a fork and bowl representing feeding

Affirming Supports for Interoception, Feeding Challenges & ARFID

Hi everyone. Kelly Mahler, occupational therapist, and I wanted to take the time to talk about interoception and feeding. This is a commonly asked question that we hear: what is the connection between interoception and feeding? And more specifically, people ask: what is the connection between interoception and ARFID or avoidant restrictive food intake disorder? And again, another great question. So let’s talk more about this.

Interoception & Feeding: What is the Connection?

First, let’s just talk generally about the connection between interoception and feeding. We know that interoception is a sense within all of our bodies. It’s giving us information about how our body feels and what is the condition of our body. So, if we think about that in the context of feeding, interoception can provide us with information about when our body needs food, when our body needs fuel and energy, or when our body needs hydration. Interoception can let us know when we’re hungry, when we’re thirsty, when we’re full, et cetera.

Underlying Factors that Might Contribute to Feeding Differences

I have so many clients who experience feeding differences. These feeding differences can be a result of many underlying factors, including interoception. But, it’s not limited to interoception differences alone. It can also be related to sensory differences, it can be related to motor differences… There are so many underlying factors that can contribute to these feeding differences. The result is that, many times, food can feel unsafe to their body.

Feeding Differences Can Make the Body Feel Unsafe

Food, or certain foods, can make a person’s body feel unsafe or under threat. So many aspects of food can set off this stress response including the texture, temperature, smell, color, presentation on the plate, sounds in the eating environment and so on. The experience of ‘food as a threat’ is not a choice–it is an automatic response of the person’s nervous system.  Foods feel interoceptively unsafe.

When we think about commonly used feeding approaches or supports, especially the supports that are more antiquated, they are rooted in compliance-based methods where we are trying to use some form of external control or external reinforcement to convince a person to try a new food.

The Issues with Compliance-Based Feeding Supports

An example of these compliance-based approaches could be: you can get a sticker if you try this new food. Or: you can earn a token on your token board if you try a new food.

Really what these compliance-based methods do is completely invalidate any of those underlying factors that are contributing to the feeding differences. They completely invalidate the concept that food feels interoceptively unsafe to a person’s body. They do not take any of that into account. They’re just external forms of control and coercion to convince a person to eat a certain food.

These compliance-based approaches, we’ve talked about this in past blogs, are very damaging for a variety of reasons, including that they derail the interoceptive experience. They condition a person to ignore what it is their body is telling them that they need in that moment. What they need in that moment to feel safe, to feel regulated. They’re conditioning that person to ignore that information in order to meet the demand, in order to please the other person.

Through exposure to compliance methods, a person’s inner world can be completely derailed. They might mask or dissociate from their internal body signals to survive (my body feels one way, but I must ignore they way my body feels so that I can survive the demand someone is placing on me). Compliance feeding approaches send messages that a person’s internal experience is unimportant, unworthy of attention or consideration.

In addition to compliance disregarding the fact that food is read as a threat, as mentioned earlier in this blog, interoception provides many of us with information regarding when our body is in need of food, hydration, etc. So when using compliance-based feeding methods that negatively impact the interoceptive experience, it is impacting the very foundation of hunger, thirst, fullness, etc. Isn’t that painfully ironic?! A support for feeding that derails a crucial foundation of feeding!  Does not make sense.

We All Have Different Inner Experiences: Doing Away With the Way Your Body “Should” Feel

One more point about interoception and feeding: there are so many messages out there about the way the body should feel. Anger should feel this way in your body. Hunger should feel this way in your body. And what we know now through interoception science is that there’s no single footprint of an emotion.

What does that mean?

It means that what your body feels like when you’re hungry is different than what my body feels like when I’m hungry. What your body feels like when you’re thirsty is likely different than what my body feels like when I’m thirsty.

We really need to help each person discover the way their body feels when it needs food, when it needs hydration, et cetera, instead of teaching hunger is when your stomach is growling, because that’s not the case for every single person. If we’re teaching about hunger, thirst, fullness, and so in in a very rigid, narrow way it can be a mismatch for a person’s inner experience and can create a lot of confusion. So what can we do instead?

Curiosity is Key for Supporting Feeding Differences.

Curiosity is key. Let’s get deep. Let’s figure out those underlying factors.

What are the factors that are contributing to the feeding differences? Is it sensory? Is it motor? Is it interoception? There are so many different possibilities.

How do we address those underlying factors? How do we support those underlying factors? How do we help a person to feel safe surrounding the activity of eating so that they can start to make gains in this area? Curiosity is key.

How does that person experience hunger, fullness, thirst? What does it feel like in their body? How can we explore and validated their inner experience?

Want to learn more about Affirming Feeding Supports for Feeding Differences and ARFID?

We are doing a course all about interoception and feeding. And I’m going to be joined by my friend Nareen Hunani, registered dietician, and she’s brilliant. Her work is brilliant. In this course, we’re going to be talking all about interoception, feeding and ARFID and how to use respectful approaches that nurture a person’s inner safety, autonomy and body listening. I hope you’ll join us in learning much more about this topic in that course.

Until next time.

Want to Learn More about Interoception & Feeding? Take our Course!

a promotional graphic for the course with kelly and Naureen about interoception, feeding and arfid