Symptoms of anxiety could include an increased heart rate and chills. Interoceptive exposure may help you manage these.
If you live with anxiety, you might be too familiar with the overwhelming experience that comes from physical and psychological symptoms.
These symptoms often feed off each other and may become intense and overpowering.
This is why it’s natural to feel anxious about anxiety, particularly if you live with panic disorder and experience regular panic attacks.
Learning to identify and manage the physical responses of anxiety can help you with other symptoms, too. Interoceptive exposure therapy might be a way to do this.
Interoceptive exposure is a type of exposure therapy that helps you identify and then recreate the physical sensations associated with anxiety. The purpose is to decrease the fear you may feel about these sensations.
For example, if you experience an increased heart rate when anxious, you may often associate a rapid heartbeat with an anxiety attack. But there are other reasons why your heart might beat faster that aren’t associated with anxiety.
So, a therapist might instruct you to run on the spot or do some jumping jacks to speed up your heart, for example.
The goal is to experience that increased heart rate in a safe setting like a therapist’s office and realize nothing happens to you. In time, you begin to lose your fear of a rapid heartbeat.
Some people call interoceptive exposure desensitization therapy. However, desensitization may refer more to the pace of the exposure than to the technique itself.
If you try cognitive behavioral therapy (CBT), interoceptive exposure might be one of the exposure therapy techniques your therapist suggests.
There are several types of exposure therapies:
- Interoceptive: recreating harmless but feared physical sensations
- In vivo: facing a fear directly, in real life
- Imaginal: using your mind to recreate and confront the subject of your fear
- Virtual reality: using VR technology to create a realistic experience when in vivo exposure isn’t practical, like in the case of a fear of flying in an airplane
Your therapist may also vary the pacing of your exposure:
- Systematic desensitization: gradual exposure combined with relaxation exercises
- Flooding: rapid exposure to the most feared and difficult situations
- Graded exposure: ranking fear exposures according to difficulty, and starting with the easiest ones then working your way up
Exposure techniques like interoceptive exposure aren’t meant to be long-term treatments. They usually take 10 sessions, but this may vary according to your case and treatment plan.
The goal of interceptive exposure is to stop the anxiety spiral that physical sensations can cause.
In other words, the purpose is to get reacquainted with physiological sensations typically caused by anxiety. This way, you can break the association between them and fear.
When you live with anxiety long enough or have panic attacks, you may begin associating its physical sensations with fear and danger. In time, similar physical sensations alone may cause anxiety symptoms.
For example, you may have a panic attack after feeling short of breath on an extremely hot day. Initially, the shortness of breath was a response to the heat and could have been managed by drinking some water or sheltering under a tree.
As these experiences repeat, you may begin to change entire routines to avoid situations that could cause these physical responses. This reinforces your anxiety and increases the hold it has on your life.
For example, you may begin skipping your daily walk or the beach to avoid the heat that caused you to feel short of breath.
The purpose of interoceptive exposure is to break that cycle between what you feel and your behavior, so you can navigate life without anticipating anxiety.
In a typical initial session, your therapist may encourage you to talk about how anxiety makes you feel.
You’ll likely discuss the kinds of physical effects you experience and how they make you feel mentally and emotionally.
In the following sessions, you may work on recreating those physical sensations through controlled interoceptive exposure exercises.
For instance, if anxiety causes you shortness of breath, you might naturally associate breathing fast with fear and losing control. This, in turn, causes you more anxiety symptoms.
Your therapist might guide you through rapid breathing exercises for 1 minute to recreate your anxiety-related breathing changes in a session.
Eventually, this will reduce the link in your mind between rapid breathing and an anxiety attack.
Maybe dizziness is a common anxiety effect for you, and your concern is that you’ll lose your balance and fall. Your therapist may have you spin in a chair to recreate the sensation of imbalance.
Prolonged exposure to these sensations is essential, though.
If you end an exercise before it’s finished, you’re practicing avoidance. Avoidance could be what’s impacting your daily life.
The therapist can help you face it, and if an exercise is too difficult, they’ll ask you to reduce the intensity so that you can continue rather than stop.
When you’re ready, your therapist might recommend transitioning into situational exposure. This involves leaving the office so you can practice interoceptive exposure exercises in real-world settings.
For the exposure to work, you’ll need more than one session.
It’s highly advisable that you don’t try exposure exercises on your own or with someone who’s not a trained therapist.
Interoceptive exposure can help with different types of anxiety disorders, such as agoraphobia and panic disorder.
It can also reduce the anxiety symptoms associated with chronic pain and dizziness and ease people’s stress with health anxiety.
A small study involving 10 adults with panic disorder and claustrophobia revealed that including real-world settings increased the effectiveness of interoceptive exposure exercises.
Another study with eight participants who had atrial fibrillation and elevated anxiety symptoms found that they experienced significant relief from their interoceptive exposure treatment.
In sum, interoceptive exposure can reduce your anxiety in several ways:
- Repeated exposure to the physical effects of anxiety results in a reduced anxious response.
- Regularly revisiting anxiety sensations can reduce the previous links you made between them and anxiety and help you build new associations.
- Following the treatment may help you realize that you can safely face your fears.
Since interoceptive exposure involves actions like increasing your heart rate or making yourself dizzy, it’s a good idea to get clearance from your health professional before you participate. Most therapists will discuss this with you.
Also, you may not be able to try these exercises if you’re pregnant or have:
- epilepsy
- a heart condition
- asthma
- lung problems
- neck or back pain
Interoceptive exposure is a form of exposure therapy used in CBT. It helps you revisit the physical symptoms you associate with anxiety in a safe and controlled setting. In time, you’ll break associations and face your fears.
Interoceptive exposure therapy may produce some physical stress and discomfort. Your health professional should give you the green light before you engage in any exposure therapy techniques.