Panic disorder affects roughly two in every hundred people. It involves sudden, unexpected panic attacks: surges of intense fear accompanied by a pounding heart, chest pain, sweating, trembling, and breathlessness. These sensations are often experienced as catastrophic, and many people come to believe they are having a heart attack or losing control. The fear of the next attack can then become a problem in its own right, gradually shrinking a person's world as they avoid places where an attack might happen.
The established treatment is cognitive behavioural therapy, which helps people identify and test the catastrophic interpretations they place on ordinary bodily sensations. It works well for many, but not for everyone, and there has long been interest in alternatives.
EMDR is one such alternative, and the reasoning behind it is interesting. A first panic attack is often experienced as genuinely terrifying, and some researchers have argued that it can function much like a traumatic event, leaving a vivid, emotionally charged memory that primes the person to fear a recurrence. If so, processing that memory might reduce the fear that sustains the disorder.
A randomised controlled trial by Ferdinand Horst and colleagues, published in Frontiers in Psychology (2017), tested this directly. People with panic disorder were randomly assigned to receive either CBT or EMDR. In the EMDR condition, therapists mapped out the memories that appeared to have contributed to the panic, starting with the first or worst attack, and reprocessed those first.
The finding was clear: EMDR proved to be as effective as CBT for treating panic disorder. A follow-up commentary confirmed that EMDR was not inferior to CBT in reducing anxiety-related thinking, easing the fear of bodily sensations, or improving most aspects of quality of life.
Some caution is still warranted. The wider evidence for EMDR in anxiety disorders is mixed rather than uniformly positive, and earlier studies produced more varied results. Reviewers have consistently called for further controlled research before firm conclusions can be drawn.
Even so, the practical message is a useful one. For someone with panic disorder who has not been helped by CBT, or who would prefer an approach that does not centre on homework and detailed cognitive challenging, EMDR appears to be a credible option rather than a second-best fallback. Where the panic clearly traces back to one frightening early episode, it may be an especially natural fit.
Source: Horst, F., Den Oudsten, B., Zijlstra, W., de Jongh, A., Lobbestael, J., & De Vries, J. (2017). Cognitive Behavioral Therapy vs. Eye Movement Desensitization and Reprocessing for Treating Panic Disorder: A Randomized Controlled Trial. Frontiers in Psychology, 8, 1409.