The slow part was never the body
From the clinician's chair, the body was never the slow one. Interoception was, and there is a name for the missing part.
There is a man in Texas who spent thirteen years measuring his own body and could not, in all that time, tell from the inside whether it had changed. He built a gym in his garage. He logged every set and every rep. Once a year he lay down inside a machine that fires low-dose X-rays through you and prints your bone, fat and lean tissue to the gram, because that printout was the only way he could find out what his own body had been doing while he lived in it.
His name is Jon Mick. He writes a newsletter called AI Gave Me Autism, and his latest piece, ‘I was late to my own body’, is one of the most exact accounts of neurodivergent interoception I have read anywhere, inside the clinical literature or out of it. Read it first. Then come back, because I want to take the single step his essay leaves sitting there, and it is a step from my side of the desk rather than his.
Jon’s word for what happened to him is ‘late’. He read the relationship manuals at ten. He built a theory of his own working memory before he could feel which of his thoughts was the fragile one. The body, he writes, was the last room in the house he entered, and he got there in his forties. It is a fine frame and it is carrying real weight. I want to lean on exactly one plank of it.
The body was not late. The body was early, loud, and largely ignored. By Jon’s own account it spent his childhood screaming: he describes lying in bed while the room stretched to three hundred feet and enormous footsteps came up the street, landing in time with his heartbeat. Read that again. The footsteps kept time with his pulse.
That is not a poetic touch. The heart really does shape what we see and fear. Garfinkel and Critchley have shown that a frightening face flashed at the exact instant your heart beats registers as more frightening than the same face a moment later, in the gap between beats (Garfinkel et al., 2014). Your pulse is not background noise to your perception. It is one of the instruments in the orchestra. A frightened ten-year-old whose monsters marched in time with his heartbeat was not making a film. He was reading a signal, accurately, in the only language then available to him, which was terror in Cinemascope.
So if the body was on time, what was late?
The reading of it. And the reading of the body is not one skill but two, stacked, and my trade has a name for each.
The first is interoception: the sense you have of your own insides. Heartbeat, breath, the gut, the tight chest, the full bladder, the specific ache that means you are about to cry. Some people have a clear channel to all of this. Others have a channel full of static. Jon’s ran to static, so he did the only sensible thing a static-blind man can do, which was to outsource the job to a bone scanner. Knowing your body fat to one decimal place while having no idea you are frightened is not a contradiction. It is a man reading his body the one way it would let him: from the outside, in numbers, after the event.
The second layer is stranger, and it is where the real news sits. On Lisa Feldman Barrett’s account of emotion, a feeling is not a thing that arrives fully formed and waits to be noticed. It is a thing the brain builds, on the spot, from two ingredients: a raw signal from the body, and a concept to make sense of it (Barrett, 2017). Tight chest under the concept ‘dread’ is assembled into dread. The same tight chest under the concept ‘excitement’ is assembled into excitement. No concept, and the signal stays noise. No signal, and the concept has nothing to work with and builds precisely nothing.
Now stand Jon in that factory. He had concepts. He had a cathedral of them, with flying buttresses and a gift shop. What he did not have was a clean signal coming up from the boiler room, so the assembly line ran beautifully and produced an immaculate empty floor, the way the most advanced robot arm in the world produces nothing at all if no stock ever arrives on the conveyor. He was not bad at feelings. He was missing a part, and it was the part underneath the words.
There is a clinical name for the missing part, and Jon, tellingly, never reaches for it. The name is alexithymia. It means, roughly, ‘no words for feelings’, which is a small joke the Greek has played on the condition, because the words were never really the problem. Jon has all the words. The problem is the thing the words are supposed to point at.
