Eye Movement Desensitization and Reprocessing (EMDR) is a recognized psychotherapeutic approach, effective for treating trauma and post-traumatic stress disorder (PTSD). It helps the brain process distressing memories, allowing for emotional healing and symptom reduction. Because this work involves intense emotional and physical sensations, questions often arise about the safety of the process. This article explores the relationship between EMDR processing and intense feelings that can resemble a panic attack.
The Direct Answer: EMDR and Heightened Arousal
EMDR therapy does not typically cause a new panic disorder, but it frequently involves periods of intense emotional release that can feel exactly like a panic attack. When the therapy accesses a traumatic memory, the physiological reactions associated with that event can surge to the surface. These reactions—including a rapid heart rate, shortness of breath, or sudden anxiety—are hallmarks of a panic response.
This heightened arousal is a temporary side effect indicating that deeply held traumatic material is being actively processed. Unlike a spontaneous clinical panic attack, these surges are directly linked to the memory being worked on. The intensity resolves as the brain integrates the previously “stuck” memory into an adaptive network. The goal of EMDR is to diminish the emotional charge of these memories, including the physical symptoms they trigger.
Why Intense Reactions Occur During Processing
Intense reactions during EMDR are rooted in the brain’s mechanism for storing traumatic memories, described by the Adaptive Information Processing (AIP) model. This model posits that when trauma occurs, the natural information-processing system can become overwhelmed, leading to the memory being stored dysfunctionally. These “stuck” memories remain isolated in a raw, emotionally charged state, complete with original negative thoughts and physical sensations.
EMDR reactivates this blocked memory network, often involving the limbic system, particularly the amygdala, the brain’s alarm center. The bilateral stimulation used in EMDR (such as eye movements or alternating tones) facilitates communication between different brain regions, allowing the unprocessed memory to link with adaptive information. This desensitization phase temporarily brings the full, overwhelming feeling and sympathetic nervous system activation to the forefront before integration occurs. The sudden flood of emotion and physiological response signals the nervous system releasing the stored trauma.
Distinguishing Processing Intensity from Clinical Panic
It is important to differentiate the transient intensity of EMDR processing from a true, unmanaged clinical panic attack. A clinical panic attack is typically unexpected and can lead to persistent fear of future attacks and avoidance behaviors outside of therapy. The emotional surges during EMDR, however, are usually contained within the session and are an expected part of the therapeutic process.
The reactions are directly tied to the target memory and occur in a safe, controlled environment with a trained therapist. Although physical sensations like a racing heart or dizziness may mirror a panic attack, the context and resolution are different. A core goal of EMDR is to reduce the subjective level of disturbance (SUD) associated with the memory. A temporary increase in distress is often a sign that processing is underway. The therapist ensures the session is not concluded until the client feels calmer and stable, mitigating the risk of emotional intensity spilling over into daily life.
Strategies for Managing Intense Emotional Surges
Before the desensitization phase of EMDR begins, a trained therapist establishes specific safety and containment protocols.
Safety and Control Protocols
One important tool is the “stop signal,” which allows the client to immediately pause processing if the intensity becomes too overwhelming. This ensures the client remains in control throughout the session.
Grounding Techniques
Therapists teach grounding exercises to manage intense emotional surges and re-orient the client to the present moment. Techniques like the 5-4-3-2-1 method, which engages the five senses, or deep, rhythmic breathing, help calm the nervous system. These coping skills are established early to ensure the client can self-regulate and stabilize during and between appointments. The development of a comprehensive safety plan reinforces that the EMDR process is controlled and manageable, even when the content feels highly distressing.