Understanding Anxiety – The Sensory Perspective. Proprioception and Vestibular

Sensory processing is integral to human existence, we all process sensory information from the environment which helps us to understand and recall memories associated with sensory stimulus. Two of the most common sensory organs are sound and vision. Over time, and with aging, the natural abilities of the senses fail, and we begin to use prosthetics like glasses or hearing aids, to enable us to engage in the environment.

However, for people with a learning disability or with a diagnosis of autism, the sensory system is more fragmented and out of balance, which affects the person – behaviourally. In other words, the non-verbal person will act up or act out, to express what they are feeling inside. Often these episodes of acting out, can be damaging to the individual. By not understanding the reason behind the meltdown, the person’s needs are overlooked and could potentially cause another more disastrous scene, if their needs, (voice) are not met.

Example; A child who is non-verbal gets irritated, so they grab a cup and start drinking the water from the toilet bowl. Initially, the first thing you would do is tell them NO? that what they are doing is dirty and dangerous. The child on the other hand, is repeating a previous behaviour! The non-verbal child doesn’t understand this concept and hits you for stopping them or saying no. Before long, the original incident is forgotten, and a battle of wills ensues for the care giver and child. The child is offered a drink from the tap, the child receives the drink and throws the drink across the room? The care giver stops offering a drink and may even choose to ignore the behaviour. The child then gets something bigger and throws it at the TV, smashing the screen. Pandemonium ensues?

Were the child’s needs met? No!

The next time the child wants to communicate that they dislike something is to repeat the earlier behaviour of drinking from the toilet bowl, but the child is not doing this to get a drink. He’s doing this to get your attention to something, as this was the most recent memory the child has, that he recorded to memory. What the child is saying is; I don’t like the sound of the TV, turn it off, make it stop!

The outcome: Broken Television. Child’s voice is heard or seen, in the chaos. Child stopped the noise, reduced the internal distress and irritation and is now being verbally punished, by caregiver!!

When someone with limited verbal ability or has a brain injury and is unable to express what they are feeling, whether this feeling is fear or pain, they seek out or they avoid, certain stimulus.

Example; a child that dislikes the texture of tight clothing against his skin, may express this by aggression, irritation or anxiety. The child, unable to verbally explain that the clothing is uncomfortable, will inevitably react until either the clothing is removed, or they are soothed, by some other sensory object.

Sensory processing is more easily understood when you analyse the anxiety and look deeper at the situation. As the example show, it’s not always clear what is being communicated and often, people will revert to a behaviour that got them results the previous time, even if the result was to get your attention!

Sensory processing is an integral practice for every human individual. The main five senses are; sight, smell, taste, touch, and sound. Additionally, to this are another two senses, that are vital to human functioning. These two additional senses are vestibular and proprioception.

The senses are activated by stimulus that records the response to memory which will also attach a specific sensory response. Such as; during early childhood, your mother made you wear something that not only felt heavy or uncomfortable, but also made you feel anxious and irritable. Your body made a mental note of the uncomfortable experience, the memory was attached to an emotional response and stored in the memory bank, for future reference. The next time you wear the said item, your anxiety will spike again, even at a time when you are at your most calm and serene. The emotional attachment relives the prior experience, thus creating another anxiety provoked situation, which could potentially escalate, into a neurotic or psychotic meltdown. As an adult, you avoid or have aversive reaction, to the item or texture!

Anxiety is the common denominator in sensory processing, the effects of anxiety can be traced back to the original experience, which is the true cause of the person’s distress. The anxiety and how it is expressed helps us to identify what is causing the upset and when or where the original cause was created.

Some sensory experiences may not have a pre-determining experience that can be reflected upon, some sensory experiences are due to an imbalance in the brain, which may have been caused at birth, or through a traumatic brain injury.

Anxiety is a principal component to sensory processing – Anxiety is either hypersensitive or hyposensitive, and this is expressed in the persons behaviours!

Hypersensitive is Avoiding
Anxiety or aversion to sensory stimulation and may not feel pain.
Hyposensitive is Seeking
Urges and compulsions, unable to recognise messy clothes and may demonstrate high pain threshold.
Self-injurious behaviours

If you were to put the two concepts at opposite ends of a spectrum, you would see that on end is the lower, unresponsive elements and at the other end is the higher, hypo response.

Hypo                                    Normal                                               Hyper
10 + ———– 5 + ——–0 1 2 3 4 5 6 7 8 9 10 0- ——— 5- ————10 –

Most of us, who have a balanced sensory system range between the 3 to 6 level of anxiety. If one is late for an important event or meeting, the average person will feel their internal anxiety levels rising to hypo arousal, between feeling uptight and agitated.

Hyper sensitivity and blocking out or numbing the internal chaos arising, to enable the person to function, the internal distress is avoided.

Therefore, hypersensitive is to avoid uncomfortable stimulus, heightened anxious reactions are noticeable in the interaction and in the person’s behaviour.

Hyposensitive, is to seek out and satiate the internal sensory drive, to enable, engage and/or motivate the person.


