Interoceptive Exposures for Those with Panic Disorder
Have you ever had a panic attack? If you have, you know how frightening and debilitating they can be. Some common symptoms include a pounding heart, sweating, trembling, and chest pain. Many people report feeling as if they are dying. These attacks can occur as a result of anxiety, but sometimes there is no obvious trigger. They seem to appear out of nowhere.
Those who suffer from panic disorder fear the recurrence of these panic attacks. They know how awful these attacks feel and understandably want to avoid them whenever possible. Unfortunately, this avoidance (which is common in many anxiety disorders) only makes things worse in the long run. For example, someone who has had a panic attack when driving might be so fearful of a recurrence that he or she gives up driving altogether. Another person might have panic attacks in social situations, so becomes a recluse in the hopes of avoiding these attacks. It’s easy to see how a person’s world can become very small very quickly. To most of us, it is obvious this is not the best path to follow.
Thankfully, panic disorder is treatable. Psychotherapy, including education and relaxation techniques, can help. Cognitive Behavioral Therapy (CBT) is another important tool and can help people with panic disorder recognize and modify actions and reactions that are hindering their recovery. Just being made aware of what is actually happening to them and the best ways to react can go a long way.
One technique that is sometimes used in the treatment of panic disorder is interoceptive exposure therapy. This therapy involves exposure to bodily sensations similar to those experienced during panic attacks. It’s the opposite of avoidance. The patient is given exercises to do that mimic the feelings of a panic attack. For example, they might be instructed to breath quickly to induce hyperventilation, put their head between their legs and then sit up quickly to produce a head rush, or spin around in a chair to create dizziness. The idea is to face your fears so you can better cope with these sensations and realize that they are not dangerous. Instead of thinking you are dying when a panic attack occurs, you are eventually able to recognize the symptoms for what they are, and therefore feel better equipped to deal with the attacks.
But do interoceptive exposures really work?
In this 2006 study, researchers examined the effectiveness of various interoceptive exposure exercises through the use of a questionnaire. Among the nine exercises measured, those that represented actual physical sensations such as hyperventilating and dizziness had a significant effect on reducing the fears felt by those with panic disorder. However, not all exercises produced the desired results. For example, breathing through a straw was supposed to lead to breathlessness but instead reproduced gastrointestinal symptoms. The authors suggest that new studies to replicate cardiorespiratory symptoms be created and also recommend further studies be conducted, as this one was a limited study.
If you are being treated for panic disorder and your therapist wants to use interoceptive exposures, perhaps the best thing to do is to talk about each exposure in detail, discuss the pros and cons, and even ask for current research supporting this type of therapy. It is up to each one of us to be an active participant in our own journey to wellness.
Singer, J. (2018). Interoceptive Exposures for Those with Panic Disorder. Psych Central. Retrieved on April 6, 2020, from https://psychcentral.com/lib/interoceptive-exposures-for-those-with-panic-disorder/