When Your Client’s Brain Stops Feeling: How Interoceptive Mismatch Creates Chronic Pain

The Moment Every Therapist  and Coach Knows

You cue a client to perform a squat.
They move with confidence, convinced their form is perfect.
Yet you see it right away. Their torso collapses slightly forward, their knees drift unevenly, and their breath halts halfway down.

You correct the pattern. They nod, repeat the cue, and the same movement returns.

And if we are being honest, you either give them a little wink and say, “It’s close,” or quietly curse your therapy skills under your breath because you have been working on this for six months.

And yes, trainers, you probably have that one client who still cannot get their squat right, and it makes you want to jump out the window because no matter what you cue, you cannot seem to connect their brain and movement.

Okay, that last part might have been me. But that is exactly why this concept meant so much to me as an educator, coach, and teacher.

Let's say it out loud: you have done nothing wrong. The client is not ignoring your instruction. Their brain simply cannot feel what the body is doing.

 It is not the FMS, flexibility or such yet, it is just that they can't fill this gap between sensation and movement.

This is called an interoceptive mismatch, and it may be one of the biggest reasons clients remain stuck in cycles of tension, protection, and pain.

Pain Is Not Just in the Body

For years, most therapy models treated pain as a mechanical issue. The focus was on posture, alignment, and strength.

 But research in applied neurology shows that pain is not produced by damaged tissue alone. It is produced by the brain’s perception of threat.

The brain’s job is not to keep you comfortable. Its job is to keep you alive. When it receives clear and accurate information from the body, it allows movement. When the signals are fuzzy or incomplete, it assumes danger.

That assumption creates protective responses. Muscles tighten. Breathing shortens. Pain signals amplify.

This means pain is not only a reflection of the body’s condition, but also of the brain’s accuracy in interpreting internal information.

That accuracy comes from one critical sensory system: interoception.

What Is Interoception

Interoception is the brain’s ability to sense what is happening inside the body. It monitors heart rate, breathing, temperature, muscle tone, hunger, and visceral feedback.

It is how you know you are hungry before you eat, how you sense anxiety before your heart races, and how you recognize calm before sleep.

The insula, located deep within the frontal, parietal, and temporal lobes, is the key structure responsible for this function. It gathers sensory input from the body, integrates it with emotion and cognition, and turns raw data into meaning. 

When this system is working, the brain knows exactly what is happening inside and can respond with precision.

When it is not, the brain starts guessing. And those guesses often show up as pain.

When the Brain Loses Accuracy

An interoceptive mismatch happens when the brain receives internal data that it cannot interpret accurately.

Imagine your client’s shoulder has full physical capacity. The muscles are strong, the joints are mobile, and the tissues are healthy. Yet the sensory feedback from that shoulder is incomplete.

The brain, unsure whether the movement is safe, limits the range of motion or creates pain as a protective strategy.

The issue is not mechanical.

It is perceptual.

Can you see now how a client can still not squat correctly after years of coaching?

This is why two people can perform the same task with completely different experiences. One moves freely and feels strong. The other experiences pain and tension.

 The difference lies in how clearly the brain senses the internal environment.

How the Mismatch Forms

Several common factors create interoceptive distortion:

1.  Chronic stress. Ongoing sympathetic activation floods the system with noise, masking subtle sensory signals.
2.  Trauma. Emotional or physical trauma teaches the brain to disconnect from internal sensation to avoid feeling.
3.  Sedentary behavior and shallow breathing. Reduced movement variety limits input to the insula and dulls sensitivity.
4.  Injury or surgery. Nerve disruption and compensatory movement patterns create “blind spots” in the body map.

When these distortions persist, the brain begins to rely on prediction instead of sensation. It guesses what is happening rather than feeling it, and those guesses are often wrong.

The Body’s False Alarms

Think of the interoceptive system like a home alarm. When the sensors work, the alarm only sounds when there is a true threat.

When the sensors malfunction, it begins to trigger at random. A breeze through a window sets it off. A passing shadow becomes an intruder alert.

This is what happens in the nervous system of a dysregulated client.

A normal heart rate spike during exertion feels like panic.
A small stretch feels like injury.
A slight change in breathing feels like suffocation.

These are not overreactions. They are false alarms from a miscalibrated sensory system.

The Insula’s Role in Feeling and Meaning

The insula does more than detect body signals. It also assigns emotional meaning to them.

The posterior insula tracks the raw sensations of temperature, heartbeat, and tension
The mid-insula integrates those sensations with other sensory systems.
The anterior insula makes sense of it all, turning sensation into conscious experience.

When these three layers communicate clearly, clients can sense change in their bodies without fear. They can notice a faster heart rate or muscle fatigue and interpret it as normal.

When that communication breaks down, those same signals feel threatening. The client experiences pain, anxiety, or panic in response to otherwise safe sensations.

This is the essence of interoceptive mismatch.

Signs Your Client’s Interoceptive Map Is Inaccurate

You can often see the signs long before the client can.

• Breath-holding during new or complex tasks
• Jaw clenching or facial tension with no awareness of it
• Difficulty describing sensations clearly
• Emotional overreaction to small discomforts
• Heavy reliance on visual feedback to “check” performance
• Pain patterns that shift unpredictably or lack mechanical explanation

These are not motivation issues or attitude problems. They are neurological signs that the brain’s internal map is blurred.

Want More...

How to Begin Rebuilding Interoception, and How To Start Learning How to Fix Interoceptive Mismatch

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If this concept resonates with you, it is exactly what we teach inside the Next Level Neuro Mentorship.

You can also begin immediately with our $37 Neuro Advantage Course, a step-by-step introduction to applied neurology that shows you what to do, when to do it, and why it works.

In less than an hour, you will understand how to assess and train the nervous system through practical drills you can use with clients right away.

When you understand how to improve interoception, you stop chasing pain and start teaching safety.
That is when real change begins.

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