How Compliance-Based Approaches Damage Interoceptive Awareness & Self-Regulation

Hi everyone. Kelly Mahler, occupational therapist. I wanted to take a few minutes to talk about interoception, self-regulation and the detrimental impact that compliance-based approaches can have on the development of these critical areas. Compliance often teaches someone to ignore their own body signals/needs in order to comply with a demand and receive a reward. This is bad for so many reasons, including causing significant damage to interoceptive awareness which is the essential foundation of self-regulation.

 

Interoception & Self-Regulation

We know that interoception is a vital foundation of self-regulation. Most infants are born into this world noticing discomfort within their bodies. How do we know this? Think about when an infant notices interoceptive discomfort what do they do? Most of the time, their urge is to cry, which alerts the caregiver that something within the infant’s body feels off and they need help regulating their bodily needs.

From day one of life, as an infant moves through the world, each and every single thing that they experience, their interoceptive system is responding. For every single experience, whether it’s a new environment or a new person or a new toy, their body is responding. They are noticing how each individual experience makes their body feel. Many times these bodily responses are not reaching their level of consciousness. Many times these reactions stay underneath the level of consciousness. But regardless, their interoceptive system is constantly responding to the world around around them.

The infant’s interoceptive system responds to all of these experiences–in other words, how do these experiences make their body feel?

  • Does this experience make my body feel comfortable?
  • Does it make my body feel uncomfortable?

These responses are stored within the body and become interoception memories or predictions. As the infant grows and and experiences the next day, the next experience, they navigate life within a prediction framework. They call upon these stored interoception predictions to guide their present behavior. In other words, these interoceptive predictions guide their automatic self-regulation responses…the things that they intuitively do without thinking through them. For example,

  • They intuitively seek out things that make their body feel comfortable
  • They intuitively avoid things that make their body feel uncomfortable.

I think it’s really important to point out that we all have very different inner experiences.

  • What makes your body feel comfortable is different than what makes my body feel comfortable.
  • What makes your body feel uncomfortable is different than what makes my body feel uncomfortable.

This is no different for young learners. As we grow, we all develop a unique set of preferences and aversions. We seek out the things that make our body feel comfortable to help us self-regulate. We also avoid the experiences that make our body feel uncomfortable in an effort to self-regulate.

The Dangers of Compliance-Based Approaches

This is where the dangers of compliance-based approaches come in. I have many neurodivergent clients and many friends who are neurodivergent, many of who connected with self-regulation strategies at very young ages. They learned things that promoted comfortable interoceptive sensations within their bodies, and they learned the experiences that made their bodies feel uncomfortable. They proceeded in the world with this understanding.

Then someone in the neuro-majority observed what it was they were doing and labeled it as atypical, disruptive, challenging, problematic, etc.

  • “Stop flapping”, they say.
  • “Don’t pace”, they say.
  • “Sit still”, they say.
  • “Look at me in the eyes”, they say.
  • “Lining up your toys is strange.”, they say.
  • “You are being oppositional.”, they say.

This is incredibly judgmental. People in the neuro-majority running these compliance-based approaches, trying to force the neurodivergents to fit within their expectations, and to self-regulate in a way that they deem ‘appropriate’. Taking active measures to continually condition neurodivergents to stop doing the things that promote comfort (e.g., stop humming). And then to compound the issue forcing them into experiences that feel extremely uncomfortable (e.g., forcing them to do work in a loud, busy classroom).

This is all extremely damaging to the interoceptive experience of neurodivergents, because many times early on they did listen to their bodies. They did connect with strategies that promoted comfortable feelings within their bodies. And now this compliance-based approach comes in and forces them to stop doing those things. It teaches them to hide or mask their needs.

Essentially, a compliance-based model is repeatedly teaching ‘your body signals are not important–ignore them–hide them–what I think you should do is more important–and if you please me maybe I will give you a reward’. It becomes this repetitive process of teaching neurodivergents to ignore their body signals and stop seeking/avoiding what their body needs to feel comfortable. Essentially, compliance-based approaches destroy interoceptive awareness which is the foundation of healthy self-regulation. Can you see how problematic this is?

Moving from Compliance-Driven to Regulation-Driven Approaches

  1. We need to stop compliance-based approaches–like immediately. They’re dangerous for many reasons, including dampening of a person’s interoceptive experience, teaching them repetitively to ignore what their body’s telling them in order to follow a demand and get a reinforcer. We need to stop this right away.
  2. We need to embrace, and we need to celebrate what each person needs to feel safe and to feel regulated within their bodies and in their environments. It is time for the neuro-majority to modify their behaviors, to think deeply and creatively at how we can provide what each person needs. If someone needs to move to learn, then how will we provide instruction while that person is moving, pacing, flapping, jumping, spinning, swinging, etc?  If someone is repeatedly running out of the classroom, how can we help them find a more comfortable place to learn? Maybe it is trialing major classroom adaptations or perhaps it is finding a completely different space.
  3. We need to educate. We need to educate all people about interoception and emphasize the fact that we all have very unique inner experiences, and we all have a very unique set of feel-good strategies. What you use to promote comfortable feelings in your body is different than what I use. We need to celebrate these differences and set up a system where each person is encouraged to use their own unique set of self-regulation strategies.

Until next time, be well.