Anxiety and other neurodivergences can cause us to be hypersensitive to bodily signals or cause our body to be overreactive to stimulating forces. Interoceptive exposure therapy is a very common method for treating anxieties that involve our bodily signals. If you are researching interoceptive exposure, I want to advise against using this therapeutic approach as a strong believer in the importance of interoception for wellness and health. I believe that the adverse aspects of interoceptive exposure are often ignored.
I want to offer you an alternative option for approaching these uncomfortable feelings that you are trying to manage with interoceptive exposure. I believe that the answer to interoceptive sensitivity and anxieties is not to force yourself to experience these signals in a way that could harm you. Rather, I believe that a slower, more positive, and accepting approach to our body signals will promote a healthier relationship with our bodies, better self-recognition, and long-lasting self-regulation strategies.
What Is Interoceptive Exposure?
Interoceptive exposure (IE) is a form of exposure therapy that is supposed to address negative feelings in people who experience undue stress or anxiety in reaction to their bodily signals. This form of therapy involves invoking these body signals – through exercise or other simulation – and attempting to develop a ‘resistance’ to these critically important self-information signals. Some occupational therapists believe this therapy can be useful for anxieties and trauma responses revolving around these signals – a socially anxious person may go out of their way to avoid exercise, or someone who has a generalized anxiety disorder might avoid coffee due to the feeling of too much energy reminds them of a loss of control.
Proponents of Interoceptive exposure – and exposure therapy in general – say this improves tolerance. The theory is that by building tolerance for these induced feelings, you will be less likely to go out of your way to avoid triggers in your life. If you are comfortable with breathing through a straw to mimic breathing difficulty, you will be comfortable with the breathlessness of exercise.
However, I do not believe this practice of interoceptive exposure is healthy or regulated in a way that supports client health.
The Risks of Interoceptive Exposure
Interoceptive exposure (IE) therapy involves repeatedly inducing bodily sensations to reduce anxiety responses. While this method can offer short-term relief, it comes with several drawbacks:
IE Promotes Desensitization
On a very basic level, interoceptive exposure is intended to desensitize you to your body’s warning signals. You approach them as something that needs to be pushed aside and suppressed rather than acknowledging the feeling, addressing what it signifies, and regulating it through healthy practices.
By repeatedly inducing interoceptive signals, interoceptive exposure attempts to replicate these feared sensations over and over again until you no longer feel the need to avoid them. The goal is to convince your conscious mind that those interoceptive signals are nothing to fear and can just be ignored. But my concern with this is simple – those signals are important. I would never want to put a sticker over my ‘check engine’ light until I could ignore it completely. Just because I can’t see the light doesn’t mean my car’s problems are resolved. Even if our anxiety is sending us into overdrive or if our body is sending big alarm bells without cause, the answer isn’t to ignore these signals. The answer is to develop comfort with our body, connect with it, and develop better self-guided regulation methods.
IE Can Have Physical Risks
What’s more, these interoceptive exposure practices can be physically dangerous to those with conditions that might be sensitive to the stress of these induced body signals – seizure disorders, cardiac conditions, asthma and lung conditions, and other physical risks. Interoceptive exposure requires inducing interoceptive signals that cause the person anxiety or extreme stress. This can include hard physical exertion to induce a rapid heart rate with exercise, shaking your head rapidly to induce dizziness, or even deliberately hyperventilating to cause lightheadedness.
I love to encourage a playful experience with interoception, like dance, splashing water, and small physical exercises – but all of my exercises are self-guided by the goal of building comfort and familiarity, not ‘pushing through the pain’ or building a dangerous tolerance of discomfort.
IE is Often Temporary
Some studies have shown that exposure therapy, in general, might not have a long-lasting effect. I think this makes sense from my interoception-driven perspective. If we aren’t developing good tools and relationships with the body that is sending signals, then you can only see temporary fixes. You are only developing small, focused bandages that can’t solve any underlying issues, just the surface of them.
Interoception should be a supportive tool that we use to help us understand and react to our emotions. If we build up these tolerances to interoceptive signals, isn’t that just ‘pushing through the pain’? In modern culture we tend to treat resiliency as a virtue, but since when do saints ignore problems? My curriculum focuses on building a healthy relationship with our interoceptive signals, providing you with the tools to better address and approach underlying problems that are causing your difficulties.
Sometimes, IE Simply Doesn’t Work
Lastly, I question the effectiveness of Interoceptive exposure therapy in general. The fundamental idea is to replicate the sensations that are causing anxieties and push you towards coping mechanisms, but to do this in a controlled environment. But you simply can’t replicate every feeling that might evoke these panicked reactions. There’s a reason so many scientific studies make a point about ‘laboratory conditions.’
Because you can’t perfectly simulate reality, some studies find that the success of IE is limited. I wouldn’t support a therapy that pushes clients to discomfort even if it were 100% effective. Interoceptive Exposure is done in a controlled environment that simply can’t perfectly replicate every situation in which anxieties or trauma might surface. You might become a pro at breathing through a straw and feeling breathless, but will that approach give you the tools to self-regulate when you’re reaching the end of a 5k run?
The Better Alternative: The Interoception Curriculum
Interoception activities and exercises are a much more healthy and helpful approach toward these uncomfortable inner feelings. The Interoception Curriculum is built off of my years of research into the concept and is driven by the goals of self-empowerment, self-knowledge, and self-understanding. Our innovative approach focuses on fostering a positive and informed relationship with your body, broken down into three actionable steps:
- Noticing: Develop the ability to become consciously aware of your body signals in a safe and comfortable environment, allowing for initial stages of understanding.
- Connecting: Learn to interpret these signals and what they specifically mean for you, turning initial awareness into actionable insights.
- Regulating: Equip yourself with individualized techniques and methods to manage these signals effectively, promoting long-term well-being and self-regulation.
Interoceptive Exposure risks becoming too focused on how your body ‘should’ feel and ignores that your body is not a collection of individual parts. These interoceptive signals that you might be finding difficult are frustrating, but forcing yourself to experience them doesn’t build a healthy attitude towards or relationship with your body.
