You may already know about proprioception (body awareness) and exteroception (outward awareness using the five basic senses) but we don’t hear as much about interoception: our felt experience of the inner workings of our body. This usually has to do with digestion, awareness of our heartbeat, and other internal organs, but it can also include awareness of temperature and pain.
Some autistic people report a decreased awareness of physical sensations that cause others pain or significant discomfort, such as an injury or temperature extremes. Self care can be challenging if we aren’t aware that something is going on with our body that could potentially be harmful to us. Here are some tips to help you SEE & ACT to take care of yourself even when your body doesn’t give you the message.
SEE means Stop and think about what’s going on with your body, Examine or observe the situation or others nearby, and Evaluate the situation to see if something should be done.
ACT means Ask for help if there’s someone nearby, Consider your options, and Take action to make the situation better.
Here are some fictional examples, Cora, Indigo, and Harrison, who found themselves in situations where their limited interoception made them vulnerable. Read how they used SEE & ACT to make things better.
Cora loved to walk in the brisk autumn air, and she especially enjoyed watching birds and squirrels in a park near her home. One day she went to the park as usual and sat on a bench. While watching the animals, she became engrossed in remembering a favorite movie; it was as if she could see the entire movie from the beginning to end in her mind’s eye. When the 90-minute movie ended, she realized she was having trouble moving her hands. Why did her fingers and her face feel so numb and useless? She couldn’t feel her feet, either. Cora decided to use the SEE & ACT strategy.
First, SEE: Cora stopped what she had been doing to focus on the problem: her hands and body felt weird. Then she examined her surroundings. It had become dark since she arrived at the park, and there were no other people that she could see. She took off her mask for a moment and noticed she could see her breath like smoke when she exhaled. She also observed that she had left the house without a sweater or jacket because she hadn’t thought of it. The cold never bothered her anyway. But now she saw a few flakes of snow starting to fall. Cora evaluated what the problem was based on her observations: she was suffering from the cold because she was unprepared for the weather and had stayed outside longer than she thought she would.
The next step was ACT: Cora should ask for help. Who could she ask? There was no one in the park, and even if she saw someone, it wasn’t safe to approach strangers. She considered her options. It was a long walk home, and her body didn’t feel right. She wasn’t sure she could make it, and she couldn’t ask anyone nearby, so she decided take action by calling her mother and asking for a ride. When her mom answered, Cora told her where she was and that she was too cold to walk all the way home. While waiting, she wrapped her arms around herself and started walking home along the street she told her mother she would be on, stamping her feet so that she could feel the ground beneath her. Soon her mother found her. The warm car felt wonderful! Cora had been smart to Stop, Examine, Evaluate, Ask for help, Consider her options, and Take action. Her thinking had gotten her out of a potentially dangerous situation.
Indigo had always been active in sports, and excelled at cross country. They loved running, any time, anywhere. One day they were running along a hiking trail, jumping over rocks and obstacles like hurdles, barreling toward the finish line. Suddenly, their foot landed on a loose rock and they tumbled to the ground. Indigo had never been bothered by pain so they started to jump up, but one ankle didn’t support them. They tried again to stand up, but each time they took a step on that foot, they fell. What was wrong? They couldn’t walk or even hop effectively. Indigo decided to use SEE & ACT to figure it out.
First, SEE: Indigo stopped trying to walk on that foot. Clearly, it wasn’t working right and it seemed useless to keep trying. They examined the situation. One ankle was beginning to swell; holding their feet out to look at them side by side, there was a big difference. They evaluated the problem: this seemed to be an injury that they couldn’t just walk off.
Then, ACT: Indigo would need help. Who could they ask? Indigo reached for their phone and realized they had forgotten to put it in their pocket. They couldn’t call anyone to pick them up. They considered their options. Since they couldn’t make a phone call, and they couldn’t walk home, they would need to rely on the kindness of strangers. Indigo didn’t like talking to other people, but it was time to take action. They cupped their hands around their mouth and called out, “Help!” as loudly as they could, pausing, and then calling again. After a few calls, they heard a voice, “We’re coming!” Quickly Indigo pulled out a mask and put it on. Soon a couple of joggers appeared, waving. Indigo waved back, and when the joggers arrived, they expressed sympathy for Indigo’s injury and offered to make a phone call. After looking at the odd angle and extreme swelling of the ankle, they called 911. Indigo was taken to a hospital where X-rays revealed that the ankle was broken, not just sprained. Trying to walk or hop home alone would have made it much worse. It was a good thing Indigo had used the SEE & ACT strategy.
Harrison had just gotten his driver’s license, and he enjoyed being helpful at home by running errands in the car. One summer day he drove his grandmother to a medical appointment and waited in the car for her. He appreciated having some down time, alone in the car, to play his favorite video game. In the car no one interrupted him or asked him to do something different. It was great! Then he noticed his screen was wet. Water was falling on his Switch controller! He looked up, but saw no leak coming from the roof of the car. Then he realized the water was coming from his face. This was unusual and concerning. Harrison decided to use the SEE & ACT strategies to figure out what was going on and what he should do.
First, SEE: Harrison stopped playing his game. He needed to examine or observe to see what was up. Since the water seemed to be coming from his face, he pulled down the windshield visor and flipped open the mirror. A very red, wet face looked back at him. Why was he so red in the face? He looked out the window and saw a sunny day and people wearing shorts, tank tops, and sunglasses. He looked at himself, wearing his favorite hoodie, hood up for privacy, and comfortable fleece sweatpants. He saw that he had turned off the engine so he wouldn’t waste gasoline while waiting, and that he had left the windows up to keep out noise. What about the air conditioning? He pushed the AC button but couldn’t hear anything, and no air was coming out of the vents. He guessed it didn’t work when the car was stopped. Harrison needed to evaluate his situation. The evidence indicated that he had become over-heated due to the sun coming through the glass in the closed car. He was also not really dressed for summer, but that usually didn’t make a big difference for him. He always preferred long sleeves and pants and a hood up, and usually he didn’t feel over-heated. But this was different. The sun’s rays were magnified in the closed car.
Harrison needed to ACT. First, was there someone he should ask for help? He didn’t want to interrupt his grandmother’s appointment or call his mom or dad, so he decided to ask the internet. He searched “Heat Stroke” and learned that he didn’t have any of the symptoms listed, so he wouldn’t have to call 911. He didn’t have the symptoms of heat exhaustion yet, either, but he did feel kind of weird, red, and sweaty. The article suggested moving to an air conditioned place, cold shower or cold compresses, plenty of fluids, and remove tight or extra clothing layers. He considered his options, and took action by rolling down the window, drinking his bottle of water even though it had become warm, and taking off his hoodie. He started to feel better immediately. As he was deciding whether he should turn on the car and run the air conditioner even though it would waste gasoline, his grandmother returned. The ac felt great on the ride home. Harrison was glad he had used the SEE & ACT strategies to take care of himself before the situation got more serious.
Maybe these strategies will work for you, too. Self-care is important at any time, but even more so during the COVID-19 pandemic when stress is high. If your interoception keeps you from being immediately aware of your body’s needs, you can SEE and ACT to take care of yourself.