When we talk about trauma and interoception, we usually talk about how trauma can change a person’s interoceptive experience. Trauma can result in body signals that are muted, intense, or change depending on the moment or situation. Past experiences can also shape what the body has learned about the meaning of those signals… whether certain sensations are connected to pain, danger, uncertainty, or safety.

But lately, I’ve been thinking deeply about how we can take that understanding and use it to look at the present moment. Could what a person’s body learned in the past help us make better sense of what we’re seeing today and ultimately lead to the most meaningful support possible?

What Has This Body Learned?

Our bodies are learning all the time, and sometimes what the body has learned in the past can help make sense of responses we see today. That includes how the body responds to its own internal signals. A body signal that has repeatedly been connected with pain, danger, uncertainty, or having a need go unmet may be experienced very differently later on. It might become incredibly intense and hard to ignore. Or it might become muted and hard to notice at all. Let’s take a look at 2 examples.

Example #1: Early Neglect and Food

Imagine a child who experienced neglect early in life, including long periods of hunger when food was not consistently provided. Years later, food may be reliably available. They may know there is plenty of food and still eat past what would be an expected point of fullness, seek food constantly, or become extremely distressed when someone says it’s time to stop eating. It would be easy to think things like: But they’ve had plenty of food for years. They know they can eat again later. This is just “bad behavior.”

But what if the response makes sense to the body? What has this body learned about hunger, fullness, and access to food?

• Maybe hunger signals became incredibly intense because hunger wasn’t always followed by access to food. Over time, those sensations may have become connected with uncertainty or worry, making the sensations even more intense: Will there be enough? When will I eat again? Will this discomfort go away?
• Or maybe hunger and fullness signals became muted as the body adapted to ongoing discomfort that couldn’t reliably be resolved.
• Or maybe there weren’t consistent opportunities to eat in response to hunger and stop in response to fullness. Eating became more about when food was available than about responding to internal body signals.

We don’t know. But now we have questions to explore that might change how we support. What happens in this body when food is put away or someone says, “That’s enough”? Maybe the body responds as though access to food is uncertain again, even when the person consciously knows there is plenty of food.

Example #2: Medical Trauma and Toileting

Now consider medical trauma. A child who experienced years of chronic constipation, painful bowel movements, and medical clean-out procedures may be described as “refusing to poop on the toilet” long after the constipation has been successfully treated. It would be easy to think, But the constipation is gone. Their poop is soft now. We know it doesn’t hurt anymore.

But what if the response makes sense to the body? What has this body learned about bowel signals and toileting?

• Maybe sensations like pressure, fullness, or movement in the bowel became connected with what came next: pain. Those sensations may now feel incredibly intense and hard to ignore.
• Or maybe bowel signals became muted after years of ongoing pain and discomfort, making them difficult to notice until they become extremely strong.
• Maybe the toilet itself became part of the experience. Over and over again, bowel sensations were followed by go sit on the toilet, and sitting on the toilet was followed by pain, pressure to poop, adults watching or talking about poop, or uncomfortable medical procedures. The toilet may have become connected with what the body learned happens next.
• And maybe the body learned something about control too. Other people decided when to sit, how long to stay, or what needed to happen before the child could get up.

The constipation may be medically resolved. But the body has had hundreds of experiences connecting bowel sensations, toileting, pain, and loss of control. Knowing “it won’t hurt this time” doesn’t automatically undo what the body has learned comes next.

Are We Giving the Body More of the Same?

Understanding what the body may have learned is important. But now we need to turn that same curiosity toward ourselves. What experience are our supports creating for the body right now?

Think back to the child who experienced neglect and inconsistent access to food. We might lock the cabinets to stop food seeking. Our intention might be to help, but what might the body experience? Food is controlled by other people. Food isn’t always available when my body tells me I need it. I don’t know when I’ll have access again. Or we might require someone to complete a task or behavior to earn food, creating another experience where access to food is limited and depends on doing what someone else wants.

Or think about the child with a history of painful constipation and medical trauma. We might use scheduled toilet sits because we know the constipation has resolved and we’re trying to establish a healthy toileting routine. Again, our intention is to help. But what might the body experience? Someone else decides when I sit. My body signals aren’t guiding what happens. My no doesn’t make it stop. I’m expected to stay in a place my body has learned predicts something uncomfortable.

Our intentions may be good. But are we giving the body another experience of the very thing it has already learned? 

We can ask the same question when someone becomes extremely distressed when told “no,” pushes away someone who is trying to help, or has an intense response to something that seems small to everyone else. We don’t need to know exactly what the body learned. We definitely don’t want to create a story about someone else’s trauma and assume it is true. But interoception gives us a different starting point:

What if this response makes complete sense to this person’s body? What don’t I understand yet? And am I doing everything I can to create new experiences for this body?

How Can We Help the Body Learn Something New?

If the body learns through experience, new experiences matter too.

If a body has learned that “no” doesn’t make something stop, we can create experiences where “no” is honored. If a body has learned that expressions of discomfort aren’t believed, we can be a person who believes them. If a body has learned that access to what it needs is controlled by other people, we can look for ways to increase access, choice, and control.

And if certain sensory or body experiences have become connected with pain, danger, or uncertainty, we can slow down. We can increase predictability. We can offer co-regulation. We can change the environment. We can make communication more accessible. We can follow the person’s lead. We can make it easier to stop, say no, or change course.

We can tell someone, “You’re safe now.” But that doesn’t mean their body experiences safety. Instead, we can help create the conditions where the body has the opportunity to experience something different: people who believe their body signals, people who honor “no,” access to what helps, more choice and control, and sensory and body experiences that happen with support rather than pressure.

We can’t talk a body out of what it has learned. But we can help create experiences through which the body has the opportunity to learn something new.

Want to Learn More About Interoception & Trauma?

If this way of thinking has you curious, join me and trauma specialist Mary Vicario, LPCC, for our new on-demand course, Interoception & Complex Trauma: Understanding What the Body Has Learned. We take a much deeper look at the connection between interoception and complex trauma and explore how this lens can help us provide more individualized, responsive support.

You can also explore my original on-demand course, An Interoception-Based Approach for Supporting Traumatized Learners, for additional learning about trauma, interoception, co-regulation, and body-based support.

Until next time.