Need to know
Four years ago, while recovering from an alcohol dependence, I heard the following words from a psychologist: ‘Your problem isn’t anxiety. It’s trusting yourself.’ At the time, I interpreted that phrase – ‘trusting yourself’ – philosophically: trusting yourself to get the job done, come to the right decision, make your friends laugh, defend a viewpoint, let the neighbour’s wily dog off its leash without a major disaster. Today, after learning more about self-regulation than I thought possible, I no longer see it that way. Trusting myself is, first and foremost, a visceral experience, less like adopting a new set of beliefs and more like a trust fall into the inner landscape of my heart, lungs, abdomen and gut. Each moment, interaction, relationship becomes a unique experience informed and guided by how my body receives it, not by the grand unifying way I’ve figured out how to live. What my psychologist really meant, whether either of us knew it or not, was: you don’t trust your body.
Most of us are familiar with what it means to ‘go with your gut’ or ‘follow your instincts’. And many of us have ignored red flags or nagging sensations from time to time, leading to consequences we later regret. Trusting your body includes these ideas but it also means more than that. When it comes to decision-making and health, people differ in how much importance they place on bodily sensations – from hunger and fatigue to anger and joy. Some of us might dismiss or suppress sensations, talk ourselves out of a strong feeling (or let others talk us out of it), or simply place more importance on logic and rationality than on feeling. People also differ in how well they can sense these signals, which affects their ability to make use of them. For example, people with alexithymia, a condition marked by difficulty identifying and articulating feelings, often don’t know they’re hungry until they’re in pain, or that they’re angry until they feel their pulse. On the other end of the spectrum are those people who arguably feel too much, leading them to become easily overwhelmed by – and therefore distrustful of – their bodily signals.
Body trust can support better mental health
Body trust is not just a folk concept – it’s also a scientific construct. It’s used to measure ‘interoception’, which is the process of sensing the body from within. Poor interoception is associated with a wide range of mental disorders, including post-traumatic stress disorder (PTSD), eating disorders, depression and anxiety. Alongside questions about body trust, researchers measure people’s interoception by tapping seven further features, from ‘noticing’ to ‘attention regulation’ to ‘body listening’. Of these features, ‘low body trust’ has emerged as particularly relevant to mental health.
People who suffer from suicide ideation, eating disorders, loneliness, and depression often report feeling ‘unsafe’ or ‘not at home’ in their bodies, in addition to mistrusting their bodily signals. The reason for this connection isn’t yet clear, but one might speculate that if these people did feel safe enough to trust their bodily signals, doing so might lead to adaptive behaviour change and symptom reduction. Whatever the explanation, these findings suggest that body trust is crucial for wellbeing.
When I started cutting back my alcohol consumption in 2018, I experienced very difficult periods of anxiety, especially in the kinds of social situations for which I’d previously used alcohol to help me relax. I used to trust alcohol to help me navigate a social situation more than I trusted my own body. Without alcohol, if I started feeling any unpleasant feelings, such as tension or a racing heart, my mind would automatically panic because it didn’t know how to regulate them on its own, which would exacerbate the unpleasant feelings. I couldn’t even hang out in the common space of my shared flat without this tension arising. Since changing the way I think about internal experience, and cutting out alcohol from my life completely, I feel calm the majority of the time. But to reach that state, I’ve had to change the way I think about my feelings – to treat my internal experience with the same consideration I give to vision, hearing or any other sense.
There are ways to improve your body trust
Although it’s early days for research into interoception, one thing that has been found to improve it, as well as body trust, is mindfulness. In order to properly engage in self-regulation, and make healthy decisions, you must be able to not only feel those physical sensations but relate to them in a curious, compassionate, mindful way. Not just when you’re at home or on your own, but when you’re out in the world, in a variety of environments, including with other people. Some of these signals you may decide to act on, and other signals you may decide to ignore. Regardless, it’s all important information meant to help you survive, and even thrive. This respectful orientation toward bodily experience is what I mean by ‘trusting your body’.
