What is Interoceptive therapy?

What is interoceptive exposure?

Many therapists ask, what is interoceptive exposure?

As CBT therapists, we are always looking for the best way to help our anxious clients get well from the suffering and limitations that anxiety can cause.

A study published last month has uncovered evidence about how the brains of anxious people differ from those of people who are not anxious when it comes to processing information about bodily perceptions.  “Interoception of breathing and its relationship with anxiety” by Harrison et all in the journal Neuron sorts study subjects into low or moderate levels of anxiety and compares how these two groups manage a series of trials that increase breathing resistance in variable predictably.  The study concludes that:

“Multi-modal analyses of data from fMRI, computational assessments of breathing-related metacognition, and questionnaires demonstrated that anxiety-interoception links span all levels from perceptual sensitivity to metacognition, with strong effects seen at higher levels of interoceptive processes.”

This is important for clinicians because it gives us yet more concrete evidence to answer the question, what is interoceptive exposure, which involves purposely increasing distressing bodily sensations, as an important part of treating anxiety

People with anxiety in this study were found to have higher levels of catastrophizing about breathing, higher perceptual sensitivity, and be more reactive to threat. This shows that both cognitive and behavioral therapy is going to be important to help our clients become less sensitive to thoughts and sensations.

Interoceptive exposures allow our clients to learn a new lesson and allow their brains to quiet the response to perceived bodily threats over time by paradoxically leaning into the sensations that scare them the most. To work, though, they must actually do the difficult work of exposure, and you will be key in helping them approach the topic and successfully learn a new lesson.

Interoceptive exposures can be things like over-breathing (hyperventilating), staring at a blank wall, or spinning in a chair.  As with all exposures, it’s crucial to set the stage for success with your clients!

Always be willing to do the exposures with your clients, and if you are nervous about how it will go for you, practice it yourself before you try with your client.  Your confidence in this important treatment technique is important to help your clients have the courage to try these exposures.

Steps to improve your client’s success with interoceptive therapy include:

  • Psychoeducation
  • Interoceptive Exposure at various levels of difficulty
  • Review to consolidate learning

To learn more, read our post, “Inducing Panic Symptoms to Treat Panic Disorder.

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