Interoceptive exposure is a highly effective, science backed cognitive behavioral therapy (CBT) technique used to treat panic attacks and severe anxiety.
Most approaches to anxiety try to calm the body down. This one does the opposite. Instead of avoiding the frightening physical sensations of anxiety, it asks you to bring them on deliberately, in a safe space, until they stop frightening you.
Why we fear our own bodies
When you have a panic attack, your heart races, your chest tightens, and you might feel dizzy. Anxiety tricks your brain into thinking these normal physical reactions mean you are having a medical emergency, going crazy, or losing control. This creates a vicious cycle: you fear the sensations, which makes the sensations worse.
Avoiding those sensations feels like the sensible response. The problem is that avoidance never gives your brain a chance to learn anything new. Every time you escape the feeling, it keeps its status as a threat.
Facing the physical sensations
Interoceptive exposure breaks this cycle through habituation. By repeatedly triggering the physical symptoms without any actual danger, your brain learns a vital lesson: these sensations are uncomfortable, but they are not dangerous.
This is not willpower and it is not positive thinking. It is repetition and evidence. Your body needs to be shown, more than once, that a racing heart in a safe room is just a racing heart.
Common exercises used in treatment
Therapists use specific, brief exercises to mimic panic symptoms:
- Hyperventilation. Breathing fast and shallow for one minute to cause dizziness and tingling.
- The straw breathe. Breathing through a narrow coffee straw while pinching the nose to simulate shortness of breath.
- Chair spinning. Spinning in an office chair for one minute to trigger vertigo and disorientation.
- Running in place. High intensity jogging for a minute to rapidly spike the heart rate.
How to practice safely
- Start with a professional. It is highly recommended to do this under the guidance of a CBT therapist first.
- Rate your distress. Track your anxiety levels before, during, and after each exercise.
- Drop safety behaviors. Do not use distraction, deep breathing, or reassurance during the test. Let the feeling peak.
- Repeat until bored. Keep doing the exercise until the sensation no longer triggers fear.
These exercises are uncomfortable by design, and they are not suitable for everyone. If you have a heart or lung condition, epilepsy, are pregnant, or live with any condition affected by exertion or changes in breathing, speak to your physician before trying them.
Reclaiming control
By leaning into the physical discomfort, you strip anxiety of its power and reclaim control over your body.
Starting treatment
Interoceptive exposure is one part of the wider approach we use in panic disorder treatment and anxiety treatment. If panic attacks are shaping your decisions about where you go and what you do, that is worth talking through with someone trained in this work.
You can meet our clinicians and see whose background fits what you are dealing with, or get in touch to arrange a free consultation and start from there.
