Interoception: telling anxiety from intuition and how it works in therapy

Is that tightness in your chest fear, or is it trying to tell you something true?

You're about to say something to a partner. Something real. A boundary. A new relationship. A scene you have been wanting to try. Right as you open your mouth, your stomach drops. Heart picks up. Chest goes tight.

So you stop. Is this fear? Or is this real information? Am I panicking, or am I finally listening to myself?

That question does not have an easy answer. It should not. Anxiety and intuition use the exact same body. Same fast heartbeat. Same tight stomach. Same flush of heat or cold. Your body hands you a raw sensation and your brain has to guess what it means, and it does not always guess right.

For a lot of the folx I work with, this mix up shows up constantly. You can spend years assuming every strong body signal is anxiety, or assuming every strong body signal is truth. Either way, you end up disconnected from a skill that was supposed to protect you.

Anxiety and intuition both live in the body. Telling them apart is a skill you build through practice.

What your body is trying to tell you

Interoception is the word for this whole system. It is your body's ability to sense what is happening on the inside. Your heartbeat. Your breathing. Whether your stomach is tight or settled. Whether you are hungry, full, tired, or overheated. Whether you need to use the bathroom. It is the internal version of the five senses, and most people never think about it because it runs quietly in the background.

For a lot of folx, it does not run quietly at all. Either it is too loud, spiking constantly and demanding attention, or it is too quiet, leaving you cut off from a body that is trying to talk to you.

Anxiety and intuition are two different things your brain builds out of that same internal signal. Anxiety feels loud, urgent, future focused. It is scared of what could happen. It comes with a story attached, a specific worst case scenario your mind is already rehearsing. Intuition feels quieter and steadier. It shows up like a fact you already know, plain and settled, without asking you to imagine a disaster first.

Neither one is fake. Both are your nervous system doing its job. The work is learning to notice which one you are hearing.

My own experience with interoception

As an autistic person, I have struggled with interoception for most of my life. I still do sometimes. Not realizing I need to use the bathroom until it is urgent. Not noticing how hungry or thirsty I am until I am lightheaded. Not catching that I am irritated until it comes out sideways in my tone, and someone else points it out before I do.

This is a common autistic experience. The signal is there. The wiring between the body and the part of the brain that names it does not always cooperate. Noticing what my body is doing takes deliberate attention. That attention is a skill I built on purpose. It did not come automatically.

When trauma turns up the volume on anxiety

Now a different spin on the same problem. Say you have lived through trauma, whether that trauma came from a relationship, a family, or somewhere else entirely. Your nervous system learned, correctly, that danger is real and that it can show up fast. Your body did exactly what it was built to do.

But it also means your anxiety can get loud. Really loud. It can start to sound almost like a bully, talking over everything else, including the quieter voice underneath it that might actually be your intuition. When anxiety has been running the show for years, it makes sense that it is the loudest voice in the room. It has had the most practice.

So the question becomes, how do you get in touch with the intuition that is still in there, underneath all that noise.

The cycle this creates between partners

This mix up rarely stays contained to one person. It shows up between partners too. Anxious attachment reaches for reassurance. Avoidant attachment needs space to process. When an anxious partner's alarm goes off, they often reach for a partner who cannot meet them in that exact moment, and there is always a reason for it, never nothing.

Anxious partners tend to need verbal reassurance and to feel prioritized. Avoidant partners tend to need spaciousness to process so they can communicate without feeling rushed. Neither need is wrong. When they collide, the work is negotiating who takes up space in a given moment, and making sure no one is relying on a single partner to meet every need.

This matters just as much in polyamory and open relationships as it does in a single pairing. The better you know your own signals, the better partner you can be, to one partner or to several.

Soothe the alarm before you trust the signal

Here is what I tell my clients. You cannot skip straight to trusting your gut when your gut has been hijacked by an alarm system that will not quiet down. The alarm has to be soothed first.

I call this inner child work. Picture your anxiety as a five year old version of you, mid tantrum, or frozen and scared. That part is doing the only thing it knows how to do to get your attention. Before you ask it to step aside, tend to it. That part might need a hug. It might need to hear that it is loved, protected, worthy of care exactly as it is. Ask what that part actually needs right now, and let the answer be simple.

