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a primary means of decreasing the emotional arousal and fear-related beliefs. The model that
underlies such treatments (Arntz, 2002; Faretta & Fernandez, 2003) posits the use of thera-
pist modeling and corrective information during extended confrontation of, or participation
in, the real-life feared situation as an important aspect of treatment. In contrast, the AIP
model guiding EMDR treatment posits that that dysfunction is primarily generated by the
dysfunctionally stored memories, which can best be treated by direct targeting. It is hypoth-
esized that the anxiety and fear felt by the client are actually the emotions and physical sen-
sations inherent within the implicit memory network (Shapiro, 2001; Stickgold, 2002).
Therefore, the processing of the etiological events that have caused and maintained the dys-
function is the pivotal aspect of EMDR treatment. In vivo exposure is suggested only after
the etiological events have been processed and the fear largely resolved. The in vivo expo-
sure is then used to reveal any specific triggers or ancillary targets that need to be processed.
As noted in this case, clients often begin spontaneously to drop avoidance and emit new pos-
itive behaviors subsequent to EMDR processing. As demonstrated in this case, Adriana
began to drive and stay alone without the therapist’s prompting. This is typical of the
20 cases of PDA treated by the authors. The dissimilarity of EMDR and CBT procedures has
important theoretical and treatment implications and warrants further investigation.
11 Recommendations to Clinicians
It should be noted that in contrast to the Goldstein et al. (2000) study that used only one
session for history and preparation, six sessions of history taking, alliance building, and
psychoeducation prepared Adriana for EMDR processing. The result is that unlike the par-
ticipants of the Goldstein et al. study, successful in-session processing was observed and
the panic disorder ceased after four processing sessions. Twelve processing sessions
resulted in a full remediation of symptoms. With Adriana, after resolving the dysfunctional
learning experiences and reprocessing past events, future templates were targeted by pro-
cessing projected feared events. EMDR was used to further consolidate the adaptive and
positive behaviors as they were enacted. This case is typical of 20 clients already treated by
the authors (Faretta & Fernandez, 2003).
As mentioned previously, EMDR facilitates both the reconstruction of the etiological
elements and the processing of the events, which, although apparently forgotten, remain
dysfunctionally stored within the memory network. In this sense, EMDR may be included
within a therapeutic program tailored for each individual client. Processing with EMDR
allows clients to re-experience the traumatic memories within the safety of a typical thera-
peutic setting.
In terms of EMDR’s applicability to panic disorders, specifically, clinical experience has
shown that the integration of EMDR into already existing models enables a cognitive
understanding of the schemas favoring and maintaining panic and a desensitization or
deconditioning in terms of the feared events or situations. This helps to reveal important
emotional conditions that constitute psychological nexes, leading to a better cognitive
understanding of the disorder and its relevant behavioral adaptation. EMDR also facilitates
the sequential organization of forgotten, meaningful traumatic memories, which, after
reprocessing, enable the activation of a better adaptation and a more realistic attitude
Fernandez, Faretta / Panic Disorder and EMDR Treatment
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