Interoception: The Inner Sense That Shapes our Experience

Introduction

Along with alexithymia, my autism diagnosis also made me aware of my lack of interoception. This has been a lifelong issue for me.

What is Interoception?

Interoception is our ability to perceive and interpret signals coming from within our own bodies. It’s an internal sense that informs us about the physiological state of our body, such as hunger, thirst, temperature, and internal pain. This sense can be both conscious and subconscious, and it plays a crucial role in maintaining homeostasis and facilitating self-awareness.

The Causes of Interoceptive Dysregulation

Interoceptive dysregulation can arise from a variety of sources. It’s often associated with mental health conditions like anxiety, depression, panic disorder, anorexia nervosa, bulimia nervosa, PTSD, OCD, ADHD, alexithymia, somatic symptom disorder, and illness anxiety disorder. Misrepresentations of internal states or a disconnect between the body’s signals and the brain’s interpretation of those signals are suggested to underlie these conditions.

Treatments and Techniques for Managing Interoception

Several approaches exist to enhance interoceptive awareness and regulation:

Mindfulness and meditation: These practices can enhance one’s awareness of bodily sensations and help regulate emotional responses.

Talking therapies: Cognitive-behavioural therapy (CBT) and other psychotherapies can assist individuals in better understanding and responding to their interoceptive signals.

Interoceptive training: Specific exercises that focus on recognising and responding to internal bodily sensations can be beneficial.

Aligning dimensions of interoceptive experience (Adie): A novel therapy that involves interoceptive heartbeat training to align interoceptive experience.

Conclusion

Interoception is a vital but often overlooked aspect of our sensory experience. By understanding and managing our interoceptive signals, we can improve our emotional regulation and overall mental well-being.

Urinary catheters: what they are and how they can help

Urinary catheters are flexible tubes that are used to drain the bladder and collect urine in a drainage bag or a valve. They can be inserted through the urethra (the tube that carries urine out of the body) or through a small opening in the lower abdomen (the tummy). Urinary catheters are usually inserted by doctors or nurses in hospital or in the community.

There are different types of urinary catheters, depending on how long they are needed and how they are inserted. The main types are:

Intermittent catheters: These are catheters that are inserted several times a day, just long enough to empty the bladder, and then removed. They are usually inserted by the person themselves or by a carer. They are suitable for people who have difficulty peeing naturally, such as those with nerve damage or bladder weakness.
Indwelling catheters: These are catheters that remain in place for several days or weeks, and are held in position by a water-filled balloon in the bladder. They are usually inserted by a health professional. They are suitable for people who have an obstruction in the urethra, such as due to scarring or prostate enlargement, or who need long-term bladder drainage, such as after surgery or during chemotherapy.
Suprapubic catheters: These are catheters that are inserted through a small opening in the lower abdomen and directly into the bladder. They are usually inserted by a surgeon under local or general anaesthetic. They are suitable for people who have damage or blockage in the urethra, or who cannot use an intermittent or indwelling catheter.

I have a Supra-Pubic Catheter. This is a tube that is inserted into a hole in my lower abdomen, just beneath my belly button, and directly into my bladder. I had the surgery for this in May 2018 after approximately 10 years of self-catheterising, which is inserting a tube into the urethra and into the bladder several times per day in order to drain the bladder. My hands got too unsteady to do this without causing significant pain and trauma. I made the decision to have surgery for an SPC and I’ve never looked back. Every 8 weeks a district nurse calls by my home to change the catheter.

Urinary catheters can have various benefits for people who have difficulty peeing naturally. They can:

However, urinary catheters can also have some risks and challenges, such as:

Infections: Urinary catheters can introduce bacteria into the bladder or the bloodstream, causing UTIs or sepsis (a serious infection that affects the whole body). This can cause symptoms such as fever, pain, burning, blood in the urine, or confusion.
Blockages: Urinary catheters can become blocked by blood clots, debris, or kinks in the tube, preventing urine from draining properly. This can cause symptoms such as abdominal pain, swelling, leakage, or reduced urine output.
Discomfort: Urinary catheters can cause irritation, inflammation, or injury to the urethra, bladder, or surrounding tissues. This can cause symptoms such as pain, bleeding, bruising, soreness, or spasms.
Lifestyle changes: Urinary catheters can affect your daily activities, such as dressing, bathing, working, exercising, travelling, or having sex. You may need to learn how to use and care for your catheter properly and safely.

To reduce the risks and challenges of using urinary catheters, you should follow some general advice:

Choose the right type of catheter for your needs and preferences. Your doctor or nurse will help you decide which type of catheter is best for you based on your medical condition and personal circumstances.
Keep your catheter clean and well-maintained. You should wash your hands before and after handling your catheter; clean your genital area and catheter daily with mild soap and water; change your drainage bag or valve regularly; check for any signs of blockage or infection; and seek medical help if you have any problems with your catheter.
Drink plenty of fluids. You should drink at least 1.5 litres (about 6 to 8 glasses) of water a day to keep your urine clear and prevent infections and blockages.
Seek support if you need it. You should get regular check-ups from your doctor or nurse to monitor your condition and adjust your treatment if needed. You should also get information and advice from various sources, such as NHS, Bladder & Bowel UK, The Urology Foundation, ERIC, etc.

