INTEROCEPTIVE EXPOSURE: WHAT IS IT?
Interoception is the perception of sensations from inside the body and includes physical sensations related to internal systems such as heart beat, respiration, satiety, as well as the autonomic nervous system activity related to emotions. However, much of these perceptions remain unconscious.
Interestingly, there is evidence that emotional feelings arise from internal bodily sensations, and for example, individuals with heightened interoceptive awareness (i.e., awareness of bodily sensations) report more intense emotional experiences.
INTEROCEPTION AND EMOTIONS
In fact, interoceptive awareness is key to identifying internal physiological processes related to affective feeling, and by so-doing is a means of integrating bodily sensations, cognitive processes, and emotional feeling.
Hence, interoceptive awareness is a window to emotional experience, as well as potentially providing access to important mechanisms of emotion regulation.
Some of us have a higher interoceptive awareness than others, which is associated with increased likelihood of developing anxiety disorders, especially panic disorder and social anxiety. This occurs when we misappraise our bodily emotions as reflecting danger or a threat to our safety, which in turn triggers emotional and physiological reactions of fear and heightened arousal.
Subsequently, these feelings motivate behavioral responses, typically avoidance and safety behaviors, intended to protect oneself from danger and to provide relief from anxiety, albeit short-term relief.
Interoceptive exposure, on the other hand, is the practice of strategically inducing the somatic symptoms that we have learnt to associated with a threat or danger. Similar to exposure therapy, interoceptive exposure seeks to eliminate the fear or anxiety associated with a specific somatic symptom.
For example, fearing a heart attack when one experiences increased heartbeats during a panic attack. The fear further fuels the anxiety. Since exposure to the feared stimulus is the most effective psychological treatment for anxiety, exposure to the feared somatic symptoms is likely to bring similar results.
Interoceptive exposure exercises are designed to help normalize typical bodily sensations. The individual consciously triggers feared bodily sensations and stays with the sensations without distraction. With time and practice, the individual learns that while uncomfortable, such sensations are ultimately not harmful.
INTEROCEPTIVE EXPOSURE EXERCISES
For each category, you can practice one or more exercises. PLEASE NOTE! Do not attempt these exercises if you have an underlying health condition or a diagnosed medical problem. consult your doctor if you are unsure
Exercises for catastrophic thoughts and fears related to BREATHING:
Deliberate hyperventilation, such as breathing rapidly for one minute. Breathe through a straw, hold your nose and breathe through a drinking straw – 2 minutes.
Hold your breath – 30 seconds.
Exercises for catastrophic thoughts and fears related to CHEST TIGHNESS:
Interlock your fingers and place hands behind the head while stretching the elbows backwards. Then take a deep breath and try to chest breath at a rate of 1 breath/sec for 1 min.
Jog on the spot or run up stairs (1 min).
Step up and down on a step; hold on to the handrail for balance – 2 minutes.
Tense all body muscles – 1 minute.
Exercises for catastrophic thoughts and fears related to THROAT TIGHTNESS:
Start to swallow your saliva and then hold the throat in the “mid-swallow” position for 5-10 sec.
Exercises for catastrophic thoughts and fears related to BLUSHING
Face a heater, hair dryer, or hand dryer: Heater blowing hot air at the face (5 min. Look at yourself in the mirror or walk around your home, showing your face to everyone.
Jog on the spot or run up stairs (1 min).
Exercises for catastrophic thoughts and fears related to DEREALIZATION/UNREALITY
Stare at yourself in a mirror without blinking – 2 minutes.
Stare at a fluorescent light and then try to read something – 1 minute.
Stare at a blank wall Concentrate hard without blinking – 2 minutes.
Stare for 3 min at a visual grid that induces visual illusions (you can google search grid illusions).
Stare continuously at spot on wall or at one’s hand (3 min).
Exercises for catastrophic thoughts and fears related to SPINNING/SHAKING
Spin around while standing up with arms stretched out (1 min).
Place head between knees for 30 sec and then lift head quickly up to a normal (upright) position.
Shake your head from side to side; then look straight ahead. Keep your eyes open. – 30 seconds.
Garfinkel SN, Critchley HD. Interoception, emotion and brain: new insights link internal physiology to social behaviour. Commentary on:: “Anterior insular cortex mediates bodily sensibility and social anxiety” by Terasawa et al. (2012). Soc Cogn Affect Neurosci. 2013 Mar;8(3):231-4. doi: 10.1093/scan/nss140. PMID: 23482658; PMCID: PMC3594730.
Hübner AM, Trempler I, Gietmann C, Schubotz RI. Interoceptive sensibility predicts the ability to infer others’ emotional states. PLoS One. 2021 Oct 6;16(10):e0258089. doi: 10.1371/journal.pone.0258089. PMID: 34613976; PMCID: PMC8494315.
Price CJ, Hooven C. Interoceptive Awareness Skills for Emotion Regulation: Theory and Approach of Mindful Awareness in Body-Oriented Therapy (MABT). Front Psychol. 2018 May 28;9:798. doi: 10.3389/fpsyg.2018.00798. PMID: 29892247; PMCID: PMC5985305.
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