Interoceptive Exposure in the Treatment of Health Anxiety and Hypochondriasis

The experience of health anxiety is seen in a range of different anxiety and somatoform disorders. Bodily sensations are often cues for anxiety or emotional distress in persons with problems with health anxiety and hypochondriasis. In treating these problems, there are advantages to including interoceptive exposure (IE) as a component of treatment. We explore the frequency of problems with bodily symptoms in community and clinical populations, the assessment of physical symptoms, and the theoretical rationale for the use of IE in treatment. This exposure strategy involves deliberately and repeatedly producing feared bodily sensations. Given that some of the anxiety-producing symptoms commonly seen in health anxiety are difficult to produce voluntarily, we also have clients use strategies involving deliberately focusing on existing bothersome sensations and using imaginal techniques to simulate body sensations. The goal of IE is to help the individual to be more accepting of and less distressed by the uncomfortable bodily symptoms. The integration of this approach with other treatment components for health anxiety, such as cognitive reappraisal, exposure to feared thoughts and behaviors, and reducing avoidance, is emphasized. Detailed guidelines for the application of IE with health anxiety are provided.