EMDR for Panic Attacks

EMDR for Panic Attacks

Short Answer: EMDR can be used to work with panic attacks by focusing on the memories, body sensations, thoughts, and fears that have become connected to panic. It is usually used during a planned session rather than as a technique to stop a panic attack while it is happening. For some people, a past panic attack becomes a distressing memory in its own right, while others become preoccupied with physical sensations or the fear of having another attack. EMDR gives those experiences a structured focus during bilateral stimulation.

Key Takeaways

• EMDR may focus on a past panic attack, fear of future attacks, physical sensations, or panic-related beliefs.
• It is generally used during planned sessions rather than as an emergency technique during an active panic attack.
• A panic attack itself can become a distressing memory that continues to trigger fear after the episode has ended.
• Research has found improvements in panic symptoms and related anxiety, and EMDR is also used in practice for panic attacks and anxiety.
• Feeling nervous about body sensations or another possible attack can become part of the cycle that EMDR is used to address.

Why Panic Attacks Can Continue to Affect You After They End

A panic attack can feel intensely physical. A racing heart, shortness of breath, dizziness, chest tightness, shaking, sweating, nausea, or a feeling of losing control can appear quickly. Even after the episode passes, the memory of what happened may remain vivid.

For some people, the most difficult part is not only the panic attack itself. It is the fear that another one could happen. You may begin watching your body for signs of panic, avoiding places where a previous attack happened, or worrying about what you would do if symptoms returned in public.

This can create a cycle. A body sensation such as a faster heartbeat may remind you of a previous panic attack. That reminder can increase fear. The increased fear can make the physical sensation feel even more noticeable. Over time, the memory of panic, the sensations associated with it, and the anticipation of another attack can become closely linked.

EMDR can be used to work with different parts of that cycle. The goal is not to pretend the panic attack never happened. Instead, the session may focus on the memory or fear that continues to feel especially charged.

What EMDR May Focus On for Panic Attacks

There is no single focus that applies to everyone. The most useful starting point often depends on what feels most connected to the panic now.

A past panic attack

A first panic attack or a particularly memorable episode may become the focus of a session. Someone might remember where they were, what they felt in their body, what they feared was happening, or how trapped or helpless they felt in that moment.

If that memory still produces a strong reaction, EMDR may be used to process the episode as a distressing experience that continues to affect how the person responds to panic.

Fear of another attack

Sometimes the main problem is anticipatory fear. You may be less distressed by the memory of a previous attack than by the thought of having another one while driving, flying, standing in line, attending a meeting, exercising, or being somewhere that feels difficult to leave.

In that situation, an EMDR session may focus on the feared future scenario and the thoughts or images connected to it.

Physical sensations

Panic can make people unusually alert to ordinary changes in the body. A stronger heartbeat, warmth, lightheadedness, a tight feeling in the chest, or a change in breathing may become associated with the fear that panic is about to begin.

Those sensations can sometimes be included as part of the focus during EMDR. The aim is not to prove that a sensation can never occur again. It is to work with the fear and meaning that have become attached to it.

Panic-related beliefs

A panic attack can leave behind thoughts such as I am not in control, I cannot handle this, something terrible is about to happen, or I am trapped. EMDR may include those beliefs as part of the material being processed.

The focus can also shift as the session develops. A person may begin with the memory of a panic attack and then notice that the strongest part is actually the fear of embarrassment, the physical sensations, or a particular thought about what the panic means.

How an EMDR Session for Panic May Work

EMDR uses a structured process that combines focused attention with bilateral stimulation. Bilateral stimulation may involve guided eye movements, alternating sounds, or tapping.

During a session, you briefly bring a selected memory, image, thought, feeling, or body sensation to mind while following the bilateral stimulation. You then notice what comes up and continue through additional sets.

For panic-related work, the starting focus might be a previous attack, a feared future situation, or a body sensation that has become strongly associated with panic. The session does not require you to spend the entire time describing the event in detail. The focus is on noticing what is present and moving through the structured process.

You do not need to begin with the most intense panic experience you have ever had. You can choose a more manageable target and work at your own pace.

EMDR Is Not Usually an In-the-Moment Panic Stopper

It is useful to separate EMDR from techniques intended to help someone get through an active panic attack.

