Interoception

Interoception

“I need to exercise to keep me sane,” said the overwhelming majority of my patients. That sanity is a feeling, a state of mind. That sanity is the end result of a quieting of your frontal lobe, your inner critic, your narrator. Physical activity dissipates the enormous mental and emotional focus you hold in your head and throughout your body. When exercising you quite literally metabolize your stress away, returning to the present moment and your sanity. The problem is when you ignore that sore back, knee, hip etc. and decide to chase your mental well-being, ignoring the signals your body is sending you. Yes, it is ok to push through some stiffness and the occasional aches and pain. But, repeatedly “pushing through the pain,” is not a sustainable strategy for your physical and mental health. If you ignore the physical feedback your body provides, you may paint yourself into a corner and be forced to take a break from, or worse permanently stop, your sport of choice. Actively and patiently listening to your body, then learning to recognize what it is telling you is called Interoception. Two interoceptive activities I attempt to engage in on a daily basis are a body scan and cadence breathing. These two practices allow me to check in with both my physical and mental state, providing me with the information I need to structure my workout or recovery for the day.

The skill of listening to your body is not recognized immediately or quickly and must be practiced. The frontal lobe of our brain is the seat of our executive function, and guides our decision making most of the day. The frontal lobe is our story teller and this is where you narrate your experiences. If you have every pushed through pain because you “needed” the workout, the frontal lobe is where that inner conversation took place. This is where you tell yourself you don’t have time to address that pain in your knee, that pain in your back, or you just need to get that 3 miler in before the kids get home from soccer. The frontal lobe is where the disconnect between your pain and your body begins.

Set aside 15 minutes , somewhere without interruptions. Lay or sit in a comfortable position. Consider how the back of your neck feels. Is there pain, tingling? Is it cold? Is there an ache in your neck and does it travel to your shoulder? Are you holding tension in the shoulder and can you relax it? Take some time to consider this part of your body. Then move to the front of your neck, then hands, forearms, shoulders, chest, back, etc. Notice how you feel at each discrete area that has your focus. Your mind will wander, but bring it back to place in your body you last considered. Work your way, slowly and deliberately all the way to your feet. Don’t tell yourself a story about why your back hurts, don’t demand that your body feel a certain way, just notice it. There are also many guided body scans published for free on apps or YouTube that can be helpful when beginning this practice.

Don’t expect a revelation on day one. A single body scan is not the solution to your pain, but the practice of doing it often just might be. With a body scan one gains insight, not from your intellect, but from your physical experience. The better you get at this, the more you will notice. Practicing a body scan often will allow your body to make connections between sensations, actions and emotions. You may notice an unusual amount of fatigue throughout your body, a lot of tension in your back, or perhaps you may notice you feel great. Any decision you make regarding the rest of your day will be informed by both body and mind.

A second interoceptive exercise that will give you insight into your nervous system is 15 minutes of cadence breathing. Find a comfortable place to sit without any distractions. Inhale through your nose for a 3 count, then exhale through your nose for a 6 count, for a 1:2 ratio. From here you can increase or decrease that rhythm according to the 1:2 ratio (i.e. 4 second inhale, 8 second exhale, and so on). After practicing this for a week or two, you will be able to feel the quality of your inhales and exhales. The quality of your breath cycle is a good physiologic correlate to the arousal of your nervous system. If you are stressed, your inhale/exhale length will tend to be shorter and the control over your breath cycle will feel relatively more difficult. If you are relaxed you will notice that the breath cycle will come with relative ease and you will be able to extend that ratio to higher numbers. Perhaps the most valuable insight you will take from this practice is the ability to influence the state of your nervous system. If you are stressed, you will notice that a slow, controlled, and rhythmic breath practice will calm you down and your breath cycle will improve by the end of the practice. The benefit of performing this practice often is that it will help you develop conscious control of your diaphragm, thus your respiration frequency and your mood.

A body scan and cadence breath work are two tools, when used together, will give your insight into your body’s tolerance to stress that day. If you are getting negative feedback from your body during these two practices, perhaps you will be better served with some meditation or bodyweight movements. Conversely if your body is telling you it is go time, perhaps you should get after it.