To complement “Prevent Burnout: Interoceptive Awareness for Professional Self-Care,” in the October 2016 issue of MASSAGE Magazine.
Interoceptive awareness, or awareness of inner body sensations, can help a massage client be more aware of bodily cues related to discomfort, imbalance or distress, and thus facilitate self-care and regulation.
Interoceptive awareness is the perception of all sensations from inside the body and includes both physical and emotional sensations. Neuroscience research is now showing how and in which areas of the brain interoception is processed and how it relates to emotion, stress and regulation.
What the research on interoception highlights is that our bodies can give us information that is critical for staying healthy; this involves cues that tell us we’re out of balance and need to adjust in order to better cope with stress.
For example, being more aware of internal sensory experiences makes it easier to notice if we are uncomfortable, tired or stressed. By paying attention to thoughts, feelings, sensations—our internal life—we become more aware of internal cues and thus more able to engage in self-care in order to maintain balance and important mind-body-spirit connections.
Sensory Cues and Stress
Interoceptive awareness is very helpful for providing information on sensory cues that can underlie symptoms of stress. Likewise, physical or mental health conditions may be better managed when one is highly sensitized to inner bodily cues that offer information about when, for example, blood sugar is low for someone with diabetes, or when one is on the verge of emotional escalation due to feeling triggered, for someone with post-traumatic stress.
Interoceptive awareness involves the ability to engage in present-moment awareness of bodily experience with an attitude of non-judgement—and is thus a mindfulness skill.
Taking the time to attend to sensory awareness is one way that interoception can translate into facilitating self-awareness and self-care. However, our massage clients often do not know how to access interoceptive awareness. Doing so involves active attention to the inner body and requires the ability to turn attention internally and observe or take note of one’s bodily state and sensations. While it is a simple process, it can take practice and patience, and is not often explicitly taught.
How Massage Therapists Can Help
Massage therapists are in a unique position to teach interoceptive awareness. Touch is extremely helpful for learning to increase attention to an area of the body and to increase interoceptive awareness of sensations.
I developed an approach to teaching interoceptive awareness in bodywork practice decades ago and now research this approach, called Mindful Awareness in Body-oriented Therapy (MABT). MABT teaches people how to become more body-aware.
Designed to promote client self-awareness and regulation, MABT is particularly helpful for clients who are struggling to manage stress and chronic physical or mental health conditions.
What Is MABT?
MABT involves four primary components for developing interoceptive awareness:
- Body literacy. The client develops a language to identify and articulate sensations in the body. This is accomplished during massage; the therapist can stop and pause in places and ask questions about what the client is aware of and helping her find words to describe what she feels.
- Interoceptive training. Exercises are used to develop the client’s ability to access interoceptive experience. A variety of strategies are used to learn how to bring mindful attention into the body.
- Interoceptive capacity. It can be challenging for a client to maintain interoceptive attention, as people tend to “pop out” of their experience and start actively thinking, vs. maintaining mindfulness attention to their internal experience. MABT helps clients learn to develop the capacity to stay connected inside, and to attend to shifts in interoceptive experience as a way to evaluate interoceptive experiences.
- Self-care skills. Through take-home practice and individualization of strategies and skills, MABT teaches people how to integrate interoceptive awareness into daily life for self-care and emotion regulation.
Benefits of MABT
MABT offers many benefits. Research demonstrates that people who develop and integrate interoceptive awareness into their lives tend to show significantly reduced stress, mental and physical health issues, and dissociation from their bodies; as well as increased emotional awareness and regulation. (My research articles are available on the Center for Mindful Body Awareness website, and free on pubmed.gov.)
Study participants also report learning a new set of tools for awareness and self-care. Those who are disconnected from their bodies report gaining a sense of safety and trust in their bodies. For example, below are quotes from MABT study participants:
- “[I learned to] connect emotions to sensations. It is still difficult for me to identify emotions sometimes, but I can now look to my body for cues.”
- “I feel a sense of calm unlike before; I am able to identify my feelings before I react to them. I am able to calm myself in situations that in the past would set me off.”
- “I am much more aware of who I am and accepting of who I am physically and emotionally because of MABT. You know, this therapy was really healing for me and it really sent me away with a much more confident feeling of ‘I’m OK the way I am.’”
The Learning Process
Touch is helpful for learning to increase attention to an area of the body and to increase interoceptive awareness of sensations. Direct guidance from the therapist helps the client bring increased intention and conscious attention to bodily experience. Thus, the practitioner uses touch to help the client focus attention inward and in a specific area of the body.
The client then practices at home, using self-touch to facilitate mindful body awareness as well. The goal is for a client to apply MABT strategies themselves in daily life to enhance embodied knowing and self-care.
Developing interoceptive awareness is an educational process; once a client learns to access it, it is then important to help the client learn to increase his capacity to mindfully attend to interoceptive experience to gain sensitivity regarding internal bodily cues and subsequent integration of self-care tools in daily life.
Interoceptive Awareness Training
It is important for massage therapists to gain personal experience with body awareness and mindfulness skills if interested in incorporating this focus with clients. The nonprofit Center for Mindful Body Awareness in Seattle, Washington, offers advanced professional training in MABT for therapists interested in teaching interoceptive awareness and related self-care strategies to their clients.
This training will be offered Monday, November 28, 2016, through Friday, December 2, 2016, in Seattle. If you are interested in this training, please see the center’s website at cmbaware.org.
The center’s staff also offers ongoing supervision for practitioners who have completed the training and are working to integrate MABT into their practice.
For practitioners and therapists at an earlier stage of their career or new to body awareness or mental health work, the center offers one-day introductory trainings and educational resources.
Also, a podcast that provides a detailed description of MABT is available through Liberated Body: liberatedbody.com/cynthia-price-lbp-060.
Cynthia Price, Ph.D., L.M.T., is a Research Associate Professor at the University of Washington in Seattle. She studies Mindful Awareness in Body-oriented Therapy (MABT), an approach she developed to facilitate body/interoceptive awareness and related skills for self-care and emotion regulation. She also directs the Center for Mindful Body Awareness, which teaches health professionals how to instruct in interoceptive awareness. Price wrote “Prevent Burnout: Interoceptive Awareness for Professional Self-Care” for MASSAGE Magazine’s October 2016 issue.