You don’t have to be facing mental health challenges to benefit from trusting your body. Better interoception is helpful for athletes, actors, students, even successful financial traders who rely on gut feelings to make high-stakes decisions. Thankfully, there are science-based practices you can adopt to help develop a more trusting relationship with your body, many of which have worked for me. In this Guide, I’ll focus on building body trust for the purposes of improving your emotional regulation. You might call these practices ‘mindfulness for the body’, but this is more than just another mindfulness guide.
What to do
Read the body trust literature
As a first step, consider reading other people’s descriptions of what it means to have body trust, to better understand how it can support you in various parts of your life. There’s plenty of literature out there, under various categories; you just have to start seeing it through this lens.
My reading and interoceptive journey began in 2018 with the essay ‘Uses of the Erotic’ (1978) by the poet Audre Lorde:
When we live outside ourselves, and by that I mean on external directives only rather than from our internal knowledge and needs, when we live away from those … guides from within ourselves, then our lives are limited by external and alien forms, and we conform to the needs of a structure that is not based on human need, let alone an individual’s.
For Lorde, body trusting is an act of self-respect:
… once we begin to feel deeply in all the aspects of our lives, we begin to demand from ourselves and from our life-pursuits that they feel in accordance with that joy which we know ourselves to be capable of.
Another insightful book is When the Body Says No: The Cost of Hidden Stress (2003) by the Hungarian-Canadian physician Gabor Maté. Describing the medical ailments that can arise from ignoring your bodily signals over time, he writes: ‘When we have been prevented from learning how to say no, our bodies may end up saying it for us.’ Just as Lorde’s body trust steers us toward wellness, Maté’s body trust steers us away from illness.
Take up a mindfulness practice
To begin building your body trust, you’ll want to carve out time during the day to start paying closer attention to your body. Research shows that two mindfulness meditation practices – breath meditations and body scans – can enhance not only interoception, but body trust specifically. Both styles of meditation are forms of ‘focused attention’, meaning focusing on an object inside or outside the body, such as a flame, a mantra – or, for our purposes, your breath or one or more specific parts of your body.
If you’re a beginner and aren’t sure about spending more time in your body, I’d recommend doing a breath meditation before moving on to a full body scan because it will provide you with a safe focal point. There are many free guided breath meditations available online. One of my favourites is a five-minute breathing meditation from the Mindful Awareness Research Center (MARC) at the University of California, Los Angeles.
Perform a basic body scan
Again, there are many versions available online, but I like a three-minute meditation also provided by the MARC. You can listen here, and below is a slightly adapted version of their transcript:
- Begin by bringing your attention into your body, whether you’re seated or lying down. You can close your eyes if that’s comfortable to you. Feel the weight of your body, on the chair or on the floor. Take a few deep breaths. As you take a deep breath, bring in more oxygen, enlivening your body, and, as you exhale, have a sense of relaxing more deeply.
- Notice the sensation of your feet touching the floor. The weight and pressure, vibration, heat. Notice your legs against the chair. Pressure, pulsing, heaviness, lightness. Notice your back against the chair. Bring your attention into your stomach area. If your stomach is tense or tight, let it soften. Take a breath. Notice your hands. Are your hands tense or tight? See if you can allow them to soften. Notice your arms. Feel any sensation in your arms. Let your shoulders be soft. Notice your neck and throat. Let them be soft, relaxed. Soften your jaw. Let your face and facial muscles be soft.
- Then notice your whole body. Take one more breath. Be aware of your whole body, as best you can. Take a breath. When you’re ready, you can open your eyes.
You might find exercises like these uncomfortable at first, but remember – your body is on your side. Its main function is to keep you alive. As a general rule, whenever you feel discomfort, rather than trying to eliminate it as soon as possible, ask yourself: ‘What is this signal trying to tell me?’
