Best Practices for Implementing Interoception-Based Supports

Hi everyone, Kelly Mahler, Occupational Therapist. We’re going to talk about best practices for implementing an interoception-based approach. Before we get to the best practices, first, what is an interoception-based approach? As the name implies, it’s all about that eighth sense called interoception. One of interoception’s most important jobs is to give us important information about how we are feeling in any given minute. Those body signals coming from within are very important clues to exactly how we’re feeling. That information, that interoceptive information, is what empowers us with the knowledge to know what to do to take care of our bodies and to promote that comfort from within. Developing that inner curiosity in our clients, helping them to discover their own inner sensations and what those sensations mean uniquely to them, is incredibly important. This interoception-based approach, whenever you’re supporting the self-regulation needs in your clients, is vital.

 


The first three best practices happen before. They need to be put in place before we start nurturing that inner curiosity, before we start inviting our learners to start tuning in within and noticing the way their bodies are feeling.

Best Practice #1: Promote feelings of regulation and safety

The first best practice is all about promoting feelings of regulation and safety within our learners, and this is done via co-regulation. We, as the supporters, as the caregivers, are offering co-regulation supports; things that promote regulation, things that promote safety within that person’s body, and also considering the world around each learner and helping to adapt the environment to promote feelings of regulation and safety. If a person is feeling regulated and safe in their environment, they are going to have more attentional resources to want to shift their attention within and pay attention within.

Best Practice #2: Be trauma-informed

The second best practice is all about trauma informed care. If you are going to be implementing an interoception-based approach, you also need to be very knowledgeable in trauma and trauma informed care. The two approaches go hand in hand; you can’t have one without the other. An interoception-based approach and a trauma informed approach are very reliant on each other, and the success of each approach depends on the other.

Best Practice #3: Establish a mutual relationship

The third best practice is all about establishing a mutual relationship with the learner. It’s our primary job to help our learners feel safe with us, to build a relationship that does not involve one person in power and dominating over the learner. It is a mutual relationship, an alliance, where we are genuinely connecting with our learner. If our learner feels safe with us, they will be more apt to feel safe enough to move forward into deeper interception-based work.


So now you have the first three foundational best practices in place. What do you do next?

Best Practice #4: Invite learners to participate (not demand or require)

The fourth best practice is all about how we are delivering interoception-based supports. Interoception-based supports are always offered as an invitation to participate. We are never presenting them as a demand that a learner must complete in order to earn a reinforcer. Giving someone the choice and the autonomy over their body is extremely crucial to interoception growth. For that person to feel like they have control over the way their body feels and what their body needs is essential for them to begin to grow in their interception journey.

We need to present these supports as an invitation. If that learner doesn’t feel like participating, then we need to think about what to do as the supporters to adapt our approach, to adapt what we are doing, in order to promote that learner’s success. Maybe we need to go back to the three foundational best practices. Maybe that learner needs more co-regulation. Maybe they need us to develop a stronger therapeutic mutual alliance with them so that they are feeling safe in their bodies, and they’re feeling safe with us, in order to take that next step and start using some of the interoception-based supports.

Best Practice #5: Be curious (don’t assume or label the learner’s emotions)

The fifth best practice is all about being curious and shifting away from a place where we are assuming that we understand someone’s experience. Somewhere along the line we were taught, in the field of mental health or the field of education, that we should label each learner’s emotion and label what we think their experience is. So we might come in and say “Wow, you look really frustrated right now”, or “Geez, that must have made you feel really sad”.  Those labels are assumptions about what that person is experiencing. What we know from a lot of people is that, many times, what we assume is the complete opposite of what their true experience is. We need to be more curious, step back, and use a curiosity approach. Of course, that looks different for each client; but whenever possible, ask questions, gain more insight, gain a better understanding of the deep experiences of each person. Ask them, “How does that make you feel right now?” or, “I see that you are squeezing your hands right now. How are you feeling?” We need to nurture that curiosity instead of label the learner’s emotions as we assume them to be.

Best Practice #6: Honor each learner’s unique inner experience

The sixth best practice is to honor each person’s unique inner experience. This work is not about helping someone get a more ‘typical’ interoception experience nor an approach designed for fixing deficits. Each of us have vastly different inner experiences. What your body feels like when you’re hungry is different than what my body feels like when I’m hungry; and we are both right and valid in our experience. We are setting up a process of nurturing that self-understanding, helping each of our learners discover their own inner experience. We need to honor and validate the vast uniqueness between all of us and really celebrate that out loud in explicit ways for our learners.

Best Practice #7: Accept and validate all that a learner shares (even when it is against what you expect)

Going along with the sixth best practice, the seventh is accepting all answers that we hear. When we’re using interoception-based supports, we might be doing something fun that evokes a bodily feeling and inviting someone to tune in and notice the way that activity is making their hands feel, or their feet feel. We might even be completely against what we expect that activity to evoke in a learner, but we need to keep in mind that we’re also very different in our inner experiences. We must accept and validate all answers that we hear. If you hear something that is a surprise to you, ask questions. Can you tell me more about that? You said your body felt wiggly. Can you tell me more about that experience? You might gain an important insight that allows you to get one step closer to understanding that person’s inner experience.

Best Practice #8: Adapt interoception-based supports

The next best practice is all about adapting interoception-based work to keep it in line with what you know works best for each learner. We hear this type of question all the time:

Can you use interoception-based work with, say, learners that might have cognitive delays? Can you use this work with people that have developmental delays? Can you use this work with people that are non-speakers? Can you use this work with people that are older? Can you use it with kids that are younger?

The answer is yes; just really consider everything else that you offer to that learner and what works. How do you successfully support that learner? What do they need to successfully participate? Use whatever you know and adapt the interoception-based work within those parameters. For example, if you know that visual supports are a really powerful tool for your learner, then everything you do with interoception-based work should be presented and supported by visuals. If you know that a learner does really well when you incorporate their favorite character into the supports you provide, then everything you do with interoception-based support should involve their favorite character. If you know that a person does well with lots of repetition, then please use lots of repetition when you are offering interoception-based work. Interoception-based work is very adaptable; just think about what you already do to promote success with the learner and use whatever that is when you are incorporating interoception-based supports.

Best Practice #9: Be playful and find the fun

The final best practice is all about being playful and doing this work with the learner, not to the learner. I invite you all to have fun in this interoception-based work. Try the interception activities together, notice and learn more about your body signals with the learner, share your differences in your experiences, and, most of all, have fun.

Until next time.

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