This formulation diagram describes a cognitive-behavioral approach to conceptualizing fear of body sensations, integral to conditions like panic disorder and health anxiety.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
A copy of the information handout in PDF format.
An editable Microsoft PowerPoint version of the resource.
The Cognitive Behavioral Model Of Fear Of Body Sensations illustrates how catastrophic misinterpretations of bodily sensations can maintain anxiety-related difficulties. This resource provides a diagrammatic representation of these maintaining factors and consequences. Suitable interventions which follow from this model include psychoeducation, cognitive restructuring, and interoceptive exposure exercises.
This handout can enhance understanding and treatment of fear-related conditions.
Sudden and repeated periods of intense fear.
Preoccupation with having or acquiring serious illnesses.
Use the handout as a psychoeducational tool.
Initiate conversations about client beliefs and fears.
Encourage exploration of cognitive and emotional responses.
The Cognitive Behavioral Model Of Fear Of Body Sensations explains how panic and anxiety can be maintained by the misinterpretation of benign somatic cues as threatening. This perspective, shaped significantly by the work of Clark (1986), suggests that individuals may interpret normal physiological arousal — such as increased heart rate or breathlessness — as signs of imminent catastrophe. These misappraisals trigger escalating fear, physiological arousal, and avoidance, reinforcing the original threat belief and perpetuating anxiety.
A complementary construct is anxiety sensitivity—the belief that anxiety-related sensations have harmful consequences (e.g., that dizziness signals fainting or madness). McNally (1990) in a review of psychological approaches to panic disorder argues that this dispositional trait is a key risk factor for panic disorder, distinct from general anxiety, and shaped by prior learning. It not only amplifies fear responses to bodily cues but also contributes to hypervigilance and avoidance, both of which maintain the cycle of fear.
Therapeutically, these insights support a multifaceted intervention strategy. Psychoeducation can help to clarify the benign nature of bodily sensations. Cognitive restructuring helps clients challenge threatening interpretations. Interoceptive exposure — eliciting feared sensations in a controlled setting — disconfirms catastrophic beliefs, reduces avoidance, and enhances tolerance.
