This last week, during a conversation about emotional processing, I had one of those moments where several things I already understood suddenly connected in a way I hadn’t consciously considered before.
We were talking about interoception: the sensory information we receive from inside our bodies. Hunger, thirst, temperature, pain, heart rate and all of those internal signals that help us understand what is happening to us physically. We were also talking about how autistic people can experience differences in how strongly we notice and respond to sensory information.
During this discussion, I suddenly thought: hang on — what about emotions?
Emotions aren’t themselves a sensory system, but we experience them partly through sensory information from within our bodies. A racing heart, tightness in the chest, heat, nausea, tension or that difficult-to-describe sense that something internally has shifted can all form part of an emotional experience.
So if the way we perceive internal sensory information can differ, what might that mean for how we experience and recognise our emotions?
That question immediately connected with something else: alexithymia.
Noticing that something is happening inside my body isn’t necessarily the same as knowing what I’m feeling, and knowing what I’m feeling isn’t necessarily the same as being ready or able to communicate it.
Suddenly, concepts that are often discussed separately — sensory processing, interoception, alexithymia, emotional regulation and communication — didn’t feel particularly separate at all.
What emotion feels like before it has a name
When I started thinking about this through my own experience, I realised that I don’t necessarily experience an emotion first as a word.
Excitement, for example, can be incredibly physical. If there’s something I’m looking forward to, I might notice a little flip in my chest even when I wouldn’t describe myself as experiencing a huge spike of excitement consciously. When I’m excited about something I’m working towards, there’s sometimes a feeling almost like being in a roller-coaster car firmly attached to the track: there’s momentum, direction and a very definite sense that I’m heading towards something I want.
Love and pride can be physical too. At times I’ve experienced them as an almost bursting feeling in my chest.
None of those sensations tells me, by itself, “this is excitement” or “this is pride.” They are information from my body that forms part of the emotional experience. Recognising what that information means is another process.
Other times, I notice the evidence of an emotion somewhere else first. I might realise I’m becoming unusually impatient, snappy or defensive before I’ve consciously identified that I’m overwhelmed or frustrated. The response can arrive in my awareness before the emotional label does.
Where interoception fits
Research into interoception in autism doesn’t give us a straightforward picture of autistic people simply being more or less sensitive to internal signals.
A 2025 systematic review and meta-analysis by Klein, Witthöft and Jungmann looked at 31 studies of interoception in autistic people. The findings varied depending on what aspect of interoception was being measured, with studies reporting reduced, increased and similar interoceptive abilities. In adults, their meta-analysis found no significant difference in cardiac interoceptive accuracy between autistic and non-autistic participants.
A 2024 review by Loureiro, Ringold and Aziz-Zadeh similarly concluded that research into interoception in autism remains mixed. However, interoception doesn’t exist in isolation: the internal information our bodies provide interacts with cognition, sensory processing and emotional processing.
So perhaps the more interesting question isn’t whether autistic people are more or less interoceptively sensitive overall.
I’m more interested in what happens when the way we notice, experience and interpret information from inside our bodies differs, particularly when some of that information forms part of an emotional experience.
If my heart is racing, my chest feels tight, my stomach has shifted or my whole body suddenly feels different, I’m receiving information. That information doesn’t arrive conveniently labelled anxiety, excitement, anger or overwhelm; noticing the signal and understanding what the signal means aren’t necessarily the same thing.
This is where the connection with alexithymia becomes particularly interesting. A 2024 systematic review and meta-analysis by Van Bael and colleagues found relationships between self-reported interoceptive processing and alexithymia, particularly difficulties identifying and describing feelings, although those relationships differed depending on how interoception was measured.
For me, that research provides an interesting framework for something I recognise in my own experience: my body can be giving me information before I necessarily know what that information means emotionally.
Then there is alexithymia
For a long time, I attributed many uncomfortable internal experiences to anxiety. Looking back, I don’t think everything I called anxiety necessarily was anxiety. Anxiety was simply one of the emotional experiences I knew how to recognise and had language for.
Over time, I’ve developed a more nuanced understanding of different emotional states. Sometimes I recognise what I’m feeling fairly readily. At other times, I seem to work it out through a combination of what is happening in my body, what is happening around me and what I’m noticing in my own responses. Sometimes the understanding comes retrospectively.
Even writing this is difficult, because sitting here while I’m not anxious and trying to explain exactly how I know I’m anxious when I am anxious requires me to reconstruct an internal process that isn’t necessarily conscious at the time.
That, for me, is where alexithymia becomes particularly interesting.
It isn’t that the emotion isn’t happening. It isn’t necessarily that I’m unaware of everything happening inside my body either.
The difficulty can be in translating an internal experience into an emotional concept that I can recognise, differentiate and eventually put into words.
When somebody expects an answer
If identifying what I’m feeling can take time, that creates another difficulty: other people don’t necessarily know that I’m still processing it.
If somebody asks me “What’s wrong?” sometimes I can answer quite easily. If something has activated my sense of justice, for example, I can often identify what has happened and explain why I’m upset.
However, it isn’t always that straightforward.
Sometimes I know that something feels wrong without being entirely sure what that feeling means. What I initially think is wrong might not actually be the problem at all; it might be my interpretation of the situation because of the feeling it has created.
There are also times when I know exactly what has annoyed me, but saying it out loud makes it suddenly sound almost trivial. The feeling itself isn’t trivial, but explaining “this particular thing happened and it annoyed me” doesn’t necessarily communicate everything that sits behind my response. Sometimes that makes me reluctant to explain it at all.
There are also experiences I genuinely can’t put my finger on yet. I know I have a feeling about a person or a situation, but I don’t necessarily know what the feeling is or what information it’s giving me.
I’ve learned not to completely disregard those experiences. Sometimes I mentally make a note of them and carry on. Then, as more information becomes available, pattern recognition kicks in and something that didn’t make sense at the time becomes much clearer retrospectively.
So when I say “I don’t know”, that can be a completely accurate answer. It doesn’t necessarily mean that I don’t feel anything, or even that I haven’t noticed that something is happening. Sometimes I simply haven’t processed enough of the information yet to know what it means.
Perhaps these things aren’t as separate as they seem
The more I’ve thought about this, the more I’ve realised how easy it is to learn about autism as a collection of separate concepts. We talk about sensory processing. Then interoception. Then alexithymia. Then emotional regulation. Then communication.
That isn’t necessarily how I experience them.
My body can be giving me information before I know what that information means emotionally. I can know that I’m feeling something without being able to identify it. I might recognise it through my responses before I can put a name to it, or understand it later when I’ve had more time and information to process. Somewhere within all of that, another person might also be waiting for me to explain what’s happening.
Understanding those connections changes the way I think about “I don’t know.”
It doesn’t necessarily mean there is nothing happening internally. It doesn’t mean I don’t have feelings, that I’m unwilling to talk about them, or that I’m avoiding the question.
Sometimes “I don’t know” really means “I don’t know yet.”
Perhaps giving somebody the time and space to reach the “yet” is more useful than expecting an immediate answer.