Interoceptive Awareness & Post-Traumatic Stress: A Plain-English Review
Post-traumatic stress disorder (PTSD) is usually discussed in terms of memories, thoughts and emotions. But trauma can also profoundly affect how people experience and respond to sensations within their bodies.
This 2024 paper by Leech, Stapleton and Patching reviewed existing research into the relationship between interoceptive awareness — our awareness and interpretation of signals arising from within the body — and PTSD.
Rather than conducting a new clinical trial, the researchers carried out a scoping review, bringing together findings from 43 existing studies to examine what is currently known and where important gaps remain.
What did the research find?
One of the clearest messages from the review is that interoception in PTSD is complicated.
Greater awareness of bodily sensations is not necessarily better.
People experiencing PTSD may notice internal sensations very strongly, but those sensations can sometimes be interpreted as threatening or become associated with traumatic experiences.
The review highlighted the importance of emotion regulation and the way a person attends to and interprets bodily signals.
This suggests that adaptive interoceptive awareness involves more than simply detecting what is happening inside the body. It also involves the capacity to experience bodily sensations without automatically becoming overwhelmed by them.
What does this mean in practice?
This distinction is particularly relevant to trauma-informed, body-oriented therapeutic work.
Asking someone to pay more attention to their body is not necessarily helpful if bodily sensations already feel frightening or overwhelming.
Instead, therapeutic work may involve gradually developing the capacity to notice bodily experience while maintaining enough safety, choice and regulation.
This helps explain why pacing can be important when working with trauma. The aim is not simply more body awareness, but potentially a different and more manageable relationship with bodily experience.
A note of caution
This was a scoping review, not a clinical trial, so it cannot demonstrate that changing interoceptive awareness will treat PTSD.
The 43 studies included in the review also differed considerably in how interoception and PTSD were measured, making it difficult to draw simple conclusions.
The authors highlight significant gaps in the evidence and the need for further research into the different dimensions of interoceptive awareness and their relationship with trauma.
Its value lies in showing that the relationship between trauma and bodily awareness is nuanced: how bodily sensations are attended to and interpreted may matter as much as how strongly they are perceived.
The original research
Leech, M., Stapleton, P. & Patching, A. (2024). A roadmap to understanding interoceptive awareness and post-traumatic stress disorder: a scoping review. Frontiers in Psychiatry, 15, 1355442.
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