Exposure to Uncomfortable Sensations
195A WARNING ABOUT SYMPTOM EXPOSURE
If you are healthy, the exercises described in this chapter are safe. However, if you have 
certain health problems, some of the exercises could worsen your condition. For example, 
if you have asthma or a bad cold, you should probably not practice hyperventilation or 
breathing through a straw. If you experience neck or back pain, we recommend against 
shaking your head from side to side or engaging in any exercises that could aggravate 
your condition. To be safe, we recommend checking with your doctor to see if any of 
these exercises are likely to be dangerous or problematic for you.
A STEP-BY-STEP GUIDE TO SYMPTOM EXPOSURE
This section describes the four main steps involved in using symptom exposure to over -
come the fear of experiencing physical arousal sensations. These include (1) discovering 
which exercises are most effective for bringing on feared symptoms, (2) developing a 
symptom exposure hierarchy, (3) practicing the exercises in nonsocial situations, and (4) 
combining the symptom exposure exercises with exposure practices in social situations.
Step 1: Symptom Induction Testing
Before beginning to practice symptom exposure exercises on a regular basis, you 
should ﬁrst determine which exercises are most likely to be effective for you. This can 
be achieved by attempting each exercise at home and paying attention to the types of 
symptoms that you experience, the effect of the exercises on your fear level, and how 
similar the experience is to the fear that you normally experience in social situations. 
The following Symptom Induction Testing Form can be used to record your responses 
to each exercise. We have included space for additional exercises that you may have 
identiﬁed earlier in the chapter.