Kelly: For so long we've been so stuck up here in the brain and cognitive and we forgot about the body and what all this exciting research about interoception is showing is that interoception is like step one of everything.

It's our foundation of being able to succeed at life. To be resilient, to feel good, to deal with our mental health. And then that feeds our cognition. So we forgot about this whole body piece and it's exciting that we're coming back into it.

Interoception is a pivotal part in our positive mental health.

Sharon: Consider this. Have you had a day recently where you skipped lunch or forgot to drink enough water? Perhaps you sat at your computer without stretching or moving your body for far too long. For some of us, when we feel under pressure, it's easier to ignore the signals from our body, but the science tells us that acting on these cues really matters. 

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Thanks for joining us for this Leadium podcast. I'm Sharon Longridge, the director of leadium.com.au. In our expert insight conversations, we delve into the mind, brain and behaviours of leaders who just like you, have a sphere of influence. We explore the evidence to help you build your presence, stamina, and impact.
We also share tools so that you have the right frame of mind to lead and live well. 

In this episode, we're getting right under your skin and there's a very good reason why.

Today we're exploring the embodied mind, the science behind gut feelings, and why being attuned to the ever-changing, subtle sensations within your body significantly impacts your ability to skilfully manage yourself and lead others.

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For thousands of years ancient practices like yoga and Tai Chi have recognised that the mind affects the body and the body affects the mind – that these complex systems are profoundly interconnected. By way of contrast, traditional theories in psychology place the responsibility for generating our behaviour in the brain.

Modern science is gradually reconnecting the body-mind. We know that 80% of the fibres in our sensory pathways travel from the body into the brain while only 20% head the other way. Our experience of these sensations is the little-discussed yet ever-present sense called interoception.

As our guest explains, interoception has vast impacts on our life.

Kelly Mahler is an author, speaker and researcher from Pennsylvania, USA. She has a doctorate in occupational therapy. Her publications include Interoception, the Eighth Sensory System, and the Interoception Curriculum - a step-by-step guide to developing mindful self regulation, which is part of a comprehensive online program. 

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Passionate and prolific. It's no surprise that Kelly won the 2020 American occupational therapy associations emerging and innovative practice award.

In this conversation, Kelly and I explore the importance of listening to your body and map it to critical leadership attributes.

Kelly: Interoception is a new term to most people, although it is something that's been widely studied in neuroscience for over a hundred years. Interoception is a sense within all of our bodies. And interoception is how we are able to feel our internal body signals.
So whether it's a racing heart or tense muscles or a growling stomach, most of us are aware of those internal body sensations or signals due to the sense called introception. So the way the interoception system works, we have receptors located throughout our body.

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So in our heart, our lungs, or stomach or bladder or muscles, even the whites of your eyeballs, these receptors are pulling in information for interoception about how your body is feeling. And those signals are sent up your spinal cord, into your brain, and all of that information lands in your insula. And everyone has a right insula and a left insula located within the deep side parts of your brain – your temporal lobe, if you're a brain geek like I am. And the insula uses these incoming signals about how our body is feeling and translates those signals into the emotion.

So those receptors in the lining of your stomach collecting information that maybe your stomach is fluttery and that sense, and your brain uses that information and allows you to understand that you feel anxious. So the insula is receiving these messages and really helping to encode them into your emotional experience.

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Sharon: So if we misread the signals, we trigger a whole cycle of emotion and reaction. That could be because we misread the source code.

Kelly: The whole brain is a predictive mechanism. So as we build predictions over our life, we start to predict, like, say, public speaking makes me feel anxious. So your insula is already predicting the way that you're going to feel. So how do you update, those predictions. How do you change those predictions to more of a positive body experience? That involves starting to reread your body maybe in a in a more comfortable way.

There's a wide-varying degree of how aware each of us are with these internal body signals. Some people are overly aware of what's going on in their body. And in fact, it can be very overwhelming where there's at the very other end of the spectrum, some people are completely unaware and do not listen to or are not able to notice their body signals.

