Free Interoceptive Exposure Worksheet: Testing Catastrophic Predictions About Bodily Sensations

What it helps with

• Naming the specific bodily sensations a client fears most and the catastrophic belief attached to each one, such as a racing heart meaning an imminent heart attack.
• Choosing an induction exercise that matches the feared sensation: spinning for dizziness, straw breathing for breathlessness, stair climbing for a racing heart, staring at a fixed point for derealisation.
• Recording a specific prediction and a believability rating before each exercise, so the client has something concrete to test rather than a vague sense of dread.
• Tracking sensation intensity, anxiety and the urge to escape during the exercise, then comparing the prediction against what actually happened afterwards.
• Dropping subtle safety behaviours, such as sitting near an exit or checking pulse, that quietly protect the prediction from ever being tested.

How clinicians use it

• Model the exercise first and complete the prediction box together before the client runs an induction alone.
• Keep exercises short and specific: thirty to sixty seconds is often enough to produce the sensation, and a client does not need to be pushed further to make the point.
• For clients with sensory processing differences or a trauma history involving physical restraint, agree a stop signal in advance and let the client control the pace and duration of each induction.
• For autistic clients who already experience sensations such as heart rate more intensely, or less clearly, than most people, spend extra time on the feared sensation profile before choosing an exercise, since the standard exercise menu may not match their actual triggers.
• Set between-session practice only once the client can run an induction without covert safety behaviours, and vary the context and posture across repetitions to build learning that generalises.
• Use alongside the Panic Cycle Worksheet to map the somatic cascade first, and the Exposure Hierarchy Worksheet when moving on to real-world situations.

Clinical Screening and Pacing Guide

1. Screen first: confirm there is no medical contraindication before selecting an induction exercise.
2. Agree a stop signal with the client and let them set the pace, especially where sensory processing differences or a trauma history make forced exposure counterproductive.
3. Debrief every exercise: name the prediction, name what happened, and re-rate believability before moving on.

What the worksheet looks like

Clinical cautions

Interoceptive induction exercises are contraindicated or need medical clearance for some clients, including those with cardiac conditions, epilepsy, asthma, vestibular disorders or who are pregnant. Screen for these before use and obtain medical sign-off where indicated. This worksheet supports face-to-face psychological therapy delivered by a qualified practitioner. It does not diagnose any condition and is not a crisis resource.

References

1. Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23.
2. Barlow, D. H., & Craske, M. G. (2006). Mastery of your anxiety and panic (4th ed.). Oxford University Press.
3. Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24(4), 461-470.

Part of

Panic and Agoraphobia Recovery Pack

Related worksheets

• Panic Cycle Worksheet
• Exposure Hierarchy Worksheet
• Safety Behaviours Worksheet