Bodily Awareness and Autism
We all know that being on the autism spectrum comes with a variety of strengths and challenges.
For me, my rote memory is top notch, solving certain puzzles can go bafflingly fast, and my hardwired-ness to take things literally makes for some funny jokes. On the flip side, I struggle with anxiety, depression, social situations, sensory processing and, the primary challenge I want to discuss today - motor function and bodily awareness, specifically proprioception and interoception.
Growing up, I was often labeled as clumsy. I tripped a lot, hip checked desks, doors and corners, dropped things, and a certain physical awareness just never seemed to develop. Where my peers often seemed to move with grace and ease, I struggled to move my body in the same configurations. Once I was "prescribed" to play video games in an attempt to develop my hand-eye coordination and sense of left versus right - well into my days as a teenager.
My sense of proprioception, the perception and awareness of one's body and its position and movements, was, and still is, off. This impacts my hand-eye coordination, gross motor skills (larger movements like walking or navigating through a crowd), fine motor skills (smaller movements like using utensils, holding objects, or writing), and plays some role in stimming.
Relating to proprioception is also the vestibular system, the feedback system to the brain providing information on motion, head position and spatial orientation.The vestibular system is also a sense, and it plays a role in movement, balance, and posture. Proprioception and the vestibular system are closely intertwined, both providing feedback on how one’s body moves and maintains stability. It’s hard to mention one without the other!
In addition to impaired proprioception, I also struggle with awareness of and ability to identify sensations within my body, or interoception. So sensations like hunger, fullness, thirst, temperature, and pain can be hard to identify.
Struggling to identify how my body expresses its needs often leads to long stretches without eating or bathroom breaks - I simply forget or don't even notice in the first place.
A more serious (read: dangerous) example is pain. I have a very high pain tolerance.
In some cases, this works in my favor: tattoos, blood draws, piercings (apparently anything with needles), but also with more general pain, like headaches, bumps and bruises.
The downside to this is that I don't always know how serious a pain is. I have to think about whether something that’s only seems slightly bothersome may actually be an issue worth investigating (e.g., mild chest pain). In addition, when I start to really notice that something hurts, the pain often goes from 0 to 60 quickly. Often what I think is only a mild headache can quickly develop into a full-blown, spend-the-day-in-bed migraine. So often in fact, that I implemented the rule, ‘if you wake up with a headache, assume it’s a migraine’.
Over time, I've found ways to cope - to increase my bodily awareness, improve skills like hand-eye coordination, and when all else fails, follow general rules to keep myself safe and functioning. I've described proprioception and interoception as though they're senses, and they are. I also like to think of them as skills, though, because they aren’t entirely innate, and it's possible to learn and improve upon them. It takes conscious effort to build and strengthen the neural connections for movement and create conscious connections between vague bodily sensations and the labels for those feelings. The benefits behind this effort are wonderful, the best of which is improved self-regulation, emotionally and physically: being able to better gauge how much energy I have left for the day, or noticing the physical expression of anxiety to gauge how intensely anxious I am, and then being able to take action with those factors in mind.
Some of my strategies to work on proprioception and interoception include:
Yoga asana: Asana, or posture, yoga practice in particular helps me so much in improving my proprioception. By having specific postures to practice over and over again and following both new and old cues (i.e., the way a yoga teacher explains how to get into a pose and how to align your body once there), I’ve learned how to identify new sensations. And by really paying attention to what my body is doing as I move through poses, I can identify what does and does not feel right. I understand better how I move, how my body feels in each pose, and regular practice keeps me in touch with my body and my movements. This generalizes off my mat too - my body feels more natural to me as a result of spending dedicated time with it.
Yoga isn’t just the asana practice either, and it’s other limbs are worth investigating as well. Much of what yoga teaches has had a positive impact on my mental health and led to a deeper understanding of myself. But, alas, we’re talking proprioception right now.
Meditation: I use body scan meditations as a way to check in with myself. A body scan meditation is especially useful if I feel off, but can’t identify why. I’ll often come across interoceptive sensations I missed, or I might identify an emotion I didn’t know was hitting me so strongly (thanks, alexithymia).
I find a comfortable place to sit or lie down, take a few moments to focus on my breaths, then start walking through my body; starting with my toes, asking myself how each part feels, and how I feel overall. I'll often sit, and use my hands to massage different parts of my body, bringing my attention and awareness to an area on multiple fronts.
Video games: As I mentioned before, video games help with my hand-eye coordination. I've found that first person shooters (FPS) and team games are best for this (though also quite challenging!). In the best of both worlds, Overwatch is an FPS team game, and one of my favorites for practicing hand-eye coordination, orientation, object tracking, and aim.
General activity: Staying active in general is important. Walking around, writing in a journal, or doing chores like folding laundry and doing dishes - and remaining present with the activity and the body. Sometimes I think of chores or exercise as a movement practice instead of a chore, and let’s be real. There’s a reason I try to hang all of my clothes. My folding is sloppy. But it’s an opportunity to practice something I kinda need to do all the time, and practice makes progress.
What are some of the ways you cope with challenges in proprioception and interoception?