EMDR is generally used during a planned session when you can focus on the panic-related memory, fear, or sensation without needing to solve an immediate problem at the same time.

If a panic attack is happening right now, there is no need to start an EMDR session in the middle of it. The experience can be addressed later when you have time and attention available for a structured session.

This distinction matters because it sets realistic expectations. EMDR is not mainly about forcing panic to stop on command. It is about working with the experiences and associations that may continue to make panic feel threatening over time.

Why Fear of Body Sensations Can Become Part of the Problem

After a frightening panic attack, some people become more aware of sensations that were easy to ignore before. A quick heartbeat after climbing stairs, feeling warm in a crowded room, or becoming slightly lightheaded may suddenly seem important because those sensations resemble part of a previous attack.

The sensation itself can then become a reminder. You notice it, remember panic, become more alert, and start wondering whether another attack is beginning. That extra attention can make the sensation feel stronger and more difficult to ignore.

An EMDR session may target the memory connected to that reaction, the feared meaning of the sensation, or a future image of panic occurring again. This is one reason EMDR for panic is not limited to working on a single past event.

What the Research Says About EMDR for Panic Disorder

EMDR has been studied for panic disorder, and therapists also use it in practice with people experiencing panic attacks, anxiety, and related fears.

The research base for panic disorder is smaller than the research base for PTSD, but several studies have reported improvements in panic symptoms and related anxiety. In one randomized trial involving 84 people with panic disorder, EMDR and cognitive behavioral therapy produced similar results on several measures of panic severity and quality of life.

Research has also looked at how EMDR may help with the memories, physical sensations, and fears that can become connected to panic. For some people, the memory of a frightening panic attack or the fear of experiencing another one can become an important focus during EMDR.

EMDR is widely used by therapists for panic attacks, anxiety, grief, depression, trauma, and other distressing experiences. While the largest body of research has focused on PTSD, EMDR is also commonly used in practice for a much broader range of concerns.

What Progress May Look Like

Progress does not have to mean that you never feel anxious again or never notice a fast heartbeat. A more realistic change may be that a past panic attack feels less vivid, the memory produces less fear, or a body sensation no longer immediately convinces you that another attack is about to happen.

You may also notice that a place or situation connected with previous panic feels easier to think about, or that the thought of another attack feels less overwhelming. These changes can happen gradually rather than all at once.

It is also possible to work on one part of the panic experience and still have another part that needs attention. For example, the memory of a first attack may become less upsetting while fear of having an attack while driving remains. That does not mean the earlier work failed. It simply means panic can involve several connected targets.

Choosing a Focus for an EMDR Session

If you are deciding what to work on, it may help to ask which part of panic feels most active now. You might choose the memory that comes to mind most often, the situation you worry about most, the body sensation you monitor most closely, or the thought that feels most connected to the fear.

A specific focus is usually easier to work with than a very broad goal such as I want to get rid of all anxiety. For example, you might focus on the memory of a panic attack in a grocery store, the fear of panicking on a plane, or the thought that a racing heart means you are losing control.

The focus does not need to be perfect before you begin. EMDR is a process, and what feels most important can become clearer as you move through a session.

Can EMDR Be Used When Panic Is Not Linked to Trauma

Yes. A panic attack does not have to be connected to a major traumatic event for someone to consider EMDR. The panic episode itself may have been frightening enough to become a strong memory, or the main focus may be the fear of future panic rather than an earlier trauma.

This is one reason it can be helpful to think in terms of the experiences that are keeping the panic fear active. For one person that may be an earlier distressing event. For another it may be the first panic attack. For someone else it may be the image of having another attack in a place where they feel unable to leave.

Conclusion

EMDR can be used to work with panic attacks by focusing on the memories, sensations, beliefs, and future fears that have become connected to panic. It is generally used during planned sessions rather than as a way to stop an active panic attack in the moment.

For some people, the most important target is a past panic attack. For others, it is the fear of another episode, a particular physical sensation, or a situation they have begun to associate with panic. Research has found improvements in panic symptoms and related anxiety, and EMDR is also used in practice with people experiencing panic attacks.

If a particular panic-related memory, fear, sensation, or belief continues to bother you, it can become a specific focus for an EMDR session.