Interoception and Massage Therapy

Written By Jenn Sharman

Summary: Interoception - our ability to sense internal bodily signals - plays a key role in how we experience stress, pain, and emotion. Interoceptive awareness can be disrupted by chronic pain, stress and trauma. Massage therapy can help reconnect people with their body through attuned touch, enjoyable sensations, and mindful presence, supporting a greater sense of grounding, safety, and embodiment.

What is Interoception?

Have you ever noticed that after a massage you feel more grounded, calm, or simply more in tune with your body? That perception is closely tied to interoception - our ability to sense the internal signals of the body.

We experience interoceptive signals as physical sensations and feelings (such as sensing our heartbeat, our breathing, warmth, tension/discomfort, pain, anxiety, calmness or ease) and these sensations influence our thoughts, emotions, and behaviours. Interoception helps maintain internal balance (homeostasis) and plays a key role in how we respond to stress and influences our capacity for emotional regulation.

Interoceptive awareness involves both noticing internal signals and interpreting them accurately. When interoceptive awareness is disrupted, due to ongoing stress or trauma for example, it can become harder to recognize what we’re feeling, to regulate our emotions, or stay present in our body.

For RMTs, this matters because:

  • Many people have challenges with interoceptive awareness, especially those living with chronic pain, trauma, or stress.

  • Massage therapy can gently support reconnection with those internal signals - through attuned touch, enjoyable sensations/pressure, and guided awareness, helping people feel more embodied, aware of, and responsive to their body’s signals.

🌿 Interoception and Massage Therapy

Massage therapy may support interoceptive awareness by first helping people connect with enjoyable external sensory inputs during the massage. These external inputs can be grounding and calming for the nervous system - especially for individuals who may otherwise find it difficult or overwhelming to tune into what’s happening inside. By becoming aware of subtle sensations like soothing warmth, steady pressure, and rhythmic movement, patients may be able to gradually build their capacity to notice internal states. 

Building interoceptive awareness is not about fixing or forcing anything - it’s about supporting patients to notice their internal sensations with greater clarity and ease, and to reconnect with their own embodied experience in a way that feels safe, enjoyable and empowering.

Massage, Meditative States & Interoception

Meditation is often studied as a path to increasing interoceptive awareness. Research shows that meditation modulates activity in the insula (the brain’s central hub for interoception) and it's increasingly understood that many of the benefits of mindfulness may be explained by enhanced interoceptive awareness. 

Gentle, rhythmic, and attuned massage can invite a meditative state and support nonverbal, body-based interoceptive engagement. 

Massage therapist and researcher Dr. Cynthia Price developed an approach to help people develop interoceptive awareness called Mindful Awareness in Body-Oriented Therapy (MABT). MABT supports patients in developing the ability to identify, access, and appraise internal bodily signals, which are considered key components for emotional regulation.

As research in this area continues to grow, it will be exciting to see how touch-based therapies like massage are further integrated into interoceptive and mindfulness-based health interventions.

How Massage Supports Interoceptive Awareness

1. Activation of the Parasympathetic Nervous System

Enjoyable touch, provided by a trusted and attuned massage therapist can promote parasympathetic activation - often referred to as the "rest-and-digest" state. In this relaxed state, patients may be better able to notice internal cues such as breathing patterns, sensations of tension or ease, or digestive activity - without feeling overwhelmed (softened emotional reactivity and reduced overall distress have been noted in research on the topic).

2. Integration of Proprioception and Interoception

Massage engages proprioceptive input (from movement, pressure, and limb positioning) and may engage brain regions like the insula that help process internal sensations.

The input to these systems may help individuals:

  • Locate themselves in space and within their own body

  • Differentiate between sensations on the skin and deeper internal experiences

  • Cultivate more nuanced and coherent body awareness

3. Thermal Stimulation Enhances Sensory Awareness

The application of heat (through heating pads or hot stones) activates thermoreceptors in the skin and underlying tissues. This thermal input may increase awareness of subtle internal sensations. For example, patients may become more aware of differences in temperature across body regions, or may begin to notice areas of tension compared to areas of ease. 

Application of heat on the skin may engage brain regions like the insula that help process internal sensations, which could support greater body awareness.

4. Therapeutic Presence and Attunement

While using touch or heat as an enjoyable sensory input, therapists can:

  • Use invitational language to gently guide awareness inward

  • Encourage patients to notice sensations without needing to change them

  • Validate and normalize a range of interoceptive experiences

Over time, skilled therapeutic presence and guidance can help regulate the nervous system and promote greater self-awareness and emotional regulation.

A Unique Opportunity

As massage therapists, we have a unique opportunity to support interoceptive engagement through safe, attuned touch - especially for patients who find it difficult to connect with their internal experience. Through the steady rhythm of our hands, the grounding warmth of a heating pad or hot stones, and the attuned therapeutic presence we bring to each session, we can help patients feel more at home in their bodies.

Jenn Sharman
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