How do you feel about purposefully inducing panic symptoms to treat panic disorder? What are your automatic thoughts about this?

We recently trained therapists in evidenced based treatment for anxiety and OCD in Illinois and Missouri. We asked how many people knew what interoceptive treatment for panic disorder is? Nobody raised their hand. We train master level therapists because we have found that master level therapists have not been taught the evidenced treatments for anxiety and ocd and yet they are the front line people who often diagnose, assess, and treat people with anxiety disorders.

Today we taught interoceptive treatment for panic. People who have panic attacks (which is the majority of humans) either cope with it and move on or get freaked out by it and fear having another panic attack. To be sure, panic symptoms are really awful and many people think they are having a heart attack not a panic attack.

Once they have ruled out heart or other problems, we can get to work on teaching their brain to handle these symptoms and not believe they are in danger. In anxiety treatment we expose people to what they fear in order for them to practice changing the way they think about this fear and changing how they respond to the fear. People who have panic disorder are afraid of having another one because the symptoms can be so debilitating. So we expose them to these symptoms so they can practice handling them and teaching their brain that, although they are uncomfortable, they are not in danger.

We begin by asking our clients what symptoms they get when they have a panic attack. We rank order these symptoms from 0 to 10..not a big deal to I can’t handle it! Then we begin practicing interoceptive therapy by creatively coming up with ways to induce these panic symptoms.  We might hyperventilate using a straw to induce the fear of not getting enough air. We practice this together, in session, so we can discuss what was going through their mind during the exercise and what they may have done about it. Then we come up with healthier ways to respond to the symptoms of distress and practice the straw breathing again. Many clients find that their anticipatory anxiety is the worst and they are surprised at their ability to tolerate the uncomfortable sensations.  We then send them home to practice these exercises several times a day to teach their amygdala that they are choosing to have the symptoms and can handle them.

For a list of interoceptive treatments go to Interoceptive exercises.