Basic HTML Version
The following week, Adriana reported that the distress associated with her mother’s
typical expression was still resolved, and she felt appropriately detached from her. She very
clearly associated her current difficulties with the traumatic event experienced at the age of
9 (when the burglars came into her garden). Thus, the image of these men wearing balaclavas,
about to enter her house, became the next EMDR target. As she recalled this event and
focused on this image, she reported the negative cognition as “I am in danger,” which was
associated with an intense fear (SUD = 8) that she felt in her heart. This memory was
processed to resolution, that is, until Adriana could think about this episode without distress.
The following week, Adriana remained at home alone for an hour, which was a vast improve-
ment, as she had been unable to stay home alone, even for 1 minute. Adriana reported expe-
riencing just a few moments of anxiety, lasting 2 or 3 minutes, but no panic attacks. She
realized she no longer worried about feeling sick, especially in the gym, and was able to walk
alone for short distances. Reevaluation of the distress associated with the previous week’s target
was zero (no distress) and the VOC was 7 for the positive cognition “I am safe.”
After processing this episode, Adriana realized that despite the nightmares and the intense
fear of remaining home alone (after the traumatic event of the burglars), the first key episode
of great distress directly related to the panic disorder feelings occurred at the age of 19, when
she smoked hashish with a friend and drove home feeling physically ill. Adriana pictured
herself in the car, feeling sick and unable to see properly while attempting to get home. The
negative cognition associated with this memory was “I am going to die” and the emotion
presently felt while recalling the event, was fear (SUD = 7), located in her throat.
During reprocessing, it became evident that her fear of driving developed after that night.
Also, because she still experienced physical discomfort after she reached home (eyes rota-
tion, suffocation, anguish, etc.), she realized that this was the point at which she developed
her fear of being alone. This fear was associated with the anxiety provoking thought “What
if I feel sick?” During the EMDR session, she experienced the same feelings she had while
under the influence of the hashish. Adriana eventually understood the influence that this
experience had on her fear of letting herself go, of falling asleep, and on her constant state
of alert. Being sick in the car created a feeling of distress associated with the situation and
engendered the panic disorder as consequence of classic conditioning.
The next session focused on an event that preceded her first real panic attack, Adriana’s
appendectomy. When asked to recall the surgery, she reported a strong feeling in her throat.
The image associated with this memory was Adriana waking up from surgery, crying, and
looking for her mother. The negative cognition was “I am in danger” and the preferred pos-
itive cognition was “I am safe,” although this was not very believable to her (VOC = 2).
While recalling this event, Adriana felt anguish, which was very distressing (SUD = 7) and
was noticed in her throat.
During reprocessing, Adriana associated the feeling in her throat to the fact that she was
intubated. She recalled waking up during surgery, unable to inform the doctors that she was
feeling everything. The doctors eventually realized she was awake and increased the anes-
thesia to appropriate levels. Apparently, the somatic memory related to being intubated at
a time when she felt acute panic had remained stored in her memory network (Shapiro,
2001). The memory was never visually conscious but was expressed through the feeling in
her throat that was generally associated with her anxiety. It was only during the EMDR ses-
sion that she consciously realized the associative connection.
54 Clinical Case Studies