Reframing Interoception, Autism, Chronic Invalidation, and Nervous System Survival
At GRANN, we spend a great deal of time listening to conversations happening across the autistic, ADHD, AuDHD, disability and neurodivergent communities.
One conversation that continues to surface, both in research spaces and clinical practice, concerns something called Interoception.
Interoception refers to our ability to notice and interpret the internal sensations of our body.
This includes:
• hunger and thirst
• pain signals
• bladder and bowel awareness
• fatigue
• temperature regulation
• nausea
• heart rate changes
• emotional arousal
• muscle tension
• internal discomfort
Conversations around autism frequently frame interoceptive differences as though autistic people are born with an inherent inability to understand or feel what is happening inside their bodies.
But what if that framing misses something far more important?
What if, for many autistic and AuDHD individuals, difficulty connecting with internal body signals is not primarily an inborn deficit…
…but a learned survival response?
The Question We Need To Ask
Not all autistic people struggle with interoception.
And for many who do, we need to ask a more uncomfortable question:
Were they unable to feel their bodies…
Or were they systematically taught not to listen to them?
When Your Body Keeps Sending Signals Nobody Believes
Many neurodivergent people experience their bodies differently from an early age.
Some experience:
• sensory hypersensitivity to lights, noise, smells and touch
• digestive difficulties and gastrointestinal distress
• chronic pain conditions
• migraines triggered by environmental stimuli
• nervous system dysregulation
• chronic fatigue and brain fog
• unusual medication sensitivities
• autoimmune or connective tissue disorders
• co-occurring chronic illness
Research increasingly recognises high rates of overlap between Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, chronic pain conditions, gastrointestinal disorders, connective tissue disorders, and autonomic nervous system dysfunction.
Yet many neurodivergent children grow up hearing something very different.
They hear:
"Stop being dramatic."
"You’re too sensitive."
"There’s nothing wrong with you."
"You need to toughen up."
"You complain too much."
"Everybody else is fine."
"Ignore it."
"Get over it."
The problem is not simply that people do not believe them.
The problem is what happens next.
Survival Sometimes Means Learning To Ignore Yourself
Imagine living in a body that is constantly overwhelmed.
Bright lights trigger migraines.
Certain smells make you vomit.
Certain clothing physically hurts.
Noise causes pain.
Food causes digestive distress.
Touch feels abrasive.
Emotions are physically overwhelming.
Now imagine every adult around you repeatedly telling you:
"That is not happening."
"You are exaggerating."
"Ignore it."
"Stop complaining."
"This is normal."
At some point, survival requires adaptation.
Because remaining deeply connected to constant pain while existing in environments that refuse accommodation becomes intolerable.
So the nervous system does what nervous systems do.
It protects you.
Sometimes protection looks like dissociation.
The brain learns to suppress internal monitoring.
Not because the body stopped sending signals.
But because feeling those signals continuously became unbearable.
Why Interoception Can Become Blunted
For many autistic and AuDHD individuals, this can look like:
Not noticing hunger until physical shaking begins.
Not recognising thirst until dehydration headaches arrive.
Not feeling bladder fullness gradually.
Instead:
There is no urge.
No warning.
No awareness.
And suddenly:
You need a bathroom immediately.
Children may appear disconnected from their body.
Adults may struggle with chronic burnout because they cannot detect exhaustion early enough.
Individuals may not notice pain until it becomes extreme.
From the outside, this may look like impaired interoception.
But internally, this may be the result of years spent learning that body signals are dangerous, inconvenient, shameful, or irrelevant.
The Clinical Blind Spot Professionals Need To Understand
This matters deeply for clinicians.
Too often practitioners assume that an autistic person struggling with body awareness has a simple interoceptive deficit.
But many autistic people have complicated relationships with bodily awareness because reconnecting with the body has historically been unsafe.
For some individuals:
Feeling internal sensations triggers anxiety.
Paying attention to bodily states feels threatening.
Body awareness feels associated with punishment.
Internal sensations have long been dismissed by authority figures.
The body itself becomes connected with shame.
This creates an enormous blind spot in therapeutic work.
Why Somatic Therapy Requires Careful Foundations
Many practitioners increasingly use trauma-informed somatic approaches.
These approaches can be valuable.
But when working with autistic, ADHD and AuDHD individuals, an important question must come first.
Has this person been taught that noticing their body is safe?
Because if a lifetime of invalidation has taught someone to disconnect from internal sensations to survive…
asking them to suddenly reconnect with their body can feel profoundly threatening.
Sometimes practitioners ask:
"Where do you feel that emotion in your body?"
For many neurodivergent individuals, the answer is not simple.
They may:
• genuinely not know
• feel disconnected from those sensations
• experience demand avoidance responses
• interpret the question as a trap
• fear giving the wrong answer
• feel exposed by reconnecting with sensations they have spent years suppressing
Before body awareness work begins, therapeutic work may first need to focus on:
• rebuilding trust in internal experience
• validating sensory differences
• decoupling bodily awareness from shame
• understanding survival-based dissociation
• slowly restoring safe self-monitoring
• recognising chronic environmental invalidation as trauma
For Families: Believe What You Cannot See
Parents and caregivers often hear messages that children are exaggerating sensory discomfort.
We urge families to remain curious.
If a child repeatedly says:
"That smell hurts."
"That shirt hurts."
"The lights make me sick."
"That sound hurts my head."
"I feel weird after eating this."
Take it seriously.
The fact that you do not experience it the same way does not mean it is not happening.
Children learn whether their bodies are trustworthy based on how adults respond.
For Professionals: Move Beyond Deficit Thinking
We urge professionals across healthcare, education, disability services, counselling and therapy to ask different questions.
Instead of asking:
"Why can’t this autistic person recognise their body signals?"
Ask:
"What experiences may have taught this person that paying attention to their body was unsafe?"
This distinction changes everything.
Community Knowledge Builds Better Systems
Too often autistic and neurodivergent experiences are interpreted through deficit-based frameworks.
Sometimes what appears to be dysfunction is adaptation.
Sometimes what appears to be inability is survival.
And sometimes what professionals interpret as disorder is the nervous system doing exactly what it needed to do to survive chronic invalidation.
We cannot build supportive systems if we continue misunderstanding adaptation as pathology.
We would love to hear your experiences.
Because communities learn fastest when lived experience leads the conversation.
We Want To Hear From Community
At GRANN, lived experience is expertise coupled with autistic-led research.
We want to hear from autistic, ADHD, AuDHD, and disabled community members.
Have you experienced being told your body sensations were impossible?
Were migraines, pain, digestive issues or sensory overload dismissed growing up?
Did adults minimise experiences that you later realised were legitimate physiological reactions?
Have professionals misunderstood your relationship with body awareness?
Have you ever learned to ignore your body simply because nobody around you would help change the environment causing harm?
🌻 In solidarity
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