Interoceptive Exposure: Research Brief

Maximizing the efficacy of interoceptive exposure by optimizing inhibitory learning: A randomized controlled trial                                             

Behaviour Research and Therapy (2013)

Patients who struggle with anxiety often catastrophize and worry about their physical sensations. Anxiety itself commonly causes uncomfortable sensations accompanied by responses—including fear, further escalation of anxiousness, and oftentimes, panic attacks. Through interoceptive exposure, an evidence-based CBT technique, a patient quickly and effectively learns how to manage symptoms of anxiety by confronting feared physical sensations.

Interoceptive exposure involves practicing a variety of exercises in order to induce the physical sensations associated with anxiety, such as a racing heart, sweating, lightheadedness, etc. When engaging in these exercises, the patient attempts to bring on the sensations that they are afraid of, without avoidance or distraction, in order to break the link between the sensations and the experience of fear or panic.

While research demonstrates the efficacy of interoceptive exposure, many therapists do not know how to utilize this method. Others use it in a low dose fashion which may not actually confront a patient’s core fear regarding lack of safety and the intolerability of anxiety.

Deacon et al., (2013) found that intensive interoceptive exposure produced significantly greater reductions in fear and anxiety as opposed to low dose interoceptive exposure and a no exposure group.  Specifically, the intensive interoceptive exposure group experienced significant reductions in anxiety, fearful responses, and worry about the sensations of anxiety. The findings suggest that the intensive delivery of interoceptive exposure exercises can improve the effectiveness of exposure-based treatments for panic and other anxiety disorders. 

Highlights from the Study

“The present findings suggest that the fear of anxiety may be effectively targeted by IE exercises using a prolonged and intensive delivery style similar to the traditional delivery of exposure tasks for other anxiety disorders.”

“…exercises appear particularly effective when delivered in a prolonged and intense manner that continues until participants believe their most feared catastrophic outcome is extremely unlikely to occur.”

“These findings highlight an important distinction between treatment likeability and acceptability and suggest that fearful individuals are able to accept, tolerate, and benefit from intensive exposure therapy despite perceiving it as moderately aversive.”

At Feeling Good Institute, we use evidence-based treatments, including exposure therapy and interoceptive exposure to help our patients overcome various kinds of anxiety. Our goal is not simply anxiety reduction, but helping our patients learn that there is nothing to fear.

Learn about the essential skills for effective cognitive behavior therapy and how we set therapists up for success.

Research Brief Author: Jill Levitt, Ph.D.

Citation: Deacon, B., Kemp, J.J., Dixon, L.J., Sy, J.T., Farrell, N.R., Zhang, A.R. (2013). Maximizing the efficacy of interoceptive exposure by optimizing inhibitory learning: A randomized controlled trial. Behaviour Research and Therapy, 51(9), 588-596. https://pubmed.ncbi.nlm.nih.gov/23872701/