Physical Symptoms of Anxiety, Exercise, and Interoceptive Exposure w/Jenna Overbaugh
Physical symptoms of anxiety are usually at the top of everyone’s “talk about” list. Today I’m joined by my friend and anxiety therapist Jenna Overbaugh to talk about how we can learn to fear the physical sensations of anxiety and how this relates to exercise. We also chat about interoceptive exposure and how it can be useful in addressing your fear of the physical symptoms of anxiety. Jenna is always a great guest and this episode is no exception, so listen in!
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The Skinny On Interoceptive Exposure
Interoceptives are essentially body exposures. In exposure work, you do things that push you outside your comfort zone to intentionally trigger anxiety and fear. Most of the time exposures tend to be externally focused. We come find the places, tasks, and situations that trigger you, then go toward those things. But what happens when you fear your own body? What happens when you fear the physical symptoms of anxiety and panic? In that case we can use interoceptives – exposures focused on creating those symptoms – to help you learn to tolerate and navigate through them.
Interoceptive exposures help us learn that the physical sensations of anxiety are normal in a frightened person, and are not dangerous even when you fear them. Interoceptives are useful because we get to go directly as what you fear without having to manufacture situations like driving or attending parties to trigger the fear.
Interoceptive exposures are not all that special. They work the same way that all exposures work. They just focus directly on the physical symptoms of anxiety.
You don’t have to learn to like your physical symptoms, but you can get used to them. More importantly, you can learn to tolerate them and navigate them without declaring an emergency when you feel them.
Let’s talk about exercise and the physical symptoms of anxiety. Many people hear that exercise is good for anxiety only to find that when they exercise they feel worse. Why is this? Because exercise creates the very sensations and symptoms that you fear! Exercise does not make you feel worse. Exercise just makes you feel. Since you hate to feel and you are trying desperately to NOT feel, you will say that exercise makes you worse, or triggers your anxiety.
In this context, we can see exercise as an excellent form of interoceptive exposure! In fact most interoceptives that a good therapist will do with you in session look just like exercise. Running in place, doing jumping jacks, and other things that get your heart rate up and make you sweat or breathe heavy can be great interoceptives.
Remember that when dealing with physical symptoms of anxiety, the goal is not to find ways to make them stop or go away. That’s relying only on “getting used to them”. We need to learn that even if the symptoms pop up, we can handle those. This is the inhibitory learning model that has become so prevalent in clinical circles.
Starting Small And Highly Targeted Is Totally OK
If you’re finding it difficult to get started with exercise and interoceptive exposures, first make sure you understand WHY you should be doing those things. If you don’t know why, and how it works, you can wind up just pushing through difficult things without making much progress. Then, think about all the small ways you can trigger your symptoms, then start working on those. You can start small. That’s totally OK. You don’t have to jump off the sofa after 6 months and immediately run a marathon or squat 600 pounds. If you can start with a light jog in place for 2 minutes or a short walk around your block, that’s perfectly acceptable. Maybe start by breathing through a straw for 30 seconds to experience shortness of breath. Spin around for 10 seconds to experience dizziness. These are small things, but they count!
What happens if I start exercising and I panic? Unfortunately, the answer is that you should do more of that. The panic is not a problem. It’s part of the process and learning that panic is not something you must automatically run from.
Don’t Forget The Response Prevention Part!
When working on overcoming your anxiety symptoms, remain mindful of the fact that response prevention is just as important as being exposed to the things you fear. Going to the gym, then running out when you feel anxious, or doing your interoceptive exposures while also using all your old coping and safety rituals, are not good plans. We care about being exposed to the symptoms, but we care MORE about doing that while we refrain from trying to escape, soothe, or save ourselves.
It’s better to walk slowly through your garden without checking your pulse or calling for help than it is to do an hour on a stair-climbing machine while doing all your safety rituals. Response prevention is really the magic ingredient in any exposure.
Sometimes It’s Worse Before It’s Better
You are likely being told all the time that exercise is a great stress reliever that will make you feel better. Yes. But in our context this is not immediately true. At first, exercise – an interoceptive exposure activity – is a challenge. It triggers your fear. It forces you to work on tolerating the things you fear. Don’t expect exercise to immediately be a feel good thing. It can be down the road, but be realistic.
Exercise As a Compulsion
Be careful. This can get sneaky. Sometimes we fall into the trap of turning exercise or other exposures into compulsions and conditions for “OK-ness”. This can happen with almost anything. Exercise is no exception. If you find yourself using phrases like, “I have to ….” or “As long as I ….” think about what you think would happen if you didn’t exercise today, or didn’t drink all 128 ounces of water that you are sure that you must have in order to be OK.
Fake It Till You Make It
At first, this is totally a fake it till you make it scenario. You won’t enjoy exercise and interoceptive exposures. You won’t feel better. You won’t believe that anything is happening. That’s OK. Let the experiences teach you. Let them add up. Over time, things change.
Here are some other episodes of The Anxious Truth that might be helpful:
Episode 019 – Why Does Exercise Make My Anxiety Worse – Part 1
Episode 025 – Why Does Exercise Make My Anxiety Worse – Part 2
Episode 136 – Proper Eating, Orthorexia, and Exercise/Fitness Issues w/Jenna Overbaugh
Episode 137 – Postpartum Anxiety and OCD w/Jenna Overbaugh
Episode 226 – How Does Exposure Work? Habituation vs Inhibitory Learning
Find Jenna Overbaugh Online:
Jenna’s podcast – All The Hard Things
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Podcast Intro/Outro Music: "Afterglow" by Ben Drake (With Permission)