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So there's really like this vast continuum of how aware we each are.

Sharon: So you've been studying occupational therapy for a very long time. You've written countless publications. You run a comprehensive online course into interoception. What is it about this particular aspect of your work that's captured your imagination?

Kelly: Because of its vast influence that it has on every single one of our lives. I've always been interested as an occupational therapist in mental health and supporting the mental health needs of the clients that I serve and interoception is a pivotal part in our positive mental health. It also allows us to be able to regulate our emotions, which I've always been really fascinated about.

Our bodies are set up to motivate us to do things to take care of our body. So we notice the growling stomach. We know we're hungry, we're motivated to eat, or maybe we notice a racing heart and a tingly stomach.

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And we have learned over time for us, that means we are anxious. And that's what motivates us to do something, to regulate that anxiety. So there's this very tight connection between being able to regulate our emotions effectively and our mental health.

Sharon: Do you feel that the digital age has collectively corroded our interoception, our ability to deeply listen to our body.

Kelly: Yeah, I think from a society standpoint, there's quite a few things that are impacting our ability to listen to our body. And I think the screen time is a biggie. It just naturally pulls our attention outward and then we don't have resources left to be able to pay attention and notice our internal body signals. Right now, to my knowledge, there are no studies looking at the connection between internet use screen-time and interoceptive awareness. But there are some studies that directly look at internet use and something called alexithymia which is just a fancy word that describes our ability to describe and identify our emotions.

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And what research has found is that that essentially is just interoception. So we had to be able to notice our body signals, describe them, identify our emotions. So if internet use is correlated to alexithymia, feasibly, we could say the screen-time, this internet usage, it's also correlated to interoceptive awareness and how aware we are of our internal body signals.

Sharon: In my leadership programs, I talk about the embodied leader and I coach my clients to practice deep listening to their body because it's explicitly linked, as you said, to positive mental health and also their performance.

For example, we know that even mild levels of dehydration, corrode cognitive ability. What else can you tell us about the link between interoception and our effectiveness at work?

Kelly: Interoception has such a wide influence on our lives.

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We know that interoception is connected to our ability to make decisions, and so when you're talking about decision making, we have two different sides. We have that intuitive emotional-driven side. And then we have that logical cognitive decision-making side and both are equally important.

People that have greater levels of interoceptive awareness are better at that intuitive lightning-fast thinking on your feet, being able to go with the flow, being more resilient, and it's like kind of our gut feeling and it's our ability to make those lightning-fast, intuitive decisions.

People that listen to their body more, are found to be able to make quicker decisions, more effective decisions on the spot. 

That's so incredibly important to many different fields and workplaces for sure.

Problem solving

Sharon: In your book, Interoception – The Eighth Sense, you link body awareness to a raft of skills that are highly pertinent to leadership and being a knowledge worker and one of them is problem solving. What's the connection.

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Kelly: Well, our bodies are designed to, to set off an alert at the first sign of a problem. So the more you're listening to your body, the more aware you're going to be of a problem early on.

We don't want to be like 10 steps into the problem when we realise 'Oh my gosh, like this is a problem'. So our body is designed in a way, if we are listening to it the way that we should be, to provide that first indication that something is off, so that we can react in a quicker way, a more effective way before the problem gets too big.

Performance anxiety

Sharon: some people are too sensitive to the signals in their body and I experienced this when I'm working with people who, for example, have performance anxiety. Say public speaking is an obvious case in point where their perception, their read of the body signals that they're getting around, say that fluttering feeling in the tummy is quickly correlated with underperformance.

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How do we train ourselves to calibrate our interoception so that we perceive body signals more accurately?

Kelly: Many people that have anxiety, their attention gets stuck on certain body signals. So whether like you're having a panic attack and you're stuck on that feeling of not being able to breathe or the anxiety feeling that you said, and you're stuck on the feeling of in your stomach or in your heart.