Urinary catheters are flexible tubes that are used to drain the bladder and collect urine in a drainage bag or a valve. They can be inserted through the urethra or through a small opening in the lower abdomen. There are different types of urinary catheters, depending on how long they are needed and how they are inserted. Urinary catheters can have various benefits for people who have difficulty peeing naturally, but they can also have some risks and challenges. To reduce these, you should choose the right type of catheter for your needs and preferences, keep your catheter clean and well-maintained, drink plenty of fluids, and seek support if you need it.

What is Multiple Sclerosis and how does it affect people?

Multiple Sclerosis (MS) is a condition that affects the brain and spinal cord, causing damage to the nerves that carry messages between them. This damage can lead to a variety of symptoms, such as problems with vision, movement, sensation, balance, thinking and emotions. MS is a lifelong condition that can sometimes cause serious disability, although it can also be mild or moderate in some cases. There is no cure for MS, but treatments can help manage the symptoms and reduce the frequency of relapses.

MS affects more than 2.8 million people worldwide and around 130,000 people in the UK. It is one of the most common causes of neurological disability in young adults. It is more common in women than men, and usually starts in the 20s, 30s or 40s. The exact cause of MS is unknown, but it is thought to involve a combination of genetic and environmental factors that trigger an abnormal immune response against the myelin sheath, the protective layer that surrounds the nerve fibres.

MS is a complex and unpredictable condition that can affect people in different ways. There are four main types of MS:

Relapsing remitting MS (RRMS): This is the most common type of MS, affecting around 85% of people with MS. People with RRMS have episodes of new or worsening symptoms, called relapses, followed by periods of recovery, called remissions. The symptoms may disappear completely or partially after a relapse, but some may persist or get worse over time.
Secondary progressive MS (SPMS): This type of MS usually develops after many years of RRMS. People with SPMS have a gradual worsening of symptoms over time, with or without occasional relapses. About two-thirds of people with RRMS will develop SPMS within 15 years of diagnosis.
Primary progressive MS (PPMS): This type of MS affects about 10-15% of people with MS. People with PPMS have a steady increase in symptoms from the onset, without any relapses or remissions. PPMS tends to start later than other types of MS, usually in the 40s or 50s.
Progressive relapsing MS (PRMS): This is a rare type of MS, affecting less than 5% of people with MS. People with PRMS have a steady progression of symptoms from the onset, as well as occasional relapses. PRMS can start at any age.

The symptoms of MS vary widely from person to person and can affect any part of the body. Some of the most common symptoms include:

Fatigue: This is one of the most common and troublesome symptoms of MS. It is an overwhelming sense of exhaustion that can make everyday activities difficult or impossible.
Vision problems: These can include blurred vision, double vision, loss of vision, colour blindness, eye pain or flashes of light. These are often caused by inflammation or damage to the optic nerve (optic neuritis).
Numbness and tingling: These are abnormal sensations that can affect different parts of the body, such as the arms, legs or trunk. They are caused by damage to the sensory nerves.
Muscle spasms, stiffness and weakness: These are problems with muscle function that can affect movement, balance and co-ordination. They are caused by damage to the motor nerves.
Pain: This can be acute or chronic pain that can affect different parts of the body. It can be caused by nerve damage (neuropathic pain) or muscle spasms (musculoskeletal pain).
Problems with thinking, learning and planning: These are cognitive problems that can affect memory, attention, concentration, reasoning and problem-solving. They are caused by damage to the brain tissue.
Depression and anxiety: These are emotional problems that can affect mood, motivation and self-esteem. They can be caused by the impact of living with MS or by changes in brain chemistry.
Sexual problems: These can include reduced libido, erectile dysfunction, vaginal dryness or difficulty reaching orgasm. They can be caused by physical or psychological factors.
Bladder problems: These can include urinary urgency, frequency, incontinence or retention. They can be caused by damage to the nerves that control bladder function.
Bowel problems: These can include constipation, diarrhoea or faecal incontinence. They can be caused by damage to the nerves that control bowel function.
Speech and swallowing difficulties: These can include slurred speech, difficulty finding words or swallowing food or drink. They can be caused by damage to the nerves that control speech and swallowing.

The severity and impact of these symptoms can vary from person to person and over time. Some people may only experience mild or occasional symptoms, while others may have more severe or frequent symptoms that affect their quality of life. The symptoms can also be influenced by factors such as stress, infection, temperature, medication or menstruation.

MS can be a challenging condition to live with, but there are ways to manage the symptoms and cope with the changes. There are various treatments available for MS, such as medication, therapy, surgery or complementary therapies. These can help reduce inflammation, prevent relapses, slow down progression, relieve symptoms or improve function. There are also support services and resources available for people with MS and their families, such as MS nurses, physiotherapists, occupational therapists, counsellors, social workers or support groups. These can provide information, advice, guidance, practical help or emotional support.

MS is not a fatal condition, but it can affect life expectancy to some extent. The average life expectancy for people with MS is about 5 to 10 years lower than the general population. However, this can vary depending on the type of MS, the age of onset, the severity of symptoms and the availability of treatment. Many people with MS can live long and fulfilling lives with the right care and support.

If you want to learn more about MS, you can visit the following websites:

MS Society: A UK charity that provides information, support and research for people affected by MS.
MS Trust: A UK charity that provides information, education and specialist services for people living with MS.
NHS: The UK’s national health service that provides information and advice on health conditions and treatments.

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