Interoception and emotional regulation: Your client’s missing skill
If you work in mental health, coaching, occupational therapy, speech-language pathology, or any field that supports people’s relationship to their inner world, you have almost certainly watched this play out:
A client who can articulate their emotional patterns with sophistication. Who understands their triggers. Who has a solid toolkit of regulation strategies. And who still, reliably, finds themselves dysregulated in ways they cannot predict or control.
The work is clearly happening. The insight is real.
But, something is still missing.
In my experience building Color Mending and working across practitioner communities for six years, that something is almost always the same thing:
Interoception.
A quick note before we go further
Interoception is the foundational sensory skill that supports both how people process sensory information from the outside world and how they interpret emotional signals from the inside.
Those are two distinct applications of the same underlying system, and both matter clinically.
This post focuses on the emotional regulation side. Specifically, the connection between interoceptive awareness and a client’s ability to identify, understand, and respond to their own emotional states.
That is where Color Mending lives, and where I can speak from direct experience.
Practitioners working in sensory integration or SPD contexts will recognize the same foundational science underneath their work. The sensory and emotional regulation applications of interoception are closely related and, in practice, often overlapping.
The top-down gap
Most of the established emotional regulation frameworks in widespread clinical use are top-down approaches.
Top-down regulation works through cognition. It intervenes at the level of thought: identifying cognitive distortions, reframing interpretations, developing coping scripts, and building metacognitive awareness.¹
Cognitive Behavioral Therapy is the prototypical example. Dialectical Behavior Therapy’s cognitive components are another. Most psychoeducation models fall into this category.
These approaches are evidence-based and genuinely effective for many clients. This is not a critique of them.
What they share, however, is a common assumption: that the client can access their emotional signals clearly enough to apply a cognitive intervention to it.
The thought can be identified. The distortion can be named. The feeling can be labeled.
For clients whose interoceptive awareness is underdeveloped, that assumption does not hold.
When interoceptive signals are unclear, arrive late, or are poorly differentiated, the client is working with noisy data. By the time the emotional state has become legible, meaning loud enough to name or intense enough to notice, the window for early, flexible intervention has often already closed.²The cognitive tools arrive after dysregulation is already underway.
This is why many clients report that regulation strategies that “should work” often don’t. Not because the strategies are wrong. Because the prerequisite skill, accurate interoceptive awareness, is not yet in place.
Bottom-up regulation and why interoception is its foundation
Bottom-up regulation approaches start with the body, with the physiological, sensory, and somatic data that precede conscious emotional labeling.³
Somatic Experiencing, sensorimotor psychotherapy, EMDR, and body scan-based mindfulness practices all operate in this domain.
What these approaches have in common is that they work with body signals directly, rather than filtering everything through cognitive interpretation first. They trust the body as a source of information rather than a site of symptoms to be managed.
This is more aligned with what neuroscience shows us about how emotions work.
According to Dr. Lisa Feldman Barrett’s Theory of Constructed Emotions,⁴ emotional experience is not triggered by external events and transmitted to the brain for labeling. It is constructed by the brain from interoceptive body signals, filtered through past experience, and filtered through current context.
The body signal comes first. The emotional label is built on it.
This means interoception is not just useful for regulation. It is the sensory input the brain uses to build the emotional experience in the first place.
Regulation tools work on the emotion. Interoception works on what created it. One is responding to the fire. The other is watching for smoke
What underdeveloped interoception looks like in a clinical context
In practice, interoceptive underdevelopment tends to present in ways that can be mistaken for resistance, lack of motivation, or emotional avoidance.
This includes clients who…
Say, “I don’t know how I feel,” not as deflection, but as a genuine report of their experience.
Can discuss their emotions analytically, but cannot feel them in the body in the present moment.
Experience dysregulation suddenly and at high intensity, without the graduated early signals that would allow earlier intervention.
Report that body-based regulation exercises like breathing, grounding, and mindfulness “don’t work” for them (this is often because the interoceptive channel those exercises depend on is not yet reliable or developed enough).
Research consistently shows that lower interoceptive awareness correlates with more difficulty identifying and verbalizing emotional states, greater difficulty reducing the emotional impact of negative experiences, and reduced effectiveness of both top-down and bottom-up regulation strategies.⁵
The implication for practitioners is significant: before asking a client to use a regulation tool, it is worth considering whether the client has sufficient interoceptive access to use it.
Interoception as a trainable prerequisite
The good news is that interoceptive awareness exists on a spectrum and can be developed at any age through targeted, body-focused practice.⁶
This is relatively well established in occupational therapy, where interoception work has been part of sensory integration practice for decades. It is less consistently integrated into talk therapy, coaching, and other mental health modalities. Which is, I would argue, one of the more significant gaps in the current emotional regulation landscape.
Research on interoceptive training demonstrates improvements in interoceptive accuracy, emotional awareness, and emotion regulation outcomes across populations.⁷
The mechanisms are increasingly well understood: consistent non-judgmental attention to body sensation strengthens the neural pathways through which interoceptive signals are received, interpreted, and made available to conscious processing.