‘Our bodies are designed in a way to feel uncomfortable at times,’ the occupational therapist and interoception expert Kelly Mahler wrote on her blog in 2021. ‘That discomfort within our body is giving us extremely important information about the world around us, about our bodies, [and about] what we need in that moment to feel safe and regulated. The same is true even when our bodies feel comfortable …’
In mindfulness meditation traditions, the step that usually follows ‘focused attention’ is called ‘open monitoring’. Although open monitoring hasn’t yet directly been shown in research to improve interoception, it has been found to affect the insular cortex, the part of the brain most involved in interoception.
Rather than focusing your attention on one particular thing – such as the breath, or a specific body part – open monitoring is about noticing whatever arises into your field of awareness, moment by moment, and just observing it without judgment. For example, if unpleasant sensations or thoughts arise, you’d acknowledge them and let them pass without focusing on or labelling them. Later in the Guide, I will explain ways to interact with your sensations, such as via labelling or by reappraising them, but first it’s important to practise disidentifying from sensation, to have that buffer of nonjudgment in place.
Perform an open monitoring exercise
Adapted from the meditation researcher Aidan Lyon’s blog, with permission:
- Sit down comfortably in a quiet place and take a few moments to let your mind settle – you may even practise focused-attention meditation briefly.
- When you are ready, begin to notice all of your sensations as they appear in your awareness. For each sensation, notice it, but don’t interact with it. Don’t engage with it, but also don’t try to get rid of it. Just allow it to arise, evolve, and then pass.
- Eventually, you will find that your attention has focused on something. For example, you may find yourself preoccupied by a warm sensation in your chest, a tingling in your foot, or the sound of traffic outside. Whatever the sensation, when you notice you have accidentally focused on it, acknowledge that this has happened, and gently bring your attention back to the watchful state, in which sensations take their own natural course.
While this can be done on your own at home, as a timed activity, the goal is to reach the point where you’re able to take this attentional style with you out into the world, everywhere you go. Writing about interoception in 2019, the psychologist Jonathan Gibson suggested that open monitoring could be particularly helpful for emotional self-regulation because of the space it creates between you and your feelings. ‘It is a recognition that one is having an experience rather than “being” the experience,’ Gibson explained. ‘Bodily sensations can simply be experienced rather than transform the experience into a self-defining attribute.’
Gibson added that this space can be especially helpful for people who don’t trust or feel safe with their sensations. ‘Over time, participants can discover that their bodies can be a helpful resource rather than a source of threat that should be avoided,’ he wrote.
Experiment with more practices and find what works for you
On my own interoceptive journey, I chose to practise a Japanese energy-healing technique called reiki rather than a conventional body scan. Although it’s not yet supported by scientific research, it is used as a treatment modality at well-reputed Western medical centres such as the Cleveland Clinic in Ohio. I recommend it because it engages the hands, which you move over different parts of your body, providing an anchoring point as you scan from head to toe. Out of respect for the practice, I won’t include the basic steps for reiki here; for more information, I suggest you read this description, sign up for a course, and receive an attunement from a trained expert.
I made the most progress after doing reiki 30 minutes a day for 30 days, spending three minutes over each part of my body. You’ll want to settle on the routine that works best for you, considering your own lifestyle and wellness needs.
After my 30-day reiki training, I began using it à la carte as a calming technique before a potentially stressful event. Over time, I found that it wasn’t the focused preparation that helped so much as the realisation that I could simply be aware of bodily sensations during the event and trust my body to bring itself back to a calm state on its own. Suddenly, it wasn’t about achieving a calm state beforehand in order to safeguard me from unpleasant feelings, but rather accepting any unpleasant feelings that might arise and staying with my body, like a good friend, while it rode them out. Over time, casually scanning my inner landscape became so automatic that I started doing it in my dreams.
Notice what you think about how you feel
Though you’ll inevitably try to make meaning out of your sensations in these first few steps (as I did after my reiki training), these steps are primarily about being receptive to sensations, and building a trusting relationship with your body, not about labelling or connecting sensations to emotions and behaviours. Receptivity is key because it trains you to slow down and decouple your sensations from the thoughts you normally have about them, which is helpful for self-regulation. Next, I’ll explain a little more about those thoughts. The steps that follow aren’t strictly linear, and may loop back on to your mindfulness practices at times, but they’ll help you start reflecting on the way you relate to your feelings in daily life.