In my practice I use Internal Family Systems, often shortened to IFS, to work with parts like this one. IFS starts from the idea that you are a whole internal cast of parts rather than one single unified self, each part with its own job. Some parts protect you. Some parts are younger and got hurt a long time ago and rarely get the floor. The work is getting curious about a part, learning what it needs, instead of trying to silence it.

The process usually looks like this:

1. Name the part. Give it a shape or a description. Naming a part is often the first step toward working with it instead of being run by it.

2. Learn its job. Ask what this part is trying to do for you. Almost always, it is trying to protect you from something, even when its method does not feel helpful anymore.

3. Notice if naming the job is already enough. Sometimes just seeing what a part is doing, and why, takes the edge off. The part feels heard. It quiets a little on its own.

4. Relieve the part of its burden, if it is ready. Other times, the part needs more than acknowledgment. It needs to know it does not have to carry this job alone anymore, that you as an adult can take some of the weight it has been holding.

5. Check back in with the body. Once the alarm has settled, notice what is left. This is usually where intuition becomes easier to hear, simply because there is less noise competing with it.

   
   

Once anxiety has been soothed, even a little, intuition gets easier to access. For a lot of people, intuition shows up as a plain statement of something you need. It is the calm voice in the back of your head.

A quick way to tell them apart

None of this is exact. It should not be. But there are patterns that tend to hold up when you are sorting out what you are feeling in the moment.

• Anxiety is loud, urgent, and focused on a future that has not happened yet. Intuition is quieter and focused on something that is already true right now.

• Anxiety comes with a specific catastrophic story attached. Intuition shows up without a story at all, just a plain sense of knowing.

• Anxiety spikes suddenly and escalates the longer you sit with it. Intuition stays steady, whether you sit with it for a minute or an hour.

• Anxiety wants you to do something right now, immediately, to make the feeling stop. Intuition is patient. It will still be there tomorrow.

  
  

This same sorting shows up outside of individual anxiety, too. It is part of what I walk clients through when they are considering opening a relationship. Are you opening from a place of strength or deficit. A lot of that question comes down to this exact skill. Are you moving toward something because you have actually thought it through and it feels clear, or are you moving because something loud and scared is telling you to act before you lose your nerve.

It also shows up in a scene. Negotiating limits, checking in mid scene, reading your own body during aftercare all ask the same question. Is this sensation telling you something true, or is it noise from an old alarm that has nothing to do with the person in front of you right now.

The overcorrection to watch for

Once folx learn that anxiety can lie to them, some swing hard the other way. Every strong feeling gets treated as intuition, the wise inner voice that must be obeyed immediately. That swing makes sense. If you have spent years ruled by a loud, scared part of yourself, a calm inner authority you can just trust sounds like relief.

But intensity by itself is not the test. A trauma response can feel just as certain as a genuine gut sense, especially early in this work, before you have had much practice telling them apart. This is part of why the soothing step matters so much. Skipping straight to trusting a feeling because it is strong, without checking whether it is scared or clear, just moves the same confusion to a new label.

The goal is not to hand your anxiety less authority and your gut more. The goal is to get curious about what is actually happening underneath either one, every time, until the pattern becomes familiar in your own body specifically.

In session, I do not rush past the anxiety to get to some cleaner, calmer version of you. I slow down and work with the part that is loud first, whether that is a fear about a partner, a decision about opening a relationship, or a scene that brought up more than expected. Once that part feels less alone, the quieter signal underneath it, the one that has probably been there the whole time, gets a chance to be heard. Sometimes this takes one conversation. More often it takes practice over weeks, since the body learns through repetition. Clients I work with on this usually come in weekly or biweekly while the skill develops.

If this is landing for you

If you are autistic, ADHD, or AuDHD and interoception has always felt harder than it seems to for other people, my work with neurodivergent adults is built around exactly this kind of nervous system honesty. More on that on my neurodivergent affirming therapy page.

If this shows up for you inside a scene, negotiating limits, or reading your own body during aftercare, my kink and BDSM page goes deeper into that territory.

And if this question of anxiety versus intuition is coming up around a decision to open a relationship, my ethical nonmonogamy page walks through the strength or deficit framework in full.

There is no template for this. Every person I work with notices their own signals differently, and the pace of learning to tell them apart is different for everyone too.

Reach out to book a free consult and let's talk about whether this is a fit.

Maya Attia, LMFT #139693