The relationship between interoception and experiences of stress, trauma, and mental illness: A scoping review

Abstract

Introduction Interoception—the process of sensing, interpreting, and integrating internal bodily signals—plays a critical role in emotional regulation, behaviour, and wellbeing. In counselling and psychotherapy contexts, impaired interoception is increasingly recognised as associated with how clients experience and respond to stress, trauma, and mental illness. This scoping review aimed to explore the relationship between interoception and these psychological conditions and to determine whether they are associated with heightened (hyper) or reduced (hypo) interoceptive sensitivity. Method A scoping review methodology was used, involving a comprehensive search of four major databases—MEDLINE (Ovid), PsycINFO (Ovid), Embase (Ovid), and CINAHL (EBSCO)—for peer-reviewed articles published between 2014 and October 2024. The screening process included title and abstract screening followed by full text review. Data were synthesised narratively. Results A total of 48 studies were included, covering trauma (n = 17), mental health conditions (n = 14), eating disorders (n = 10), and stress-related physical health issues (n = 7). Most studies reported impaired interoception across these conditions. Reduced awareness and interpretation of bodily signals (hypo-sensitivity) were more commonly reported than heightened sensitivity, although variability existed across conditions. Conclusion Findings support the relevance of interoception and its relationship to wellbeing in counselling and psychotherapy. In particular, findings suggest that trauma, especially interpersonal trauma, may be associated with clients’ tendencies to avoid bodily awareness, potentially as a protective strategy, and this may co-occur with increased external vigilance. These insights underscore the value of trauma-informed and body-oriented therapeutic approaches. Supporting clients in safely reconnecting with their bodily experiences may enhance emotional regulation and facilitate psychological healing in counselling and psychotherapy settings.