Interoceptive exposure to feared physical sensations

Interoceptive exposure is a key behavioral technique in the treatment of Panic Disorder.

It consists of deliberately and in a controlled manner inducing the internal physical sensations (interoceptive) that the person fears and associates with panic attacks, with the aim of helping them learn that these sensations are not dangerous and reducing their fear of them.

Rationale. Fear of One's Own Sensations

People with Panic Disorder often develop an intense fear of the normal physical sensations that accompany anxious arousal (palpitations, dizziness, shortness of breath, etc.), interpreting them catastrophically.

This fear of internal sensations (sometimes called "anxiety sensitivity anxiety") is a major driver of the panic cycle.

Interoceptive exposure directly addresses this fear, allowing the person to confront these sensations in a safe environment.

Designing and Performing the Exercises

The therapist and the person first identify the most feared physical sensations.

Then, a series of specific exercises are designed to elicit those sensations in a controlled manner.

Common examples include:

• Voluntary Hyperventilation: Breathing rapidly and deeply during 1-2 minutes to induce dizziness, a feeling of unreality, or tachycardia.

• Brief, intense physical exercise: Running in place, walking up and down stairs quickly to increase heart rate and breathing.

• Spinning in a chair: To induce dizziness or vertigo.

• Breathing through a thin straw: To simulate the sensation of shortness of breath.

• Holding your breath: For a short period.

• Tensing the muscles of the body: To experience tension.

These exercises are performed in sessions, starting with those that generate a moderate level of anxiety and gradually progressing.

The person keeps experiencing the sensation induced until anxiety decreases through habituation, without resorting to escape or safety behaviors.

Objectives and Learning

The main object