What is interoceptive exposure?

Elizabeth Spencer

Many therapists ask, what is interoceptive exposure?

As CBT therapists, we look ways to help our anxious clients get well and to stop the suffering or limitations anxiety causes.  Interoceptive exposure might be the answer.

New Research

A study published last month has uncovered evidence about how the brains of anxious people differ from those who are not, when it comes to processing information about bodily perceptions.

“Interoception of Anxiety and its Relationship with Anxiety” by Harrison et al 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.”

Why this is important to therapists

It gives mental health providers even 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. They were also found to be more reactive to threat.

Interoceptive exposures allow our clients to learn a new lesson. They also allow their brains to quiet the response to perceived bodily threats over time by paradoxically leaning into the sensations that scare them the most. 

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!

Be willing to do the exposures with your clients. If you are nervous about how it will go for you, practice it yourself before the client session.

Your confidence in interoception exposure is important to help your clients have the courage to try these exposures.

Three steps to improve interoceptive therapy

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


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