CHAPTER 9
Exposure to  
Uncomfortable Sensations
Symptom exposure (also called interoceptive exposure ), involves intentional exposure to inter -
nal physical sensations, such as dizziness, racing heart, sweating, shaking, and blushing. 
This technique was originally developed as a treatment for an anxiety-based condition 
known as panic disorder . Panic disorder is a problem in which people experience sudden 
rushes of fear without any obvious trigger or cause. People with panic disorder tend to 
be very fearful of the physical sensations they experience during their panic attacks, 
and they often interpret these symptoms as a sign of imminent danger or threat (like an 
impending heart attack or a complete loss of control). Symptom exposure was developed 
to teach those with panic disorder to stop fearing the physical feelings associated with 
physical arousal and anxiety. With repeated exposure to these induced physical symp -
toms, people learn that these feelings are not dangerous, and they eventually become 
less frightened of their own internal feelings and sensations.
Anxiety over experiencing physical arousal symptoms is not unique to panic dis -
order. A number of studies (Chambless and Gracely 1989; Taylor, Koch, and McNally 
1992) have found that people with other anxiety-based problems are also often anxious 
about experiencing certain physical sensations. This includes people with social anxiety, 
where the fear may be strongest for sensations that might be visible to others, including 
blushing, sweating, shaking, and losing one’s train of thought. Just as symptom exposure 
leads to reduced fear of sensations in people with panic disorder, it makes sense that 
deliberately exposing oneself to feared symptoms while in social situations might lead to 
decreased fear of sensations for people with high levels of social anxiety. By combining