Treating Panic Attacks with Interoceptive Exposure Therapy

Treating Panic Attacks with Interoceptive Exposure Therapy

Life is challenging, and sometimes that challenge takes the form of panic attacks. Panic attacks often occur when our brains interpret a situation or sensation as more dangerous than it truly is. Symptoms of a panic attack include recurrent, unexpected, sudden, intense, and distressing feelings of fear accompanied by physical sensations such as shortness of breath, raised heart rate, and muscle tension.

Traditional exposure therapy is highly effective for treating certain forms of anxiety, such as phobic reactions (e.g., blood, aeroplane, heights, dogs) or a fear of crowds. To treat panic attacks, we use a particular type of exposure therapy called interoceptive exposure. This involves working with our clients to identify the sensations that are most closely associated with their feelings of fear and panic, and then beginning to systematically reduce the intensity of the fear reaction to these sensations using repeated exposures.

The idea of Interoceptive exposure therapy can seem counter intuitive. You may be asking yourself, “how can exposing myself to these scary feelings possibly help me when they themselves are the problem?” Well, the short answer is that we can’t control when these feelings come on, but we can try to control how our brain perceives them.

Interoceptive exposure therapy allows our brains to reinterpret these sensations as less dangerous over time, so that when they occur, they cause fear reactions that are less likely to lead to panic attacks. Whether the sensations you are experiencing are dizziness, shortness of breath, increased heart rate, pressure or pain in your chest, or depersonalization (i.e., feeling “detached” from your body or mind), there are specific techniques we can use in therapy to help simulate these symptoms.

Before starting with interoceptive exposure therapy, clients often feel afraid to simulate sensations that have led to panic attacks in the past. I work collaboratively with clients to determine exactly what level of exposure they are prepared for before therapy begins, and then we will work progressively towards the client goals while always being mindful of their level of comfort and readiness.

Noah Butler is a Graduate student of Yorkville University, currently practicing at Grandi & Associates in Windsor, Ontario.