Neuroception and Self Regulation An Occupational Therapy Perspective

Neuroception is the subconscious system for detecting threat and safety.  Doctor Steven Porges, PhD theorizes in the Polyvagal Theory, that neuroception is the process that evaluates risks within the environment without our conscious awareness. That the brain distinguishes whether situations or people within our relationships are safe and trustworthy or dangerous and threatening.

Neuroception takes place in the primitive portions of the brain without conscious awareness. You may not be conscious of threat, but the body has already started a sequence of neural processes, that lead to an adaptive survival response of fight/flight/or freeze.

Our capacity to form social bonds is integrally dependent on our ability to neurologically inhibit our defense mechanisms. To switch from a defensive state into social engagement, your brain assesses risk.  If your environment feels safe you will subconsciously inhibit the primitive defensive reactions and comfortably engage.

The nervous system automatically knows when the environment or people within it are safe and provide security or are distressful and threatening. The brain makes these evaluations by detecting features including body and facial expressions, vocalization and posture.  Non-verbal factors contribute to the overall impression of safety and trustworthiness.

Nonverbal communications reveal the state of another person’s mind. Another’s facial expressions and eye gaze subconsciously decides for us whether to approach (positive) interaction or withdraw (negative) retraction.

Neuro-diverse students including those with diagnosis of autism, ADHD, trauma, anxiety, depression, aggressive disorders or medical interventions prior to three years of age are possibly in a neuroceptive state of immobilization.

Just because the classroom does not appear threatening to us, does not mean the circuits of children with neuroceptive awareness deficits agree.  The environment may be too loud, too bright, too busy or they may be in a state of physiological distress.

Treatments for improving neuroceptive awareness and self regulation:

Somatic experiencing therapy emphasizes guiding the student’s attention to interoception, kinesthetic and proprioceptive experiences. It is considered the art of reconnecting with bodily sensations in a way that is safe and self aware.

Survival activation can remain stored in the body disrupting mental and emotional processes. You must interrupt this destructive loop and move away from the state of persistent activation. When addressed the allostatic load (the cumulative burden of chronic stress and life events) can slowly be released, building resilience.

When focusing on resolving the symptoms of chronic stress it is a bottom up process. It is an approach that avoids direct contact with intense evocation of traumatic memories.  It is indirect and done very gradually.

Interoceptive therapies involve investigating inner awareness or the capacity to identify access and appraise internal body signals. To adapt and demonstrate appropriate emotional responses, facilitation of new corrective interoceptive experiences must be practiced. Interoceptive awareness assists with increasing attunement to body cues, signals and messages prior to overwhelm or reactivity. Interoception improves relevance to sense of self, cognition and mental health. 

To begin, notice, describe and label physical sensations within the body.  First engage in a positive manner, investigating easeful and relaxing emotions. Put the student in touch with positive inner feelings of safety, strength, comfort and optimism. Provide positive social engagement with proximity and face to face contact, vocalizing with appealing inflection and rhythm, all creating a safe and secure therapy environment.

Approach inner experience gradually reducing arousal, to enable restoration to occur slowly overtime. Train students to practice noticing the sensations and emotions without reacting, labeling them with granularity and detail. Staying present and feeling the experience, furthers the discharge of distressing stored energy and increases the level of regulation and resilience.

Mindfulness meditation is beneficial with improving the overall awareness of inner emotional state. Sustaining focus on the breath with a practice of sensing all subtleties is restorative and calming.

Breathing therapy is used to attend to the sensations and flow of the breath. Deep inhalation through the mouth followed by exhaling through the nose is calming and inhibitory.

Body scans are beneficial to decrease stored body tension.  Tense and release muscle groups, bringing attention to specific areas of internal body (chest, shoulders and abdominals). Tensing the muscles on the in-breath and releasing or softening the stored tensions on the out-breath.

Body literacy defines and articulates sensory experiences associating back into the body, improving awareness, increased resilience and providing stress reduction.

Integration of interoceptive experiences into greater self understanding improves daily life, well being, self care, body connection, social connections and embodiment of emotional regulation. With practice insights and shifts in understanding can take place, bringing increased ease of being and greater freedom to access life tasks.

Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). “Somatic Experiencing: Using interoception and proprioception as core elements of trauma therapy”: Corrigendum. Frontiers in Psychology, 6, Article 423.

PORGES, S. W. (2011). The polyvagal theory: neurophysiological foundations of emotions, attachment, communication, and self-regulation. New York, W.W. Norton.

Price, C. J., & Hooven, C. (2018). Interoceptive awareness skills for emotion regulation: Theory and approach of mindful awareness in body-oriented therapy (MABT). Frontiers in Psychology, 9, Article 798.

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