Learning to name sensations is another important step in building body trust. I’ve found that labelling will help you distinguish between nuanced types of bodily reactions – for instance, a gut feeling about a current situation, versus a conditioned response that has more to do with your past experiences – which could help to improve your decision-making by giving you more confidence to rely on your assessment of those sensations in the future.
Another of Mahler’s blog posts explained that when she’s working with school-aged kids and their caregivers, she encourages them to label the way their body feels during daily activities, even aloud to others (eg, ‘My muscles feel loose when you cuddle me’; ‘My heart feels fast when I play tag with you’). ‘Not only are you serving as a good model,’ she writes, ‘but body talk also naturally tunes you in to your body signals.’
To practise labelling your sensations, ask yourself the following:
- How would I describe this sensation to someone else?
- What emotion is this sensation normally connected to for me?
- What does a gut feeling feel like for me, and what happened in the past when I acted/didn’t act on it?
- What does a conditioned response feel like for me, and what happened in the past when I acted/didn’t act on it?
You may want to record your answers in a journal for future reference, so you can start to see how you tend to make meaning out of your sensations. You could consider incorporating the first two steps of this exercise into your body scan and breath meditation practices or, if you’re comfortable doing so, use them throughout your day, whenever sensations arise.
This is the part where we pay closer attention to ‘what we think about how we feel’ and question whether or not it’s helpful to us. Take anxiety – while it’s commonly assumed that anxiety is just something that befalls us from time to time, which we try our best to prevent, interoception experts look at it differently.
As the developmental psychologist Kristina Oldroyd once explained to me: ‘It is the bias to interpret bodily signals in a negative manner, rather than the noticing of bodily signals, that contributes to both the cognitive [eg, worry] and behavioural [eg, avoidance] symptoms of anxiety.’
In other words: when it comes to anxiety, it’s not what’s going on inside your body that is the problem; it’s what you think about what’s going on inside your body. Instead of worrying about sweaty palms or a pounding heart when you feel them, you could tell yourself they are perfectly normal sensations – just your body’s way of preparing you for an important event. It’s a matter of trusting that your body is on your side, even when it occasionally sends strong signals.
Changing what you think about how you feel is called ‘reappraisal’ and it’s another component of building body trust. ‘Developing the capacity for interoceptive awareness is thought to facilitate positive and adaptive reappraisal processes, a critical aspect of emotion regulation,’ said Cynthia Price, the Seattle-based research professor who created Mindful Awareness in Body-Oriented Therapy (MABT), and her co-author Carole Hooven at the University of Washington in Seattle.
To practise reappraisal, ask yourself the following:
- Is this sensation inherently good or bad?
- What do I usually think when I feel this sensation?
- What is my body trying to tell me?
Again, I’d recommend that you either incorporate these steps into your body scan and breath meditation practices or practise using them throughout your day.
Pressing pause between sensation and emotion state
Next, it’s important to learn to step back and consider how you think about the relationship between your emotions and your bodily state. You might think of emotions as mental reactions to events in your life, which then trigger a reaction in your body. A person says something that angers you, and your mental state becomes ‘angry’, followed by a sensation of anger in your body. In his book The Principles of Psychology (1890), William James proposed the opposite: that following an event, you have a bodily reaction (whether you’re aware of it or not), and your emotional state is a response to that physical reaction. In recent years, this view has come back into favour, especially through a field known as embodied cognition.
Although there has been debate about the replicability of specific findings, the basic idea is that what happens in the body can affect the mind and emotions. For instance, one seminal study in 1988 suggested that if you hold a pen between your teeth, thereby forcing a smiling expression, you’ll actually end up feeling happier as a result.
