Let's Talk About Interoceptive Exposure Eating Recovery Academy Podcast

What is interoceptive awareness and can it play a role in the development of eating disorders?
What is interoceptive exposure and how can it be used in the treatment of eating disorders?
In this podcast episode, Kate Fisch speaks with Dr. Melanie Smith about interoceptive exposure and awareness. She discusses how interoceptive exposure can help assist our clients and develop more effective treatments.
MEET DR. MELANIE SMITH
Melanie Smith, PhD, LMHC, CEDS-S, is the Director of Training for The Renfrew Center. In this role, she provides ongoing training, supervision and consultation to clinicians across disciplines for the purpose of continually assessing and improving competence in the treatment of eating disorders. Dr. Smith is co-author of The Renfrew Unified Treatment for Eating Disorders and Comorbidity Therapist Guide and Workbook (Oxford University Press), is a Certified Eating Disorders Specialist and Approved Supervisor, and is a Certified Therapist & Trainer for the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP). 
Visit Melanie Smith to find out more.
  IN THIS PODCAST What is interoception?
What is interoceptive awareness?
How can we use interoceptive exposure to help clients?
The brain and body image.
 
Where do we start in terms of interoception? “Let’s start with interoception in and of itself. This is just our body’s internal perception, so our bodily senses of what is happening inside our body.”
Dr. Melanie Smith
Our clients are always looking for as many tools as they can to treat their eating disorder clients. It is important for us, as therapists, to understand all the factors that can influence eating disorders…
“When we think about eating disorder application; our ability to sense if I'm hungry, if I'm full, if my stomach doesn't feel good; all of that is what we're talking about when we're talking about interoception.”
Dr. Melanie Smith
 
What then is interoceptive awareness? “Interoceptive awareness is the level to which we are consciously aware of the things happening inside our bodies.”
Dr. Melanie Smith
 
It is important to understand what level of interoceptive awareness a client has and how they react to what is happening inside the body, because most of us, most of the time, shouldn’t be (or aren’t) noticing things such as our heart beating or ourselves breathing.
“Heightened levels of interoceptive awareness also results in heightened anxiety about what is happening inside our body. So we might start to overthink it or overinterpret what it means.”
Dr. Melanie Smith
 
How can we use interoceptive exposure to help clients?  
“The ultimate goal with interoceptive exposure is to intentionally evoke those same unpleasant, uncomfortable sensations. So, we're going to allow ourselves to experience that emotion, allow it to rise, BUT allow it to fall and learn that this is actually something we can tolerate.”
Dr. Melanie Smith
 
Interoceptive exposure seems to align with other methods and skills that we already understand as therapists or clinicians. If we were to think about Mentalizing, Acceptance and Commitment Therapy or Dialectic Behavioral Therapy.
“Those same principles are absolutely at work here, which is why I would suggest it as a wonderful adjunctive that could nicely coincide with any of those treatment approaches.”
Dr. Melanie Smith
 
When was this developed and is there any current research into the method?  
“The first places you'll see it in the literature as a proposed intervention, from an experimental standpoint, was back in the late 80s, maybe early 90s. But I think in the 80s specifically, it was proposed as a Cognitive behavioral exposure-based intervention for panic disorders.”
“There's also a lot of really interesting evidence out there and people doing more trials with this with individuals with PTSD because when you think about trauma response and the