We need to be able to shift our attention to other grounding body sensations.

So maybe it's a feeling of your feet on the floor and you're grounded in that moment and you feel strong and you feel connected. So really practicing that outside of the anxiety experience, practice shifting your attention throughout your body can be really, really helpful.

And also with anxiety. Many people begin to just anticipate that anxiety experience. So how do we update those predictions?

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A person predicts that this is going to make me feel a certain way. So how do we gradually show that person or help that person experience a calmer sensation within their body during whatever experience, whether it's public speaking or whatever else, makes them feel anxious? How do we kind of baby-step their confidence and recalibrate the way they predict that they're going to feel in that situation?

Sharon: So, so much of that has to do with the lens of perception, doesn't it?

Kelly: Yes, it does.

Sharon: And yet the mind is so often at the mercy of the major senses, you know, taste, smell, touch, sight and often those senses then, if they're perceived as unpleasant sensors, they activate the alarm bell in the brain, the amygdala, which then triggers off the stress response, which has a cascading effect.

How can we listen to our body in such a way that we reduce that tendency towards the reactivity that I just flagged through that sensory input.

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Kelly: It's very individualised for each person and what I've been becoming really fascinated with is  how do we focus on the good stuff, so to speak, and getting more of the good ones.
Stuff that's coming from a field of positive psychology, which is an amazing field – How do I make my body feel calm and what things make my body feel calm and how do I get more of that proactively in my life – has a side benefit of decreasing those uncomfortable feelings within our body without ever having to focus on the uncomfortable feelings.

Which is really fascinating concept because the whole mental health field has been for so long, been focused on how do you fix those uncomfortable feelings? Like, how do we fix your depression? How do we fix your anxiety? And I, that's why I think this whole notion of focusing on more of the good stuff, focusing more on the comfortable feelings within your body is refreshing and exciting.

Sharon: I'm a big fan of the work of Dr Rick Hanson and his practices around self-directed positive neuroplasticity.

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And one of the practices that I use extensively, having trained under Rick,  is the ability to find in the moment small examples where things went well.

But now what you're saying is that you can also do that at the embodied level. You know, what is a pleasant sensation in my body and build the library, the stockpile of positive sensations in the body, and again, to reduce this negativity bias in our interoception.

Kelly: That's absolutely right. Yeah, and I think you could hook the two together. So what you're talking about, like what cognitively I'm picking out makes me feel good. Then can you tie that to a lower embodied level? Like what exactly does that 'feel good' mean in my body?

So whether it's like that I have like loose, relaxed. shoulder muscles or my jaw is like loose or my heart is slow, or you know, whatever that feeling is, to really tie those two things together, I think it could take you to a whole other level.

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For so long we've been so stuck up here in the brain and cognitive and we forgot about the body and what all this exciting research about interception is showing is that interception is like step one of everything. It's our foundation of being able to succeed at life. To be resilient, to feel good, to deal with our mental health. And then that feeds our cognition.

So we forgot about this whole body piece and it's exciting that we're coming back into it.

Empathy and insula

Sharon: Neurobiologist , Dr Dan Siegel, makes the connection between interoception and empathy. What does the science tell us is the link between our ability to be deeply attuned to our own body and our ability to connect with other people?

Kelly: this is another very interesting connection. What a lot of the research shows us is that our ability to identify how we feel allows us to be more attuned to the feelings of other people.

They've done a lot of interesting studies. Like there's one really cool study where they brought a research participant into the clinic, and they hooked that person up to a brain imaging machine and they gave the person a painful stimulus and they wanted to see what area of the brain was activated.

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And it was the area of the brain called the insula, which is our interoception centre of the brain. So the person felt pain, which is this emotional response processed in the insula.

