Interoception, the ability to recognize  bodily signals like heart rate, hunger, temperature..., is often a significant  source of  stress and anxiety in autistic youth.  

They may struggle to control the overload their body is experiencing by being unable to recognize the physical symptoms they are experiencing, leading to a potential crisis when the build up becomes too much.

Or, an autistic youth may go without eating or drinking anything for an entire school day.  A student may wear clothes that are inappropriate to the weather, seeming not to recognize heat and cold.  

Or, some may experience both depending on the situation and stimulus. 

The study that I used for this episode explores the issue and presents effective ways to lessen to impact of interoceptive weaknesses.

Here are links to resources used in the episode:

file:///Users/davidpoeschl/Desktop/ASD%20and%20anxiety/Autism%20and%20Anxiety%20-%20Autism%20Research%20Institute.html

https://www.google.com/search?q=Experiences+of+interoception+and+anxiety+in+autistic+adolescents+%E2%80%93+CRAE&oq=Experiences+of+interoception+and+anxiety+in+autistic+adolescents+%E2%80%93+CRAE&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIHCAEQIRiPAjIHCAIQIRiPAtIBCDE0ODVqMGo3qAIAsAIA&sourceid=chrome&ie=UTF-8

Summary

David Poeschl discusses the link between interoception (awareness of internal bodily signals) and anxiety in autistic adolescents, summarizing a study on how hyperawareness, hypoawareness, and fluctuating perception contribute to emotional distress. He concludes by offering practical strategies to improve interoceptive awareness and reduce anxiety.

Key takeaway

Anxiety in autistic adolescents

Anxiety is nearly twice as common in autistic adolescents compared to their peers, and in Great Britain it is considered a hallmark of autism. (David Poeschl)

David Poeschl noted that social interactions and sensory overload are commonly discussed, but interoception is an overlooked factor.

Hyperawareness of bodily signals

A heightened awareness of internal sensations (e.g., heart rate, breathing) can become overwhelming and anxiety-inducing, creating a reinforcing loop that makes relief harder to find. (David Poeschl)

Participants reported bodily signals becoming an unavoidable focal point, intensifying distress rather than providing helpful feedback.

Hypoawareness and missed cues

Struggling to detect bodily signals until they become extreme leads to missed early signs of anxiety, making emotional regulation difficult and causing exhaustion from overlooked needs like hunger or thirst. (David Poeschl)

David Poeschl explained that some individuals might go an entire day without eating or drinking, unaware of their body's needs until discomfort sets in.

Fluctuating and misinterpreted awareness

Interoceptive ability can shift unpredictably depending on stress, environment, or sensory load, and signals are sometimes misinterpreted as a medical emergency, causing overwhelming fear. (David Poeschl)

A few participants described neutral or adaptive interpretations, suggesting that reframing bodily cues could help manage anxiety.

Strategies for teaching interoception

David Poeschl recommends self-awareness training to recognize bodily signals early, using smartwatches to track heart rate, teaching cognitive-behavioral reframing of cues, and reducing the cognitive load of masking to improve self-regulation. (David Poeschl)

He emphasized that reducing the need to mask is not just about comfort—it is about reclaiming bodily awareness and managing anxiety before it spirals.

Thanks to  soundimage.org for the free access to the AI generated music used in this podcast (https://soundimage.org/)