Interoceptive exposure

Interoceptive exposure

Interoceptive exposure is a technique that was developed specifically to help patients suffering from panic attacks. It is a type of exposure therapy, but instead of seeking to expose the person to a feared situation, this time the exposure is to what is happening physically inside the body. Interoceptive exposure uses a list of exercises that provoke different, possibly fearful sensations for the person (such as shortness of breath, dizziness, heart palpitations, chest discomfort, etc.). Among them, some will turn out the be anxiety provoking for the person that suffers from panic. The goal then in exposure is to specifically trigger those sensations repetitively and for longer periods of time until the anxiety is clearlyl lower or the patient experiences something new and different.

Interoceptive exposure stems from the knowledge that patients who experience panic disorder have higher sensitivity in detecting changes in their bodily sensations, such as changes in their heart pounding and their breathing while being in public, driving, or being trapped in an elevator. These can be interpreted as something bad happening and can send the person into a sense of fear. This interoceptive capacity, accompanied by catastrophizing interpretations, can trigger panic attacks. What follows are ways of trying to take control that are counterproductive, such as avoiding public places, driving a car, or any situation that are conditioned to such anxiety-provoking inner sensations.

Overview of the therapy

Your therapist will help you identify the internal sensations that create discomfort and may be the precursors to your panic attacks. This is done through a standard list of exercises, such as hyperventilating to trigger shortness of breath, spinning to trigger dizziness, and breathing through a straw to trigger chest discomfort. These exercises allow your therapist to identify the specific sensations you fear and avoid.

After creating a an exposure hierarchy for the exercises that were related to anxiety, your exposure to these sensations will be gradual, moving from the least feared to the most feared. Each exercise will be repeated a sufficient number of times and experienced long enough to give you the opportunity to learn that the sensations are not harmful and that the anxiety can be tolerated. These interoceptive exercises are practiced daily outside of therapy sessions until the anxiety is significantly lower and you feel more free, not letting bodily sensations hinder you in everyday life.