Interoceptive Exposure Exercises for Evoking Depersonalization and Derealization: A Pilot Study

This study examined the potential of 11 interoceptive exposure exercises to produce deperson-alization and derealization among high anxiety-sensitive undergraduate students. Inspired by a February 2007 thread on the Association for Behavioral and Cognitive Therapies listserv, we identified nine exercises and compared their capacity to produce depersonalization and de-realization with two previously validated tasks: mirror and dot staring. Results indicated that five exercises, including hyperventilation (1 minute), hyperventilation (5 minutes), hyper-ventilation plus spiral staring, hyperventilation plus strobe light, and strobe light alone, were superior to either mirror or dot staring at inducing depersonalization or derealization. If replicated in a clinical sample, our findings may be used to assist clinicians seeking to evoke these states via interoceptive exposure. Keywords: depersonalization; derealization; unreality; interoceptive exposure Interoceptive exposure (IE) is a valuable component of cognitive behavioral treatments for panic disorder (Gould, Otto, & Pollack, 1995) that is commonly employed to induce physical sensations approximating those present during panic attacks (e.g., heart palpitations, dizzi-ness). Although IE exercises such as breathing through a straw or running in place are effective in eliciting many panic-related sensations, evoking episodes of depersonalization and derealiza-tion presents a challenge for many clinicians. An episode of depersonalization or derealization i