The vestibular is the sensory function that contributes to the sense of balance and spatial awareness and is directed by the inner ear, and the balance of water within the cochlear, within the cochlear is a labyrinth. For example, when you consume alcohol, your brain starts to feel lightheaded, your body starts to feel out of your control, you begin to slur words and your balance, or stride is impacted. These physical actions are evidence of the vestibular gyroscope within the inner ear, that has lost is stable position. Another example is someone who has an inner ear infection, these inner ear infections can have a detrimental impact on the physical body, thus Meniere’s disease and also labyrinthitis are two ear disorders, that may not impact on sound, but does impact on the body’s ability to equilibrium or balance.

Hyposensitive (seek)
Enjoys rocking, swinging
Needs vigorous activity to get into gear (may present as hyperactive)
Adopt odd posture
Need to be on the move to focus
Therapy Ball – bouncing on or lying over.
Use weight with movement.
Rocking chair

Vestibular dysfunction can be identified by the person’s behaviours; are they avoiding, irritated and anxious. These signs indicate that the person is uncomfortable and highly agitated.

Think about how it feels to be sea sick, travelling on a choppy sea inside a boat, this experience is what is occurring inside the vestibular canals!

Hypersensitive (avoiding)
Ridged in posture
Fearful of movement
Don’t like travelling in vehicles
Gravitational insecurity (don’t like feet off the floor)
Difficulties changing direction and speed
May lock joints to stabilise body
Controlled, predictable movement (Linear).
Reassure and explain what is expected (environmental obstacles)
Adaptation i.e. rails etc. (Something for support)
Weighted vests or blankets
Balance boards

Though proprioception is vital to sensing our bodies position in space and developing a sense of ownership of your body. This is especially clear when you consider just how easy it is to get your sense of your own body to contradict with what you see with your eyes.


The brain integrates information from proprioception and vestibular system into its overall sense of body position, movement and acceleration. The central nervous system runs throughout the human body, alongside of this, is the peripheral nervous system, which corresponds with the internal and external environment.

Proprioception is the bodies awareness of itself in the space it holds.

Rather than sensing external reality, it is the sense of the orientation of one’s limbs in space. This is distinct from the sense of balance, which derives from the fluids in the inner ear. Without proprioception, we’d need to consciously watch our feet to make sure that we stay upright while walking.

Proprioception doesn’t come from any specific organ, but from the nervous system. Its input comes from sensory receptors distinct from tactile receptors — nerves from inside the body rather than on the surface.

Inside the ear canal, we have a vestibular canal and the sense of balance is dependent on the flow of air along the fine hairs within the ear canal, allowing the flow air within the ear. When this system is affected or impaired, imbalance, unsteadiness and poor verbal communication is observed. The ear canal houses millions of tiny hairs, that instructs the sound waves to flow through the ear and to the brain. When this system is damaged or impaired, poor balance and poor hearing can be observed. Whereas, proprioception is recognized along the whole body, by receptor under the skin, driven from commands in the brain and related to MEMORY and memorable experiences!

(Why do boys enjoy rough and tumble play, or fighting? Why would someone enjoy physical pain – imbalanced proprioception!)

Proprioception runs alongside the central nervous system and the peripheral nervous system.

The two nervous systems are the bodies channels to receive information from the external environment and also to send internal information to the brain for the neural response needed to complete the task.

Many disorders demonstrate evidence to the internal damage of the sensory processing system. The senses can work individually, but they tend to work with another of the senses for memory or emotional storage and retrieval.

Proprioception -Lack of body awareness – sense of self – trouble distinguishing self from non-self.


Hyposensitive (seeking)
May appear to be aggressive/ rough in approach
Exert too much pressure
Difficult in manipulating small objects (buttons)
Stomp when walking
Push, bang and pull too hard
Chew on objects and clothing
Enjoy tight clothing, belts, jackets
Self-Injurious behaviours

Activities to try:
Any activities that requires movement
Weight (deep tactile pressure) this makes movement more strenuous
Around the home:
Hoovering, sweeping
Laundry, hanging out wet washing
Shopping, carrying heavy objects

The brain — particularly the cerebellum — takes information from all of these proprioceptive inputs to try to determine the location and movement of body parts. But the way we sense our body and its motion generally involves more than just proprioception.

Experimenting with two senses;

Take a banana or melon, pinch your nose and chew the food. Can you TASTE ANYTHING? Before swallowing, release your hand off your nose and swallow the food……What happened?

Did you taste buds just go bland!?

Blindfold a friend and try to instruct them to direct food into your mouth, with your hands behind your back…..Frustrated yet!

Close your eyes and touch your nose. If everything is working properly, this should be easy because your brain can sense your body, as well as its position and movement through space. This is called proprioception. But how does this “sixth sense” work — and what happens when it clashes with other senses?
Sensory processing = over stimulation and under stimulation of the senses.



Next post; The five main senses

2 thoughts on “Understanding Anxiety – The Sensory Perspective. Proprioception and Vestibular

  1. You actually make it seem so easy with your presentation but I find this matter to be really something which I think I would
    never understand. It seems too complicated and extremely broad for me.
    I’m looking forward for your next post, I will try to get the hang of it!


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