EMDR is known by clinicians to be efficient in the treatment of panic disorder with or without agoraphobia (PDA), but there is little research on this topic. Cognitive-behavioural therapy is recognized as the best evidence-based treatment to reduce symptoms that develop after the onset of the first panic attack (PA) but about 30% of patients do not respond and about 30% relapse. Furthermore the roots of PA are rarely assessed nor considered in the research treatment protocols.
In some cases, the roots of PA are recent stressful events or traumas. In other cases, Jacobs & Nadel (1999) propose that the first PA has its roots in early critical experiences when the hippocampus was not mature yet (before age 2), leading to incomplete or dysfunctional integration of that experience. With Jacobs & Nadel we believe that the reprocessing of the critical experiences that have led latter to the onset of PA will maximize treatment outcome and best prevent relapse, particularly when the critical experiences occurred at a very young age.
In this presentation we bring together the AIP model (and the work of Katie O’Shea), cognitive-behavioural concepts, the neurodevelopmental model of the etiology of PDA (Jacobs & Nadel, 1999) and extensive clinical observations and trials, with the goal to maximize the use of EMDR and treatment outcome. Case studies of EMDR treatments will illustrate a proposed categorization of PDA subtypes, based on the different possible origins of panic attacks. We will also present differentiated adapted procedures for each subtype.
Olivier Piedfort-Marin is psychologist and licensed psychotherapist in Switzerland, working in private practice in Lausanne, with main interest in the assessment and therapy of anxiety disorders, PTSD, complex trauma and dissociative disorders, as well as supervision and teaching. After a training in CBT, he has been trained in EMDR in 2004 and is now EMDR Europe Consultant and facilitator of the EMDR Institute Switzerland. He has en extensive training in the theory of structural dissociation of the personality (E. Nijenhuis) and in the ego state therapy (L. Reddemann). He is co-director of the Institut Romand de Psychotraumatology – IRPT.