This line of research suggests there is a subtle moment – nearly as hard to identify as the moment night becomes day – before a bodily feeling becomes a full-blown emotional state. If you can identify it, you have much more power over how your emotional reaction to the world affects your behaviour.
Imagine receiving an ambiguous text message from a friend that seems to suggest they’re blowing you off. You have a bodily reaction: a flash of heat in your chest. Instead of letting that reaction become your reality, the state of things (read: you’re angry at the friend for blowing you off), what if you just observed it, and didn’t let it go beyond a reaction? Maybe you misread the message. Wouldn’t you like to clear up your confusion before you take action based on your reaction? You decide to simply hold your feeling in mind and ask for clarification from your friend, only to find that they made an honest mistake and forgot your date.
Your feelings do not always reflect what’s true of the situation, despite the fact that your feelings are always valid for you. It’s essential to be able to make space between reaction and reality, because you will change your behaviour (and thereby your reality) based on what you believe to be the state of things.
Practise social interoception
It’s one thing to develop a trusting relationship with your body at home, in private. It’s quite another to develop it in a social environment. How does the inside of your body feel when you’re talking with another person, versus being on your own? Are there people in whose presence the inside of your body feels calm? Or others who provoke discomfort? Get to know your ‘social body’ so you can use it as a guide.
‘Interoceptive awareness is necessary, but not sufficient, for high-quality social connection, especially in socially challenging situations,’ as the interoception expert and psychologist Andrew J Arnold and his colleague, the neuroscientist Karen Dobkins, told me. ‘Awareness needs to switch between internal and external experience, in a moment-by-moment fashion, so that the two may be integrated for adaptive learning in social situations.’
Arnold and Dobkins call this attentional switching. The better you get at switching, the more quickly you learn what internal and external cues mean in relation to each other, which can help you manage your relationships.
As an example, Dobkins told me that, when conveying one’s inner experience to another, it helps to name the objective event followed by how you felt: ‘When you said: “This tuna casserole is over-spiced,” I felt hurt and embarrassed.’
Over time, you’ll be able to trust and act on these signals more efficiently.
I knew that body scans and breath meditations were only part of the picture for me. Building body trust also required deliberately placing myself in a variety of social situations without alcohol, relying fully on my body to train itself to relax. Part of that training was becoming aware of how I felt around others and why.
Keep an interoceptive journal
Finally, keep a record of your bodily experiences so that you can refer to it later and understand your own interoceptive patterns. Record sensations, emotions, decisions and other behaviours. Focus on describing each sensation in as much detail as you can. Is it the first time you’ve felt it? When did you feel it before? What happened when you felt it? You can add entries on a monthly, weekly or daily basis – whatever works for you – though it’s best to do so as soon after each experience as possible, while it’s still fresh in your mind.
I keep a Word document and record insights as they come to me throughout my week, mostly as an attempt to chart the connections between my sensations, emotions, thoughts and behaviours. I’ve found it invaluable to be able to look back on entries from previous years. Writing about these things will help you build body trust as well, by giving you another chance to value your inner experience by taking the time to reflect on it.
Key points – How to trust your body
- Body trust is about more than ‘going with your gut’. It’s recognised by psychologists as a component of interoception, which is the sense of your body from within.
- Body trust can support better mental health. People with various mental health problems tend to have poor interoception and especially low body trust – suggesting that fostering body trust is important for mental wellbeing.
- Read the body trust literature. Before taking up specific practices to increase your body trust, it’s worth reading other people’s descriptions of what it means to have body trust, from Audre Lorde to Gabor Maté.
- Take up a mindfulness practice. If you’re a beginner, I’d recommend doing a focused breath meditation before moving on to a full body scan. After that, progress to open monitoring, which is about observing your sensations with a nonjudgmental, open awareness.
- Experiment with more practices and find what works for you. On my own interoceptive journey, I chose to practise a Japanese energy-healing technique called reiki.
- Notice what you think about how you feel. Connecting bodily feelings to emotions and behaviours will become easier if you get into the habit of labelling and reappraising what you’re feeling, and pressing pause between sensation and emotion state.