So they're finding that the insula is activated when the person was experiencing pain. But where it gets really interesting is they kept the original participant hooked up to the brain imaging machine and brought a loved one into the room and gave the loved one the painful stimulus. The area of the brain that was activated and the original participant was again, the insula. And so what researchers are finding is that not only do we use the insula and the interoception centre of our brain to identify how we feel, we also use it to identify how someone else is feeling in the moment, like lightning-fast, being quickly attuned to someone else.

So in order to understand how someone else is feeling, we recreate our own emotional interoceptive experiences in that moment.

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So if you were more in tune with our own interoceptive experiences, then that just feeds into our ability to be more attuned to the emotions of other people, which is the whole definition of empathy, right? Just that lightning-fast ability to really put ourselves in someone else's shoes, so to speak.

Sharon: To build your emotional intelligence you need to build your deep attunement to the subtle and ever-shifting sensations in your body. 

Kelly: Yes, absolutely. And emotional intelligence is such an exciting field of study, but they really are missing that underlying science, the whole intersection, the whole body piece of it. Again, it's stuck at that cognitive level, and I think we can take that work one step further with the embodied experience and interoception. 

Sharon: While we're mapping the mind and the body, which again, ancient practices like yoga have always connected, but contemporary practice is still catching up with, can you explain for us please?

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The link between interoception, full body awareness and cognitive flexibility

Kelly: It kind of goes back to what we were talking about with the decision-making. If we can listen to our body, we have better gut feelings, so to speak, which is part of our intuitive ability to be able to make lightning-fast decisions. If we only can really rely on our logical decision making side and everything is tedious and we have to think through every situation and every option, we really become very cognitively inflexible.

We really can't go with the flow because every decision we make is painstaking and we have to think through everything. Whereas, if we have this ability to listen to our bodies – hat feeds our intuition. It makes us more flexible. And when something doesn't go right, we're able to really, make the next decision that we need to make intuitively and quickly.

Neurodiversity

Sharon: We have much more neurodiversity in the workplaces these days. So we know that some people have sensory processing differences.

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What's your view on the notion of training people in interoception to actually improve our workplace cultures and, and even as part of a diversity and inclusion strategy.

Kelly: I think it's absolutely essential that everyone understands sensory processing in general, as well as interoception and how that can impact the differences that we all experience.

Like what we talked about in the very beginning of this interview, that we all have such a diverse interoception experience. There's no right or wrong experience, but if we're under aware, overly aware of our internal sensations, that can definitely present in behaviours that might be confusing to other people.

So if we can all really understand sensory processing interception, it allows us to be less confused and proceed with more empathy for each other and more understanding of each other. So I think it is absolutely critical to have all this education.

Sharon: And are you seeing more of this?

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I mean, I've been in corporate training for many years and because I'm a yoga teacher, I bring body awareness into the training room as a part of our practice. But interoception is not a course on most MBAs, for example.

Kelly: I have been working really hard for like over eight years trying to disseminate this information, but we have such a long way to go. Not enough people know about interoception, especially in the business world. My husband is in an MBA program right now and they have not discussed interoception at all. So yeah, that's why I was excited to learn about your work. What you're doing is absolutely fantastic and joining forces with you and hoping, helping to educate people.

Sharon: I know that mindfulness is one of the primary tools that you use to support people to build their interoception, their body awareness. Please explain why from your perspective.

Kelly: So right now, mindfulness is the only evidence-based intervention that has shown to improve interoceptive awareness. 

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We know there's a lot of great benefits of mindfulness and what I'm saying, mindfulness, I know it can be defined by so many different people in so many ways. It's just our ability to pay attention to our bodies in the present moment, um, and how our body is feeling. And mindfulness is wonderful. It has a lot of benefits, including improving interoceptive awareness.

But for many people,  they're really not at a place that they're ready to jump into traditional mindfulness practice. And I think a lot of people become then very closed off and very shut down at trying something so hard. I've never heard one person ever tell me that mindfulness is easy. So we really are working to adapt traditional mindfulness and make it more accessible for different types of learners, whether it's someone that does not have a condition or we're even adapting it to make it more successful for individuals with, say, autism or ADHD.

