Can EMDR help with anxiety, phobias, and panic attacks?

Eye Movement Desensitization and Reprocessing has accumulated substantial evidence for anxiety disorders, phobias, and panic — though the mechanism remains genuinely contested, and the depth-psychological question of what is actually happening in the soul during that bilateral rhythm is worth sitting with alongside the clinical data.

On the empirical side, the evidence is reasonably strong. Abbass et al. (2014), in a Cochrane systematic review of 33 randomized controlled trials, found that psychodynamic approaches to anxiety disorders — including panic disorder, generalized anxiety, social phobia, and PTSD — showed significant improvement over control conditions, with effect sizes increasing at long-term follow-up. Shapiro (2001) reports that EMDR has been studied specifically for PTSD, phobias, and panic, with controlled trials supporting its efficacy, and notes that the treatment has been extended well beyond its original PTSD application. Shedler (2010) adds the broader context: psychodynamic therapies show effect sizes that not only match but tend to grow over time, in contrast to some manualized approaches whose benefits decay — a finding that matters when we consider that anxiety often has deep roots that outlast symptom-focused interventions.

The mechanism is where things get interesting and unresolved. Shapiro (2001) herself acknowledges that no one fully understands why EMDR works. The leading hypotheses involve hemispheric synchronization — bilateral stimulation may activate both cerebral hemispheres alternately, facilitating integration of emotional and cognitive processing — and a mimicry of REM sleep, in which the brain consolidates and metabolizes emotionally charged memories. Payne et al. (2015) offer a somatic perspective: the bilateral rhythm may decouple prefrontal avoidance patterns from interoceptive experience, allowing the nervous system's own discharge processes to complete what trauma interrupted. Fogel (2009) notes that eye movements during REM sleep activate the HPA axis in ways that help consolidate emotional memories, lending neurophysiological plausibility to the REM-mimicry hypothesis.

What the clinical literature describes, at its best, is something like this:

When it works, EMDR heightens embodied self-awareness, allowing the individual to stay in the subjective emotional present with previously suppressed memories and emotions.

That phrase — stay in the subjective emotional present — is worth pausing over. Much of what drives chronic anxiety, phobia, and panic is precisely the soul's inability to remain present to its own experience. The phobic response is a flight from something that has already happened, encoded in the body as if it were still happening. Hollis (1996) observes that the thing feared often symbolizes a deeper anxiety that has not been made conscious — the acrophobic patient he describes was not merely afraid of heights but afraid of her own depths, the risk of believing in herself. The phobia was a defense against angst, which was itself a defense against something more fundamental. EMDR may work, in part, because it forces a kind of dual attention — holding the feared image while remaining anchored in the present body — that prevents the usual flight into avoidance.

The panic question is worth treating separately. Hillman (1972), reading panic through the figure of Pan, argues that panic is not a pathological malfunction but a legitimate response to the numinous — the soul's instinctual participation in something larger than the ego's managed world. Jung, writing to a correspondent in 1945, put it with characteristic directness:

As a psychotherapist I do not by any means try to deliver my patients from fear. Rather, I lead them to the reason for their fear, and then it becomes clear that it is justified.

This is not an argument against EMDR — it is a caution about what we are asking it to do. If the goal is symptom reduction, EMDR has genuine evidence behind it. If the goal is understanding what the panic is about — what logic of not-suffering it is disrupting, what the soul is trying to say in its terror — that requires a different kind of attention, one that EMDR alone does not provide. The two are not mutually exclusive. Najavits (2002) notes that EMDR has been combined productively with other approaches, and clinical experience suggests that somatic stabilization often makes depth work possible rather than replacing it.

For phobias specifically, the evidence is more mixed. Shapiro (2001) acknowledges that controlled studies of EMDR with phobic clients show replication problems, and that simple phobias may respond well to shorter behavioral interventions. The more complex the anxiety — the more it is woven into character, history, and the soul's habitual strategies — the more EMDR functions as preparation for deeper work rather than a terminus.

  • James Hillman — portrait of the founder of archetypal psychology, whose reading of Pan reframes panic as numinous rather than pathological
  • Donald Kalsched — on the archetypal defenses of the personal spirit and how trauma encodes itself in the psyche
  • Shadow — the Jungian concept most relevant to what anxiety defends against
  • Somatic experiencing — the body-based trauma approach that complements and contextualizes EMDR's mechanism

Sources Cited

  • Abbass, Allan A., 2014, Short-term psychodynamic psychotherapies for common mental disorders
  • