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Eye Movement Desensitization
and Reprocessing in the
Treatment of Panic Disorder
With Agoraphobia
Isabel Fernandez
Italian Association for Cognitive Behaviour Therapy
Elisa Faretta
H. Bernheim Italian Institute of Clinical Hypnosis and Psychotherapy
This article describes a comprehensive treatment of a case of panic disorder with agoraphobia.
A thorough history taking revealed that experiential contributors had a pivotal role in the
development of the condition. Therefore, eye movement desensitization and reprocessing
(EMDR) was used to address early traumatic events as well as the present stimuli that caused
disturbance and had maintained symptomatology for the past 12 years. Although the client’s
symptoms were resolved after 15 sessions, EMDR was also effective in addressing future
behaviors and resolving anticipatory anxiety. During EMDR processing, the client demonstrated
emotional and cognitive changes consistent with trauma resolution, insight, and personal
growth. The client gradually enacted functional new behaviors spontaneously as treatment
unfolded. The therapeutic process and the targets are described in detail.
Keywords:
panic disorder; agoraphobia; eye movement desensitization and reprocessing; trauma
1 Theoretical and Research Basis
Eye movement desensitization and reprocessing (EMDR) is an integrative psychother-
apy that has been extensively evaluated in its approach to trauma and posttraumatic stress
disorder (PTSD). In 1998, the American Psychological Association’s Division 12 Task
Force on Psychological Interventions designated EMDR, along with exposure therapy and
stress inoculation therapy, to be probably efficacious in the treatment of trauma (Chambless
et al., 1998). The International Society for Traumatic Stress Studies (Chemtob, Tolin, van
der Kolk, & Pitman, 2000), the Israeli National Council for Mental Health (Bleich, Kotler,
Kutz, & Shaley, 2002), and the Northern Ireland Department of Health (Clinical Resource
Efficiency Support Team, 2003) soon followed by also designating EMDR as an effective
form of treatment for PTSD and victims of terror. Most recently, the U.S. Departments of
Defense and Veterans Affairs (2004) and the American Psychiatric Association (2004) have
given EMDR the highest level of recommendation.
Authors’ Note:
Correspondence regarding this article should be directed to Dr. Isabel Fernandez Via Paganini,
50 20030 Bovisio Masciago (MI) Italy; e-mail: isabelf@tin.it.