Hi everyone. Kelly Mahler, occupational therapist. And I want to talk about five ways that an interoception based approach might be more effective for mental health than traditional approaches.
Are Cognitive Approaches for Mental Health Problematic?
Cognitive Behavioral Therapy (CBT) has been widely promoted as the gold standard for mental health treatment, praised for being evidence-based and effective across a wide range of conditions. It’s often the first approach recommended by therapists and medical professionals.
But lately, I’ve been reflecting on a big question:
What if CBT—and other cognitive-first approaches—aren’t the right fit for everyone?
CBT is built on the idea that mental health differences are rooted in faulty or unhelpful thinking. The goal then is to reframe distortions, challenge negative thoughts, and adopt new mental habits to improve well-being.
But that makes me wonder:
- Who decides if a thought is “faulty” or a “distortion” of reality?
- What happens when distress isn’t about cognitive errors, but about a very real and valid lived experience?
- What if emotions can’t just be “thought” away—because they also live in the body?
For many people—especially neurodivergent individuals, trauma survivors, and those living with chronic illness—CBT can feel dismissive. Instead of being met with validation and curiosity, they’re encouraged to question their own inner experiences, as if their pain, fear, or distress is merely a cognitive misfire.
This is where interoception-based approaches such as The Interoception Curriculum offer a different path forward—one that centers body awareness, self-trust, and genuine emotional regulation rather than simply changing thoughts. Before we get to the part on how interoception-based work compares with traditional mental health approaches, here’s a quick overview of The Interoception Curriculum for context (like what in the world does an interoception-based approach actually look like?)
What Is An Interoception-Based Approach?
The Interoception Curriculum (IC) is a sequential, body-based framework designed to help people reconnect with their internal experiences in a way that is deeply personal, affirming, and curiosity-driven.
Instead of assuming how emotions “should” feel or what coping strategies “should” work, the IC guides each person in discovering their own body-emotion-action connections.
It follows a three-step process:
1️⃣ Body: Noticing body signals in a variety of different body parts (How does my body uniquely feel?)
2️⃣ Emotion: Connecting body signals to emotions or personal meaning (What do these feelings mean uniquely to me?)
3️⃣ Action: Exploring a variety of regulation strategies (What does my body uniquely need for comfort, regulation, and felt safety?)
By focusing on the body, the IC can help people develop genuine self-understanding and emotional regulation that isn’t about compliance, suppression, or cognitive reframing.
5 Ways the Interoception Curriculum Compares to Traditional Mental Health Models
1. Traditional Mental Health Approaches Ignore That Emotions Live in the Body
CBT focuses heavily on thoughts—but emotions aren’t just cognitive. They come with physical sensations, shifts in energy, and body signals that can’t be ignored.
- Anxiety isn’t just a thought—it might be a tight chest, nausea, restlessness, zappy skin, heavy brain, or something else entirely.
- Depression isn’t just “low” thoughts—it can be heavy limbs, an aching joints, brain fog, blurry eyes, or something else entirely.
CBT encourages people to challenge negative thoughts—but what if the issue isn’t the thought, but rather the reduced reliability and trust of your body’s signals?
💡The IC starts with noticing and understanding body signals before attempting regulation. Unlike CBT, which focuses on changing thoughts, the IC acknowledges that emotions live in the body—ensuring emotional understanding is grounded in physical experience, not just thoughts and cognitive reframing.
2. CBT Suggests Your Thinking Is the Problem—IC Helps You Make Sense and Trust Your Body’s Signals
CBT is built on the belief that distress is often caused by “faulty thinking patterns.” The goal is to identify cognitive distortions and reframe them.
But this raises a difficult question:
What if your thoughts aren’t faulty at all?
- If a person with chronic illness feels anxiety about medical appointments, is their fear “irrational”—or is it a valid response to past experiences of not being believed?
- If an autistic person dreads social situations, is their discomfort “distorted thinking”—or is it a real reflection of navigating a world that doesn’t accommodate their needs?
💡The IC helps people recognize their body’s signals as valid, rather than something to be “fixed.” Instead of focusing on self-correction, it teaches self-trust—allowing individuals to interpret and respond to their body’s needs with confidence.
3. Traditional Approaches Assume Everyone Experiences Emotions the Same Way
CBT and other cognitive-first therapies often assume that emotions are universal—that everyone experiences anxiety, depression, or anger in the same or similar ways. So even if a CBT program briefly touches on the concept of the body, it often times is done in more generic ways. For example,
- Anxiety = racing thoughts, fast heartbeat, jitteriness.
- Depression = sadness, fatigue, lack of motivation.
But what if your internal experiences don’t match those descriptions (hint: a lot experiences do not match these descriptions!!!)?
- What if your anxiety feels like numbness instead of racing thoughts?
- What if your sadness feels like irritation instead of crying?
💡The IC doesn’t state what emotions “should” feel like—rather it is a deep and thorough guide in noticing how your emotions actually feel in your body. This makes emotional regulation more personal, accurate, and effective.
4. CBT Often Prescribes Coping Skills—Interoception Helps You Discover What Actually Works for You
CBT often involves learning new coping strategies—challenge your thoughts along with deep breathing, mindfulness, journaling, etc.
But what if those strategies don’t work for your body?
A therapist might recommend a coping skill that they think is a good idea, but what if:
- Deep breathing makes you feel more anxious?
- Sitting still feels impossible when you’re dysregulated?
- Journaling feels more frustrating than helpful?
💡 The IC provides a structured framework for exploring a wide variety of strategies, allowing you to discover what actually works for your body. Instead of assuming what should help, it helps you figure out the best matches from a wide variety of possibilities.
5. CBT Focuses on Changing the Person—The Interoception Curriculum Focuses on Helping the Person Understand and Advocate for What They Need
CBT assumes that the individual needs to change—to fix your thinking patterns, emotions, or behaviors.
But what if the real issue isn’t the person, but their environment?
- Instead of forcing a child to sit still in a classroom that is too loud, too bright, and overwhelming, what if we changed the sensory environment so they could learn without anxiety?
- Instead of telling an autistic person to “cope” with neuronormative social norms, what if we encouraged mutual understanding in relationships instead?
- Instead of expecting someone to “push through” or ignore chronic pain, what if we validated their inner experience and helped them discover what their body needs to feel as safe and regulated as possible?
💡The IC shifts the focus from a fixing approach (“your experience is flawed”) to an approach filled with curiosity and validation (“your experience is valid, let’s learn more together”). The IC can create space for exploring current environments and daily lived experiences and the impact they can have on your body and mental health—our systems are flawed and until they change, it is up to us to advocate for adjustments that are as protective of the interoceptive experience as possible.
Final Thoughts:
Could the focus on “fixing” thoughts be missing something deeper?
CBT works for some—but for others, it can feel invalidating, dismissive, and/or incomplete.
Perhaps, interoception offers a different way forward—one that centers on understanding the body, building self-trust, and developing individualized emotional regulation instead of simply teaching people to adjust, suppress, or “fix” themselves.
Ready to explore? Learn more about The Interoception Curriculum here
