The Elicitation of Relaxation and Interoceptive Awareness Using Floatation Therapy in Individuals With High Anxiety Sensitivity

Abstract

BACKGROUND Floatation-REST (Reduced Environmental Stimulation Therapy), an intervention that attenuates exteroceptive sensory input to the nervous system, has recently been found to reduce state anxiety across a diverse clinical sample with high levels of anxiety sensitivity (AS). To further examine this anxiolytic effect, the present study investigated the affective and physiological changes induced by Floatation-REST and assessed whether individuals with high AS experienced any alterations in their awareness for interoceptive sensation while immersed in an environment lacking exteroceptive sensation. METHODS Using a within-subject crossover design, 31 participants with high AS were randomly assigned to undergo a 90-minute session of Floatation-REST or an exteroceptive comparison condition. Measures of self-reported affect and interoceptive awareness were collected before and after each session, and blood pressure was measured during each session. RESULTS Relative to the comparison condition, Floatation-REST generated a significant anxiolytic effect characterized by reductions in state anxiety and muscle tension and increases in feelings of relaxation and serenity (p < .001 for all variables). Significant blood pressure reductions were evident throughout the float session and reached the lowest point during the diastole phase (average reduction >12 mm Hg). The float environment also significantly enhanced awareness and attention for cardiorespiratory sensations. CONCLUSIONS Floatation-REST induced a state of relaxation and heightened interoceptive awareness in a clinical sample with high AS. The paradoxical nature of the anxiolytic effect in this sample is discussed in relation to Wolpe’s theory of reciprocal inhibition and the regulation of distress via sustained attention to present moment visceral sensations such as the breath.

Reduced Environmental Stimulation in Anorexia Nervosa: An Early-Phase Clinical Trial

“…Reduced Environmental Stimulation Therapy via floatation is a relatively unexplored non-pharmacological intervention that has recently begun to be investigated for potential anxiolytic effects ( Jonsson and Kjellgren, 2016 ; Feinstein et al, 2018a , b ). The REST experience is calibrated so that input from exteroceptive sensory channels (e.g., visual, auditory, olfactory, gustatory, thermal, and tactile) is minimized, as is most vestibular, gravitational, and proprioceptive input, movement, and speech.…”

“…Regardless of diagnosis, the float experience induced a strong short-term reduction in state anxiety and a substantial improvement in mood. In a recent follow-up study using a within-subject crossover design, we recruited 31 participants with clinically elevated levels of anxiety to undergo a 90-min session of floatation-REST and an exteroceptive comparison condition (watching a relaxing documentary film) ( Feinstein et al, 2018a ). Measures of self-reported affect and interoceptive awareness were collected before and after each session, and BP was measured during each session.…”

“…The primary objective of the study was to investigate whether there is evidence of negative health consequences associated with exposure to the REST environment in partially weight-restored AN. We selected orthostatic hypotension as our primary outcome for safety since (1) our prior research ( Feinstein et al, 2018a ) identified reductions in BP as an acute effect associated with floating, (2) orthostatic hypotension could increase fall risk when transitioning from laying to standing (an action occurring at the end of each float) ( Sachs et al, 2016 ), and (3) orthostatic hypotension is a major medical condition associated with acute dehydration that is especially common in underweight and even partially weight-restored AN ( Lanier et al, 2011 ). We hypothesized that floating would be safe and well tolerated by individuals with AN and predicted that there would be no adverse physical effects (e.g., no orthostatic BP reductions, or falls, upon standing).…”

Waiting, Thinking, and Feeling: Variations in the Perception of Time During Silence

“…Mind-body interventions, such as meditation, yoga, and other relaxation techniques, like resting in a floatation tank, have been introduced into the clinical and health sciences (Esch Feinstein et al, 2018;Kohls et al, 2019). Combined DRMT/HMT and silence could be an effective approach to induce relaxation.…”

The Development of Anxiety Sensitivity Interventions from Manual to Computerized

“…Of the 18 research reviewed, there were 8 studies using CBT interventions, namely research from Boswell et al, 2013;Feinstein et al, 2018;Holtz et al, 2018;Keough & Schmidt, 2012;Korte & Schmidt, 2015;Olthuis et al, 2015;Sahranavard et al, 2018;Worden et al, 2015. The studies have in common was the use of the same therapeutic procedure, which emphasizes psychoeducation and interoceptive exposure in the intervention.…”