Interoceptive exposure means deliberately producing the physical sensations you’re afraid of. In panic disorder the feared thing isn’t really a place or a situation — it’s the sensations themselves, and what you believe they mean. So the treatment goes at them directly.
The standard exercises
These are done first in session, with a clinician, and then as homework. Each runs about thirty to sixty seconds, is rated for how much it resembles your panic, and is repeated.
Spinning in a chair for dizziness and unreality. Breathing through a thin straw with your nose pinched, for breathlessness and chest tightness. Hyperventilating deliberately for lightheadedness and tingling. Running on the spot or up stairs for a racing heart. Head between the knees, then sitting up quickly for the head rush. Staring at a spot on the wall for derealisation. Holding your breath for chest tightness. Tensing your whole body for trembling and weakness.
You do the ones that produce your particular symptoms. Most people have two or three that are far worse than the rest, and those are the ones that matter.
Why it works
Panic disorder rests on a belief that these sensations are dangerous — a heart attack, suffocation, losing control, fainting. That belief can’t be argued away, because it isn’t really held propositionally; it’s held in the body.
Producing the sensations on purpose does something no reassurance can. You get the racing heart, the dizziness, the tightness — and nothing happens. Then you do it again tomorrow, and nothing happens again. What that teaches is that these are just sensations, that they mean nothing, and that they require no response.
It also dismantles the specific fear that has to be dismantled: not the fear of a place, but the fear of your own body.
How it goes in practice
Uncomfortable, and considerably less bad than people expect. Almost nobody has a full panic attack during it, because you produced the sensations on purpose and you know why they’re there — which strips out the catastrophic interpretation that turns sensations into panic.
The rule that matters: no safety behaviours during. Do not sit down early, don’t slow your breathing to manage it, don’t distract, don’t check your pulse afterwards. The precaution is what prevents the learning.
And do it daily. Twice a day for a couple of weeks is more effective than once a week for two months.
The medical caveat
These exercises deliberately alter your physiology. If you’ve a cardiac condition, respiratory disease, epilepsy, are pregnant, or have any medical condition that could be affected, this is a conversation with a doctor first — and it’s one reason a proper cardiac assessment comes before this treatment, not after.
It should be introduced by a clinician trained in it, not attempted from a webpage. If panic is your issue, ask a prospective therapist whether they use it — the answer sorts the trained from the untrained faster than any other question.