware of their body signals than other people. This can cause problems like not noticing when they are uncomfortable or sick, or misunderstanding changes in their emotions, which are important for social interactions and taking care of their health.

Here are some examples of how this can affect autistics:

• Eating: Not knowing when they feel full, which can lead to overeating.
• Anxiety: Not feeling their heart race when they are anxious, making it harder to know they are stressed.
• Pain: Feeling an injection as more painful than usual, or not showing pain, which can confuse doctors.
• Exercise vs. Anxiety: Mixing up a racing heart from exercise (good) with a racing heart from fear (not good).
• Toilet Training: Taking longer to learn to use the toilet or having random accidents even into adulthood  because their body can't recognize when they need to go.

From a brain science perspective, the insular cortex and the anterior cingulate cortex (ACC) are important for interoception. The insula helps combine body signals with thoughts and emotions, while the ACC is involved in feeling pain. In autism, these brain areas might work differently, affecting how body signals and emotions are processed. Studies using brain scans have shown that the insula reacts differently during body signal tasks in autism, which might explain their unique interoceptive experiences.

Addressing both alexithymia and interoception is important for improving emotional understanding and overall well-being. Helping autistics improve their interoceptive skills can lead to better emotional control and awareness, making it easier for them to connect with others and take care of their health.

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