- Practise social interoception. It’s one thing to develop a trusting relationship with your body at home, in private, but you also need to develop it in a social environment via a skill known as ‘flexible switching’.
- Keep an interoceptive journal. It will give you another chance to value your inner experience by taking the time to reflect on it – and build more body trust in the process.
One question you may have been asking yourself is: ‘How does body trust (or lack thereof) develop in the first place?’ Are some of us born with more of it than others, or is it a learned skill? The developmental psychologist Kristina Oldroyd has argued that interoception forms during childhood, and is heavily influenced by our social environment.
Oldroyd’s team looked for links between people’s interoception and their attachment style – their ways of relating to other people. In an initial study in 2019 they found that young adults with avoidant and anxious attachment styles showed lower interoceptive functioning and exaggerated interoceptive functioning, respectively. That is, avoidantly attached individuals had a blunted bodily response to emotion, while anxiously attached individuals tended to overreact.
In a follow-up study, the researchers found that boys aged eight to 17, whose mothers dismissed or downplayed their negative emotions, were less accurate at detecting their own negative emotional sensations. The researchers wrote that there is a ‘substantial window of opportunity for environmental input to impact the development of the interoceptive network’.
To picture how this might play out, Oldroyd gave me the example of a child who is about to perform a dance recital and has an increased heart rate and her palms are sweaty. Her caregiver could either say: ‘That’s really normal; your body’s preparing for a challenge. This is your body’s way of telling you you’re prepared; you’re going to be great.’ Or they could say: ‘Oh my gosh, you’re having a panic attack; let’s pull out a Xanax.’ The first response validates inner experience and teaches emotional self-regulation; the second invalidates experience and gives the child no roadmap for contextualising – rather than overidentifying with or completely ignoring – one’s pain.
You may have experienced something similar growing up, or know someone who did. Take heart knowing that it’s possible to change your own relationship with bodily sensation and emotion, and that the research on body trust and interoception is paving the way toward understanding how. Social interoception, in particular, may prove to be an especially promising line of research, as it frames bodily experience as relational in the same way, for example, that relational psychotherapy frames psychology as intersubjective. In other words: if people first learn emotional self-regulation through their bodies, and through interactions with other people, then perhaps the key to improved regulation in adulthood lies as much in the wilderness of interpersonal interactions as it does in the individual will to change.
Links & books
You can download the Multidimensional Assessment of Interoceptive Awareness test online, which includes a measure of body trust, to assess your current skills.
The article ‘Interoception: The Hidden Sense That Shapes Wellbeing (2021) by the British science writer David Robson for The Observer provides a nice overview of how interoception affects mental health.
In the YouTube video ‘Interoception, Emotion and Mental Health’ (2020) on the Dissenter channel, the neuroscientist Sarah Garfinkel dives into the connection between interoception and emotional regulation.
Another neuroscientist, Andrew Huberman, devotes a few enlightening minutes to interoception, and hints at its significance for social interaction, in the video ‘How to Optimise Your Brain-Body Function and Health’ (2021) on his own popular YouTube channel. He covers the topic in greater depth here.
The book How Do You Feel? An Interoceptive Moment with Your Neurobiological Self (2014) by A D ‘Bud’ Craig was among the first to launch interoception into mainstream awareness among neuroscientists.
The book Interoception: The Eighth Sensory System (2015) by Kelly Mahler provides practical solutions for improving self-regulation, with a focus on Autistic individuals.
The book The Zen of Creativity: Cultivating Your Artistic Life (2004) by John Daido Loori, a Zen Buddhist rōshi (teacher), highlights the importance of self-trust in one’s life. He uses the term ‘implicit’ to hint at the role of the body in this process: ‘When you learn to trust yourself implicitly, you no longer need to prove something through your art.’
The book The Extended Mind: The Power of Thinking Outside the Brain (2021) by the award-winning science journalist Annie Murphy Paul showcases the latest research on interoception and explains what it means to ‘think with our bodies’.