Coping with body sensations
Different emotions are associated with different sorts of body states. When we are sad or low we can feel tired and heavy. When we are anxious we can feel jittery and on-edge. It is not unusual to dislike certain body sensations and sometimes we can become afraid of them. However, because we have to live in our bodies these kinds of fears can prove limiting!
Identifying the difficult meaning associated with a body sensation
Remember that CBT says it is not situations, events, or sensations that bother us - it is the thoughts we have about them, or the meaning that we bring to them.
Bill's father had died from a heart attack at a young age and Bill had always worried that the same thing could happen to him. When they were both 25 Bill's friend died in a car crash and Bill became more aware of how fragile life can be. He started to pay more attention to his heart, and would worry if he noticed it beating fast or if he felt it was beating irregularly. He began to monitor his pulse, and would walk everywhere slowly so as not to over-stress his heart.
Whenever Bill noticed his heart beating, the meaning he associated with it was "I'm going to have a heart attack".
Facing your fears: Interoceptive exposure
Our bodies are capable of giving rise to a great range of sensations. The best way to become more comfortable with the sensations it can generate is to expose yourself to them. This is called interoceptive exposure: interoception means being aware of sensations within our body, and exposure is one of the most powerful ways of overcoming fears.
For Bill to overcome his fear he needed to do exercises to increase his heart rate. His therapist encouraged him to do exercises such as running on the spot, or stepping up and down a stair. Bill initially found these exercises anxiety-provoking because he thought he might damage his heart. However, he became more comfortable with them over time. The more he practised the interoceptive exposure exercises the less he came to believe that he was going to have a heart attack. Eventually he completely changed the way he thought, and began to exercise regularly.
Safety: "...but I'm worried that doing these exercises could be dangerous"
These exercises are for people who find certain bodily sensations difficult. They are not dangerous and will typically produce mild to moderate symptoms. Most people should be able to do them safely. However, for people with certain medical conditions particular exercises may be unsuitable and it is recommended that you check with your medical doctor whether they are happy for you to complete the exercises. It may be helpful to take the worksheet with you to your doctor and ask them to say which exercises they are happy for you to do. If you suffer from any of the following medical conditions it is recommended that you check with your doctor before attempting the exercises:
- High blood pressure
- If you are pregnant
How to carry out exposure to body sensations exercises
To overcome fear of body sensations you need to work through all of the exercises on the Interoceptive Exposure (fear of body sensations) worksheet. The tasks are not dangerous, but even in people without panic or fear they tend to produce moderate feelings of discomfort. To begin with you will need to try all of then, one by one, until you find the ones your panic responds to. Before each exercise read the instructions carefully.
- Only do one exercise at a time
- You might find it helpful to have someone with you when you practice these exercises initially (can you treat it like a game and both do them together?)
- Always try to complete the task for the allotted time - stopping early counts as avoiding
- Focus on the sensations you feel during the exercise - don't try ot distract yourself
Coping with body sensation worksheets
Learn about how your 'threat system' gets your body ready to face danger
Things to do:
Identifying the meaning associated with a particular body sensation
Exercises to overcome fear of body sensations
References and further reading
Barlow, D. H., & Craske, M. G. (2007). Mastery of your anxiety and panic workbook (4th edition). Oxford: Oxford University Press