Interoception & Exteroception: Their Roles in Healing Trauma

Let's start with exteroception, since this one is pretty easy to understand, given our cultural context.

Exteroception is simply the information we get from our senses...what we see, hear, smell, taste, & touch. Oftentimes folx healing from trauma will register external environments as unsafe. In fact, it is well-known that people with PTSD interpret neutral faces as hostile. There is a saying by the great sage Patanjali who was responsible for compiling the ancient teachings of yoga that were usually verbally passed down from guru to student...the outer mirrors the inner. So if we see the world as dangerous, it is often because there is a part or parts of us that have not been updated, i.e., the younger parts of us are frozen in time and still carry the limited abilities that were available. When we are triggered, it is a part of us that is triggered [See IFS blog]. During therapy, it is important to orient to the external environment, looking for cues of safety...because we already have parts that are constantly scanning for danger. It is this exteroception that is important to be mindful of in order to create those neuronal circuits of safety. In therapy, it could be something in the room, a pillow that is pleasing to change the color of the sequins by rubbing your fingers or hand across it, maybe a pink salt lamp emminating a warm glow, maybe it's the therapist's face, reassuring you that all is welcome in this space. The more we identify cues of safety, the more cues of safety we identify. This can be especially helpful prior to going into mindfulness, and upon returning to a normal state of consciousness, to again find that object.

OK, so now interoception...what bodily sensations am I aware of? For many clients who are now coming to therapy with a generalized anxiety or depression, there is very little capacity for interoceptive awareness. This is because awareness left their bodies when trauma happened. The body was not a safe place to be, so check-out/dissociate. This is why folx with trauma oftentimes have very little childhood memories. Dissociation is simply a way for your system to be safe. Again, those young parts carry this belief. Oftentimes people with trauma have over-developed cognitive abilities, they intellectualize (like creating several blogs:) Staying in the head was and is a safe place...but this is why talk therapy can only go so far. If the thoughts are rational and calm, but the body is all sorts of tight and tense..signs of danger. Starting to develop the capacity to notice sensations in the body is part of identifying cues of safety.

Dr. Stephen Porges, who discovered and named Polyvagal Theory, coined the term 'neuroception' to address how the unconscious mind is constantly scanning for signs of danger and signs of safety both within and without. OK Jamille, so what does all this have to do with healing trauma? If you are not aware, or even if you are aware of tension in your body, neuroception is then telling the mind that you are NOT safe. I was sharing a story with an esthetician friend of mine that I got botox a handful of times for my furrowed brow lines years ago and had the revelation that unless I became aware of my tendency to frown, I would keep creating those lines. The furrowed brow really reinforced circuits of anger. So once I became aware of them, I could lovingly and without judgment let my forehead smooth, relax around my eyes, and maybe even bring a slight smile to my mouth and eyes. Incidentally, if the jaw is clenched, there is a high probability that the breath is shallow (not in the belly) and that the pelvic bowl is also clenched.

Interoception is cultivated slowly, over time, so that the system does not become overwhelmed. This is one of the reasons I love Yoga Nidra and yin yoga and why I share these practices in my counseling. Becoming aware of sensations in the body allows us agency to change those patterns of tension, to address those parts that are carrying those burdens causing the tension. In both my individual sessions as well as group, there is always a moment or several where we can slow down and become mindful of the internal sensations. This interoceptive awareness is integral in healing trauma.