The practical implication: interoceptive training is not a complement to regulation work. For many clients, it is the prerequisite that makes regulation work viable.
How Color Mending fits into this
Color Mending is a body-based, interoception-forward emotional regulation methodology. It is not therapy, and it is not a replacement for clinical care. It is an educational tool. Specifically, a structured daily practice that builds interoceptive skills through a consistent, accessible process.
Color Mending comprises of two steps.
The first step is intuitive coloring.
To determine what to color about, a client identifies a feeling they can’t name, a pattern they’ve noticed, or a question that has been on their mind.
After selecting a topic, the client then completes a body scan while thinking about what they selected. They are looking for the noisiest part, or the strongest sensation, in their body. They are not labeling an emotion. They’re looking for a physical sensation. Where it is. What it feels like. How loud it is.
Once they have found the noisiest spot, they color out the sensation using any color and shape they want. They continue coloring until it feels complete.
The second step is decoding the coloring.
Using the proprietary Color Mending Color and Shapes Charts, clients begin gathering clues about what their coloring represents.
Clients then draw meaning from the clues, make connections, and gain a clearer perspective about what the body signal was communicating.
What this builds, practiced consistently over time, is exactly the interoceptive capacity the research describes as a prerequisite to effective regulation: the ability to notice body signals earlier, more accurately, and with greater differentiation.
For practitioners, this creates a meaningful clinical complement.
Clients who are struggling to access their emotional signals in session, or to apply regulation strategies effectively between sessions, can build an interoceptive foundation through a consistent Color Mending practice.
They can also bring their insights gathered from their coloring sessions into the clinical setting to discuss with practitioners.
Color Mending supports, rather than replaces, clinical work. Practitioners who are interested in introducing it to clients are pointing clients toward a body literacy tool grounded in the same neuroscience that underlies their own practice.
Experience Color Mending for free
If you are a licensed therapist, counselor, coach, or other practitioner who sees Color Mending as a useful complement for your clients, use the link below to schedule a 45-minute Color Mending session with Chelsea K-K, the creator of Color Mending.
During this coloring session, Chelsea will guide you through a session and teach you how practitioners around the world are using this methodology with their clients.
References & further reading
The following sources directly inform the content of this article. For readers who want to go deeper into the science, each is worth your time!
1. Hofmann, S.G., Asnaani, A., Vonk, I.J.J., Sawyer, A.T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. (Widely cited review of CBT efficacy, establishing its status as a top-down, cognitively mediated intervention.) https://pmc.ncbi.nlm.nih.gov/articles/PMC3584580/
2. Panayiotou, G., et al. (2022). Interoceptive attention facilitates emotion regulation strategy use. Journal of Affective Disorders. PMC. (Research demonstrating that interoceptive attention is positively associated with the use of adaptive and flexible emotion regulation strategies — establishing interoception as a prerequisite for effective regulation.) https://pmc.ncbi.nlm.nih.gov/articles/PMC9512845/
3. Price, C.J. & Hooven, C. (2018). Interoceptive awareness skills for emotion regulation: Theory and approach of Mindful Awareness in Body-Oriented Therapy (MABT). Frontiers in Psychology, 9, 798. (The foundational paper describing interoceptive awareness as a distinct, trainable skill underlying effective emotion regulation, with a framework for how to develop it clinically.) https://pmc.ncbi.nlm.nih.gov/articles/PMC5985305/
4. 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. (Peer-reviewed paper establishing that emotions are constructed from interoceptive body signals and past experience — not triggered by external events. The foundational neuroscience for understanding why interoception is structurally prior to emotional regulation.) https://pmc.ncbi.nlm.nih.gov/articles/PMC5390700/
5. Longarzo, M., et al. (2019). Relationship between interoception and emotion regulation: New evidence from mixed methods. PubMed. (Research finding that lower interoceptive ability is associated with greater difficulty verbalizing feelings and reducing the impact of negative emotional experiences in daily life.) https://pubmed.ncbi.nlm.nih.gov/30599372/
6. Mahler, K. (2019). Interoception: The Eighth Sensory System. / Mahler, K., McLaughlin, E., & Anson, D. (2020). Interoception Across Varying Degrees of Mental Wellness. American Journal of Occupational Therapy, 74(S1). (Research establishing that interoceptive awareness is trainable at any age, and that it exists along a spectrum across the population regardless of clinical diagnosis.) https://www.kelly-mahler.com/what-is-interoception/
7. Nikolaidis, N.P., et al. (2024). Interoceptive ability and emotion regulation in mind-body interventions: An integrative review. PMC. (Review of evidence demonstrating that interoceptive training improves interoceptive accuracy, emotional awareness, and regulation outcomes across populations and modalities.) https://pmc.ncbi.nlm.nih.gov/articles/PMC11591285/
