EMDR for Panic Disorder

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EMDR can treat symptoms associated with panic disorder. Microsoft

Eye movement desensitization and reprocessing (EMDR) is a type of psychotherapy that was developed by psychologist Francine Shapiro in 1987 to help people deal with and heal from experiences that have caused emotional trauma. Research on and use of this method has continued to grow, making EMDR an increasingly popular technique in treating mental health disorders. In recent years, EMDR has become a more common treatment option for panic disorder.

How It Works

As a therapeutic approach, EMDR is based on several theories of psychotherapy, including concepts of cognitive behavioral therapy (CBT). Through EMDR techniques, which use eye movements, hand tapping, and/or audio stimulation to unblock emotional processes that have been stagnant due to distress, you can reprogram your brain, in a sense, to begin to heal from the fear and pain associated with such trauma and emotional distress. Additionally, EMDR may allow you to gain a new perspective that can facilitate improved self-esteem and enhance your personal beliefs about your capabilities.

The Eight Phases

EMDR involves eight phases of treatment that focus on the past, the present, and the future, helping you work through emotional distress and trauma and learn skills to cope with current and future stress. Treatment may cause rapid relief from your symptoms and even has the potential to help you begin to feel better after the first session, although there is a great deal of variability in patients' responses.

The eight phases include:

  • Phase 1: The first phase involves getting your complete history regarding painful memories, events, or experiences from your past, as well as your current stresses. You and the therapist then develop a treatment plan that targets specific memories or incidents. At first, this may be more focused on your childhood. If you have panic disorder, you may be asked details about your panic attacks such as when they started, what your worst one was like, and when you had your most recent one.
  • Phase 2: In this phase, your therapist will help you learn some ways to deal with stress and anxiety, such as doing mental exercises.
  • Phases 3 to 6: These phases are where the hard work is usually done. First, your therapist will have you choose one of the targets you've determined in phase one; for instance, a particular memory. You then describe the visual picture you have in your head of that memory, as well as how it makes you feel, both physically and emotionally. You will also be asked to identify both a negative and a positive belief about yourself related to the mental picture. You'll rate both of these beliefs as to how true they are. At this point, the EMDR stimulation takes place (see below).
  • Phase 7: This is the closure phase, in which you'll discuss the positive steps you've made and how to keep them going on a daily basis.
  • Phase 8: At this point, you and your therapist will talk about your progress, look at your treatment goals, and see how well they've been met and if you need to work through other targets you identified in phase one or not. You'll also discuss ways to cope with current and future stress.

EMDR Stimulation

During an EMDR session for panic disorder in phases 3 to 6, your therapist will ask you to recall the chosen target memory or trauma, as discussed above. As you picture the target memory in your head, as well as the negative belief about yourself and the physical sensations you feel, your therapist will have you move your eyes from side to side.

To help you focus on moving your eyes, your therapist will hold up his or her first three fingers and move them in a bilateral (two-sided) motion for your eyes to follow. Instead of eye movements, you may be asked to perform hand or finger tapping or to wear a set of headphones to listen to tones that alternate from your right ear to your left ear. You will continue to focus on the traumatic feelings or memories while you participate in these bilateral eye movements, taps, or tones.

Once you're finished with the EMDR stimulation, your therapist will instruct you to clear your mind and discuss any insights, thoughts, memories, feelings, or images that came to mind. Depending on whether you're starting to feel positive physical sensations or you're still feeling negative ones, your therapist will work you through the stimulation again, but it will be different if you're feeling positive. This helps reinforce the positive sensations or thoughts. Repetition is the key until you are no longer experiencing distress from that memory or incident.

When you aren't experiencing distress related to a certain memory any longer, your therapist will have you decide if the positive belief you stated about yourself at the beginning is still what you would choose and, if not, how you want to change it. You'll also learn to apply and focus on this positive belief in the future when you find yourself in a distressing situation by "installing" it with eye movements.

How EMDR Treats Panic Disorder

EMDR is primarily used to overcome symptoms associated with post-traumatic stress disorder (PTSD). However, EMDR has been found to effectively treat other mood and anxiety disorders, including depression, phobias, and panic disorder. EMDR may be particularly helpful in treating panic disorder, panic attacks, and agoraphobia when your past traumatic experiences are contributing to your current symptoms.

One study that compared the effectiveness of EMDR to CBT in treating the symptoms of panic disorder and improving patients' quality of life determined that EMDR is just as effective as CBT. A review of published studies on how effective EMDR is for treating trauma-associated symptoms in people with psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain found that EMDR does indeed improve these symptoms. The review also found evidence that EMDR may even help improve the other, non-traumatic symptoms found in mood disorders and may be useful as an additional treatment for people who have chronic pain.

When used in the treatment of panic disorder, your therapist may ask you to bring your attention to feared physical sensations or thoughts that are linked to your panic attacks. EMDR is meant to break any associations you have between certain circumstances and symptoms. Through EMDR, you may be able to learn to manage anticipatory anxiety related to panic attacks. For instance, if driving in a car often leads to anxiety and panic attacks, EMDR may be able to help you remain calm before driving and feel safer while you're on the road.

Therapists who use EMDR often assign homework to help maintain progress between sessions. You may be asked to try a self-help technique that requires your imagination to envision a peaceful environment, such as visualization. Imagery desensitization may be practiced between sessions, allowing you to picture what it would be like to gradually face your fears. EMDR practitioners also often suggest keeping a daily journal that tracks your progress and the relaxation techniques you learn.

Getting EMDR Treatment

EMDR techniques are performed by trained professionals who are also qualified to treat panic disorder, such as psychologists or mental health counselors. If you are currently seeing a therapist who is not trained in EMDR, you can ask him or her to provide you with a referral. EMDR practitioners can also be found through online directories, including the EMDR Institute, Inc. directory or the EMDR International Association's list of treatment centers.

EMDR is a complex and controversial technique. It's not totally clear how it works and it's not effective for everyone. Your doctor or therapist will be able to help you determine if EMDR is the right treatment option for your particular needs.

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