International Conference on Psychophysiology of Panic Attacks

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Eda Gorbis
Westwood Institute for Anxiety Disorders, Inc., United States

Using Interoceptive Exposure to Treat Panic Attacks Comorbid with other Anxiety Disorders

Eda Gorbis

Panic disorder with and without agoraphobia is an incapacitating condition with a lifetime prevalence of approximately 1.5%, which indicates that several million people in the United States alone suffer from this debilitating disorder. Panic disorder also co-occurs with other anxiety disorders, including social phobia (approximately 30%), generalized anxiety disorder (approximately 25%), specific phobia (approximately 20%), and obsessive-compulsive disorder (approximately 10%). This high comorbidity rate makes treating the debilitating symptoms of a panic attack more difficult and complex. Furthermore, approximately one-half of people with panic disorder at some point develop such severe avoidance as to warrant a separate description of panic disorder with agoraphobia.

Using interoceptive exposure to treat panic symptoms as a first-step to treatment is an effective approach to treating comorbid panic conditions. Interoceptive exposure involves exposing patients to somatic sensations originating inside the body. In general, patients are systematically and repeatedly exposed to the internal sensations that trigger panic attacks. The sensations are produced through idiosyncratic methods, such as hyperventilation through a paper bag, spinning in a chair, physical exertion, breath holding, and muscle tension. The goal is to desensitize a patient to the overvalued physiological sensations of a panic attack. Following which, patients are to compare the self-induced physiological sensations to the sensations of an actual panic attack. In doing so, interoceptive exposure helps to enhance the patients' awareness into the distorted perceptions and over-appraisals of their fears, and allows them to feel empowered that they can induce and control their own panic attacks.