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fear, were acquired. Once the appropriate targets are chosen, the EMDR protocol addresses
all experiential components (images, thoughts, emotions, bodily sensations) to stimulate
the information processing system as explained by the AIP model.
2 Case Presentation
In the following case, EMDR was used to successfully address panic disorder with ago-
raphobia. Adriana presented for treatment at the age of 32, with a diagnosis of panic disor-
der with agoraphobia. Although her symptoms first appeared at the age of 20, by the time
of treatment, her panic attacks were occurring once or twice per month (with some episodes
occurring at night).
3 Presenting Complaints
Adriana was reporting a constant underlying tension, worry, and pervasive apprehension
for the next panic attack, which contributed to her agoraphobic avoidance. A daily activity
most affected by Adriana’s panic attacks was driving. Eight years previously, she had expe-
rienced an intense panic attack (the worst one) and had not been able to drive alone with-
out fear ever since. The panic attacks were unexpected and invariably occurred when she
was driving alone. Her symptoms included a feeling of choking (because of a disturbance
in her throat), tachycardia, sweating, feeling faint, tingling in her hands, leg tremors, visual
disturbances, and a fear of dying. Eventually, Adriana’s agoraphobia extended beyond her
fear of being alone in the car to include any place where it might be difficult to escape or
to receive help in case of a panic attack. These included being blocked in a traffic jam,
shopping, and riding elevators.
Over time, Adriana became afraid of being alone, even when in her own home.
Consequently, she actively avoided being alone (at home or outside) and performed all of
her daily activities with an accompanying person. Naturally, this significantly affected her
ability to function, in that it substantially limited her outings. Adriana was unable to go
shopping or to the supermarket and even postponed her wedding several times. Using the
subjective units of disturbance scale (SUD; Wolpe, 1958), where 0 reflects no disturbance
and 10 the highest imaginable, Adriana rated her anxiety-provoking situations to range
from being in a traffic jam with an accompanying person (SUD = 4) to driving to work
alone (SUD = 10).
4 History
During the first phase of EMDR treatment, a complete history is taken to identify perti-
nent information for a focused treatment plan. Past events related to the distress are inves-
tigated, as well as present situations triggering the disorder and behaviors or skills the client
requires. In Adriana’s case, it was discovered during this phase of treatment that there were
no other cases of panic disorders or mental problems in her family. However, her father had
Fernandez, Faretta / Panic Disorder and EMDR Treatment
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