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Sharon: Can you share one specific practice that you're getting good results with in your mindfulness library that is, is helpful for people to build this body awareness?

Kelly: Being mindful during activities that are evoking stronger body sensations can be very helpful for a novice learners. So whether that is being more in tuned to what your body is feeling like when you're out for a jog or when you're lifting weights, or even when you're washing the dishes. Like what? How does that make your hands feel? Just being more attuned during activities that are evoking stronger sensations can be a really successful for early learners, where I think even doing yoga and instead of focusing on the pose, focusing on how does that pose make your body feel? So if you're in downward dog, how is that, how is that pose making your calf muscles feel? How is that making your arm, your hands, pushing into the floor? How does it make your hands feel? So just anytime you're evoking stronger sensations, it can be really helpful.

Yoga interoception

Sharon: A very senior yoga teacher that I had the benefit of having some time with, shared something that was really profound to me.

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And she said, your role as a yoga teacher is almost singular. And that is to build the interoception within the people you are teaching. And I thought that was such a crystalline insight because so often, you know, yoga teachers – just to stay in the yoga space, but this is metaphorical – come over and push someone deeper into a pose. Like they know what the internal experience in their body is more so than the person in the pose.

Whereas, people listening to what their body is telling them and responding accordingly. Building that body wisdom is in many ways, at the heart of some of these ancient practices. And that's what you're saying in terms of using mindfulness in this way, to really understand and hear your body. And then I guess it's about, uncoupling labels to some of those sensations, isn't it?

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Oh, yes, there's a big language piece to interoception and developing the language to be able to describe what it is your body is feeling. Even some of the brightest people I've met have a really hard time describing how the body is feeling because they're, they haven't spent a lot of time being really in tuned to their body and developing that language to be able to describe it. So yes, you're right. There's a very big language piece too involved in this.

Sharon: How can we build that vocabulary?

Kelly: We need to start early and lots of caregiver and parent education. Even when I was raising my children – my oldest is 11. And even when she was an infant, I didn't really understand interoception and the impact. So I wish I would have known from an early age that I needed to start labelling the way my body was feeling in the moment and really helping to build that vocabulary so she was hearing it, and then as she became older, to really start to help her to discover her unique interoception experiences and start labeling them so that she can communicate it to other people and understand it for herself.

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Because I think it bears repeating that we all have such a different and unique interoception experience. There's no right or wrong experience. And so the only person that really can discover your experiences is yourself. So if we can start nurturing that from a young age, I think that it would really pay off for us in adulthood.

Sharon: So if this body sensation experience is so individualised, how does a person know whether their interoception is well moderated? How do you assess that?

Kelly: well, there are some standardised measures out there that you can take for free online, if you just google interoception assessment. But, honestly, I think you just need to assess your life and your function and where you're at. And if you like how are you able to handle your emotions. Do you feel like you're successful at managing your emotions? Do you feel like you are in tune with other people and you can really connect with other people and you understand how they feel.

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If the answers to any of these questions – if you feel like there is a concern or you feel like you have room to grow, then I would say, you know, definitely work on building your interoception.

The research clearly shows it's good for all of us and there's no contraindication or drawback to becoming more aware of your body.

In modern day, most of us are pulled out of our bodies unless we are doing a more ancient practice like yoga or Tai Chi or something like that.

Sharon: What profound implication this deep body awareness has. Thank you so much for your time and your passion and the work that you're doing to advance this conversation because, as you've so clearly shared,

This innate body awareness is foundational to our experience of life and it sounds like now we're dropping back out of the head, back into the body, and that the mind is going to work more skilfully as a result.

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Kelly: Absolutely. Yes. It was a pleasure talking to you about this. Thank you for having me.