The paper jittered and danced in my trembling grip, each erratic movement blurring the words into streaks. It was day two of my 3-month stay in an in-patient rehab facility and the alcohol withdrawal was making it very difficult to remain focused on anything. I had worked as a Firefighter for 12 years, and a Paramedic for 10 years, and found myself turning to alcohol to numb out the harsh realities of the traumas that haunted me. Tuning into my inner world and paying attention to my body’s clues (interoception) was harder and scarier than I had been willing to face. For the 7 years prior to this moment, there was rarely a day in my off-shift time from being a firefighter/paramedic that I wasn’t drinking. It had become far easier to numb out and ignore my own experience of the emotions residing inside; to effectively shut off interoception.

As a first responder, I needed to be able to shut down my fight or flight system to a certain extent just to be able to do the job. I wouldn’t be very effective going into a burning building if my survival system kicked in and I ran out of the building without putting out the fire! If I wasn’t able to shut down my emotions to a certain extent, I wouldn’t be able to do CPR on the guy I grew up with who had just had a heart attack, and remember medication dosages at the same time. Those are necessary adaptations to a challenging work environment. However, one of the biggest challenges that I, and many other first responders, have is being able to turn that back on and tune in again. This was my battle over the next few months of rehab, and certainly even beyond that.

To match the outer trembling, for the first time in a long time I was becoming aware of the inner battle being waged. For the first time in a long time I now had to face the things that I had been avoiding. Interoception allows us to be aware of what is going on internally, whether it is physical sensations or emotions, though for myself, the line is often very fuzzy between these two! It is this sense that gets numbed out when we choose to medicate the pain in our lives by using substances or behaviours. These coping mechanisms are genius, short-term ways of coping with a situation that feels completely overwhelming. Unfortunately, they rarely get us to where we want to go and instead often result in more pain and chaos.

As a person in recovery for the last 8 years, and as a mental health professional dedicated to working with first responders and addiction, I know the value of interoception on a deep level. Tuning into my inner world allows me, and allows a lot of my clients, to be aware of what a trigger or craving feels like in our bodies. Being aware of the inner world highlights an ability to choose different coping strategies; if I’m not intentionally aware of it, I will always resort to ‘default mode’. However, once I’m aware of it, even though it’s often not comfortable, I am given the gift of choice back.

One of the things that I love having my clients do is a daily check-in that looks something like this:

• - What was I feeling today?
• - Where in my body was that emotion located?
• - What situations/people/places/things triggered a desire to use my substance of choice today?
• - What did I learn about myself today?

The aim of this daily check-in is to increasingly tune into our inner world and face the uncomfortable head-on. Often, this also increases our ability to experience comfortable emotions more fully also!

Ultimately, the journey of recovery, especially for those who have faced the unique demands and traumas of first response work, is a process of reawakening this inner sense. It's about learning to decipher the whispers of the body, to distinguish the subtle cues of discomfort, craving, and emotion that were once deliberately silenced. By intentionally cultivating interoceptive awareness, we not only gain the power to navigate triggers and choose healthier paths, but we also rediscover the richness of our internal landscape, allowing us to truly feel – both the pain and the joy – of being alive. This reconnection within is not just a step towards recovery; it's a profound act of self-reclamation and a vital pathway to lasting well-being.

Richard Evans, MA, CT