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Getting comfortable with physical discomfort

A scoping review of interoceptive exposure in physical and mental health conditions

Bibliographic Data

ID14446335
AuthorsSamantha G Farris (0000-0003-2567-2463, Rutgers, the State University of New Jersey), Lilly Derby (0000-0001-6566-0550, Rutgers, the State University of New Jersey), Mindy M Kibbey (0000-0002-4188-3669, Rutgers, the State University of New Jersey)
Year2025
Volume151
Issue2
Pages131-191
Publication date2025-02-01
Open AccessYes
TypeARTICLE
VenuePsychological Bulletin (JOURNAL)
Journal identifiersISSN: 0033-2909 • E-ISSN: 1939-1455
PublisherAmerican Psychological Association (APA) (PUBLISHER)
DOI10.1037/bul0000464
PMID40014537
OpenAlexW4407991105
LanguageEN
Citations received4

Interoceptive exposure (IE) involves the use of exercises, activities, or tasks to intentionally induce (or exacerbate) physical symptoms in the body, to challenge misconceptions about the harmful nature of the physical symptoms that maintain fear and problematic avoidance. IE was originally developed for the cognitive behavioral treatment and prevention of panic disorder. Bodily sensations and concern about physical symptoms are common features in many conditions, not limited to panic disorder. For this reason, IE could be theoretically relevant to cognitive behavioral intervention for many psychological, behavioral, and medical conditions. Yet, IE remains relatively underrecognized and underused as an intervention. Exposure involves feeling discomfort before experiencing relief; thus, it is often perceived as an aversive, unsafe, and illogical intervention because of the seemingly paradoxical approach. We conducted a systematic literature search for a scoping review with the aim of locating published studies on IE to understand how it has been studied beyond panic disorder. Studies focused solely on panic disorder were excluded. We were able to identify and extract data from 132 studies (published between 1992 and 2022), though this published literature is difficult to find. The use of IE has been widely investigated in conditions beyond panic disorder, although evidence for its efficacy is difficult to isolate from other forms of exposure and cognitive behavioral features. There is the strongest evidence for the efficacy of IE as a part of multicomponent cognitive behavioral treatments for posttraumatic stress disorder, health anxiety, irritable bowel syndrome, and to aid in benzodiazepine discontinuation. Interventions that were primarily or exclusively IE-based did not consistently or directly influence claustrophobia fear, separation anxiety, suicidality, insomnia symptoms, cigarette or drug abstinence, or pain-related fear. No serious adverse events were reported in any study. Studies of IE require larger sample sizes, detailed descriptions and rationale of IE exercises, higher IE dosing, extended follow-up assessment, and documentation of safety. (PsycInfo Database Record (c) 2025 APA, all rights reserved)

Mental health · Physical activity · Physical fitness · Physical health · Physical therapy · Psychiatry · Applied Psychology · Clinical Psychology · Medicine · Pain Management and Placebo Effect · Paranormal Experiences and Beliefs · Psychology · Psychosomatic Disorders and Their Treatments

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Citations per year4
Citation span2025 - 2026 (2)
Highly citedNo

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