Here is where the discipline earns its keep, and where the finding turns genuinely contrarian. Alexithymia rides alongside autism in a large minority of cases, somewhere between forty and sixty-five per cent of autistic adults by the estimate in the paper that named the hypothesis (Bird & Cook, 2013). And the argument Geoffrey Bird and Richard Cook actually make is the sharp one. The emotional flatness the world has spent decades pinning on autism itself—doesn’t feel much, can’t read a room, low on empathy—is, where it shows up at all, better explained by the alexithymia travelling with the autism than by the autism. The two go about together often enough to be mistaken for one thing. They are not one thing. And that distinction matters enormously, because the autism is a way of being and the alexithymia is a reading problem, and reading problems can be worked on.
Which is exactly what Jon did, and how he did it is the part I most want other clinicians to sit with. He did not think his way into his body. He changed the conditions and let the body back in. Neurofeedback retrained the hardware until the anxiety he had run as ambient weather his whole life finally stood out as a discrete sensation he could point at. A coach sat with him, unhurried, one quiet hour a week, and taught him the language of a signal he had never been able to hear. Working alone, with no clinical training and a great deal of stubbornness, he arrived at the least fashionable conviction a counselling psychologist can hold, which is that mindset is mostly downstream of environment. You do not affirm your way to a feeling. You change the room, and then the room lets you feel.
There is one more thing in his essay that made me laugh out loud in recognition. When the anxiety first spiked, Jon steadied himself by naming three colours he could see, two textures he could feel, one sound he could hear. That is a clinical grounding protocol, and he reinvented it on his own chest at ninety seconds’ notice, without the name for it. Putting a feeling, or a sensation, into words does not merely describe it. It measurably quiets the brain’s alarm (Lieberman et al., 2007). The man was doing therapy to himself in a text message.
Now the part that implicates all of us, me included. Our culture, and a good slice of my own profession, keeps quietly confusing thinking about a feeling with feeling it. Insight-oriented therapy, handed to an articulate person, can become a machine for producing ever more sophisticated ways of not feeling the thing. More concepts. Better maps. A more elegant account of the grief, delivered dry-eyed. And the better the map gets, the less often anyone visits the territory, until one day you can narrate your own sadness in clean prose and feel nothing come up from below while you do it. The most articulate person in the room is not always the one most in touch with what they feel. Sometimes they are the one who has built the finest available cage out of vocabulary.
Stand far enough back and we are mammals who evolved a nervous system a few hundred million years before we evolved a word for anything it did. Interoception is the old technology. Language is the bolt-on. And a certain kind of clever, wired-sideways human learns the bolt-on so well and so young that they mistake the running commentary for the thing being commented on, and spend forty years describing a house they have never actually been inside.
Jon is inside the house now. He ends his essay in a chair on his patio, a small sadness moving through him, arriving and landing and staying a while and leaving, the whole thing over in about four minutes and no experiment required to tell him what it was. A year earlier he had needed a controlled test to work out what his own chest was doing. Now the reading comes free.
The late arrival of a feeling is not a verdict on your character but a location on a map. It tells you where the missing part is. And a missing part, unlike a character flaw, is something that can one day be fitted.
References
Barrett, L. F. (2017). The theory of constructed emotion: An active inference account of interoception and categorization. Social Cognitive and Affective Neuroscience, 12(1), 1–23. https://doi.org/10.1093/scan/nsw154
Bird, G., & Cook, R. (2013). Mixed emotions: The contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry, 3(7), e285. https://doi.org/10.1038/tp.2013.61
Garfinkel, S. N., Minati, L., Gray, M. A., Seth, A. K., Dolan, R. J., & Critchley, H. D. (2014). Fear from the heart: Sensitivity to fear stimuli depends on individual heartbeats. The Journal of Neuroscience, 34(19), 6573–6582. https://doi.org/10.1523/JNEUROSCI.3507-13.2014
Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, S. M., Pfeifer, J. H., & Way, B. M. (2007). Putting feelings into words: Affect labeling disrupts amygdala activity in response to affective stimuli. Psychological Science, 18(5), 421–428. https://doi.org/10.1111/j.1467-9280.2007.01916.x