Rethinking Bodywork as Interoceptive Modulation
If you’ve ever taken a course in massage therapy, physical therapy, or bodywork, you’ve probably been taught that you’re “releasing” something — fascia, adhesions, knots, blockages.
But more and more, the research — and the experience of seasoned practitioners — tells us something else:
We’re not changing tissue structure.
We’re changing perception.
And that means what we’re really doing is modulating interoception.
Explore the neural mechanisms behind internal body awareness and discover how interoception influences emotion, decision-making, trauma, and social connection.
What Is Interoception?
Interoception is the brain’s ongoing sense of the body’s internal state. It includes sensations like:
Breath and heartbeat
Warmth, pressure, tension
Hunger, fullness, nausea
Calm, agitation, fear, and shame
It’s not just the raw signals from the body — it’s how the brain predicts, interprets, and
responds to those signals in real time. Interoception helps shape our mood, our decision-making, and our sense of self.
Touch as Interoceptive Input
When we touch someone — slowly, attentively, and with skill — we’re offering a new stream of interoceptive input. That input gets processed by the insular cortex, a brain region central to mapping the body’s internal state and creating what neuroscientist A.D. Craig called “a sentient moment of self-awareness.”
Gentle, slow touch stimulates C-tactile fibers, which bypass the spinal cord’s traditional pain pathways and go directly to the interoceptive centers of the brain. These signals aren’t about force or alignment. They’re about safety, presence, novelty, and regulation.
That’s why someone can feel transformed by a gentle hand on the shoulder — not because it “released” anything, but because it created a new internal experience that felt different, and most importantly, okay.
We’re Not Fixing Tissue — We’re Updating Maps
In manual therapy, we often act as if we’re sculptors working with tight clay. But the nervous system doesn’t work like clay — it works like a prediction engine. It learns through sensory surprise.
In persistent pain, trauma, or stress, the body becomes over-familiar with certain interoceptive states: tension, vigilance, numbness, effort. The brain expects those signals and sometimes maintains them long after the original cause is gone. The body isn’t broken — the map of the body is stuck.
What helps isn’t force — it’s new, safe, slow, and surprising input.
Manual therapy becomes effective not because of what we do to the tissue, but because of what the body begins to feel through the tissue. That’s interoceptive modulation.
Manual Therapy as a Conversation, Not a Correction
When we shift our thinking from “correcting dysfunction” to “offering new interoceptive experiences,” everything changes:
Pressure becomes less important than quality of contact
Techniques matter less than attunement and presence
Sessions become co-regulated explorations, not mechanical adjustments
Outcomes are measured by safety, sensation, and agency, not symmetry or alignment
This doesn’t mean techniques don’t matter — but it does mean that how we apply them, and what kind of experience they create in the nervous system, is far more important than the anatomical structures we believe we’re targeting.
Why This Matters for Trauma and Chronic Pain
For people with trauma histories, interoception is often disrupted. The internal landscape feels confusing, absent, or overwhelming. Manual therapy offers a chance to reconnect — not through force, but through gentle, consent-based sensory exploration.
And for people in chronic pain, the issue often isn’t damaged tissue — it’s a nervous system that’s been taught to expect danger. New interoceptive input, delivered with attunement and curiosity, helps the system recalibrate. It tells the brain: This is safe. This is different. You can soften now.
This is not a mind-over-body message. This is the body — remapping itself through lived experience.
Final Thoughts
What if manual therapy has always been about interoceptive modulation, and we’ve just lacked the language to name it?
What if our hands aren’t tools for fixing things — but instruments for creating new experiences of safety, sensation, and presence?
When we stop trying to “release” things and start helping people feel differently inside, we begin to understand what manual therapy really is:
An invitation for the body to tell a new story — one sensation at a time.
Author
Dr. Mark Olson holds an M.A. in Education and a Ph.D. in Neuroscience from the University of Illinois, specializing in Cognitive and Behavioral Neuropsychology and Neuroanatomy. His research focused on memory, attention, eye movements, and aesthetic preferences. Dr. Olson is also a NARM® practitioner, aquatic therapist, and published author on chronic pain and trauma-informed care. He offers a variety of courses at Dr-Olson.com that provide neuroscientific insights into the human experience and relational skill training for professionals and curious laypersons.
