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Why are our senses important? Hypermobility issues and autism/neurodiverse differences



Astronaut sitting in chair


There were 5 senses, smell, taste, sight, touch and sound then later when I started teaching followed by vestibular and proprioception senses. This was new, to us anyway, and we thought it was ground breaking. Vestibular is akin to the astronaut landing back on Earth after travelling in space. Your sense of horizontal or vertical axis is offline so slightly defective. Which is part of why astronauts are carried out of the space pod after landing back on Earth. Proprioception is the sense of knowing where the parts of your body are without you actually looking at them. I used to teach delegates a little exercise in my conferences or training and they always loved it. Little did I know then that I would have to practise these exercises in physiotherapy regularly after my soon to be various injuries due to hypermobility issues. Cats use their whiskers in this way to work out their environment.


Picture of cat’s whiskers So the other sense, interoception, relates to our internal sense of knowing our physical, mental and emotional states. Bringing up my eldest child we faced a few issues. I brought up my children and I volunteered in playschools or primary so my eldest didn’t face informal exclusion, which was quite common with certain groups of children. My eldest didn’t know if they were hot or cold, hungry or not, never thirsty. Pain was another issue. Both my children had severe eczema and eldest would scratch but not really notice the pain. Nothing ever bothered them except for stomach cramps at night and they would be very long nights until suddenly the pain would be really overwhelming and seem to come ‘right out of the blue’. Or it can be a sensation and my eldest was worried with a pain in abdomen but turned out to be a stitch after a bout of laughing. Same with the itch sensation. Everything was put down to being autistic but in fact interoception can affect differences in body health understanding as well as the added complexity of recognising emotions and regulating them both mentally and physically for hypermobility and autistic/neurodiverse people.

Goodhall (2018) We are so used to pain it can be hard to articulate and express when we are asked on a scale of 1-10 to grade it. I still can’t work it out and then worry I have said it wrong and want to alter it. If we have acute and persistent pain regularly that becomes more complex. Also when in pain some of my expressive speech seems to disappear. It might be that I am also slightly anxious in medical situations or environments due to past experiences. References

https://pubmed.ncbi.nlm.nih.gov/26724504/ accessed 15.9.20 Critchley H. D., Garfinkel S. N. (2017). Interoception and emotion. Current Opinion in Psychology, 17, pp. 7-14.

Clinch J et all, 2011 accessed 25.9.20 https://pubmed.ncbi.nlm.nih.gov/21547894/ Eccles, J.A., Beacher, F.D., Gray, M.A., Jones, C.L., Minati, L., Harrison, N.A., & Critchley, H.D. (2012). Brain structure and joint hypermobility: relevance to the expression of psychiatric symptoms. The British journal of psychiatry: the journal of mental science200 (6), pp. 508–509.

Eccles J, Iodice V, Dowell N, et al, 2014 JOINT HYPERMOBILITY AND AUTONOMIC HYPERACTIVITY: RELEVANCE TO NEURODEVELOPMENTAL DISORDERS Journal of Neurology, Neurosurgery & Psychiatry 2014;85:e3. Eccles, J., Iodice, V., Dowell, N, et al. (2014). Joint hypermobility and autonomic hyperactivity: relevance to neurodevelopmental disorders. Journal of Neurology, Neurosurgery & Psychiatry, 85:e3.

Eccles, J., & Owens, A., Mathias, C., Umeda, S., & Critchley, H. (2015). Neurovisceral phenotypes in the expression of psychiatric symptoms. Frontiers in Neuroscience, 9 (4). Garfinkel, S. N., & Critchley, H. D. (2013). Interoception, emotion and brain: new insights link internal physiology to social behaviour. Commentary on: “Anterior insular cortex mediates bodily sensibility and social anxiety” by Terasawa et al. (2012). Social cognitive and affective neuroscience, 8 (3), pp. 231-234. Eccles, J (2020) https://www.medrxiv.org/content/10.1101/2020.09.14.20194118v1.article-info Accessed 25.9.20 Garfinkel, S. N., Tiley, C., O’Keeffe, S., Harrison, N. A., Seth, A. K., & Critchley, H. D. (2016). Discrepancies between dimensions of interoception in autism: Implications for emotion and anxiety. Biological psychology, 114, pp. 117-126. Goodhall E, (2018) https://www.youtube.com/channel/UCyIovxevV3W2l2WXHDBkKxA Accessed 24.9.20 Tsakiris, M., & Critchley, H. (2016). Interoception beyond homeostasis: affect, cognition and mental health. Phil. Trans. R. Soc. B, 371. https://sites.google.com/site/ehlerdanlosfordummies/the-history-of-eds accessed 31.8.20 https://autismawarenesscentre.com/interoception-and-autism-body-awareness-challenges-for-those-with-asd/ accessed on 4.9.20 Green, J 2020 in EDPsy.UK 2020 https://edpsy.org.uk/blog/2020/raising-awareness-of-pupils-with-ehlers-danlos-syndromes-hypermobility-spectrum-disorders/ Accessed on 9.9.20 Critchley, H. D., Eccles, J., & Garfinkel, S. N. (2013). Interaction between cognition, emotion, and the autonomic nervous system. Handbook of clinical neurology117, 59–77. https://doi.org/10.1016/B978-0-444-53491-0.00006-7 Tsakiris, M., & Critchley, H. (2016). Interoception beyond homeostasis: affect, cognition and mental health. Phil. Trans. R. Soc. B, 371. https://sites.google.com/site/ehlerdanlosfordummies/the-history-of-eds accessed 31.8.20

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