Introduction to the Special Issue on Interoceptive Exposure in the Treatment of Anxiety and Related Disorders: Novel Applications and Mechanisms of Action

Interoceptive exposure (IE) involves having an individual repeatedly induce and experience feared arousal-related sensations (e.g., shortness or breath, heart palpitations, dizziness) as a means of reducing the fear of those sensations. IE exercises such as hyperventilation, chair spinning, and breathing through a straw have been demonstrated effective in the treatment of panic attacks and panic disorder, both as part of a broader cognitive-behavioral program and as a stand-alone intervention. This article introduces a special issue of the Journal of Cognitive Psychotherapy focusing on cutting-edge findings on novel applications of IE in the treatment of anxiety and related disorders and research that begins to investigate IE’s mechanisms of action. We set the stage for the following series of six original articles by first providing a historical review of the use of IE in cognitive-behavioral treatments of panic. We then provide a brief overview of the various theoretical perspectives that can be applied to understanding the mechanisms of action of IE in reducing fear of fear: conditioning, cognitive restructuring, emotional processing, self-efficacy, and emotional acceptance. Finally, we provide a brief overview of the articles included in the special issue. This special issue should prove helpful to cognitive-behavioral therapists in improving and expanding their use of IE in clinical practice. The issue also should stimulate additional research on the mechanisms of action of IE to ultimately permit refinement of treatments for anxiety and related disorders and, it is hoped, enhance the efficacy of cognitive-behavioral psychotherapy.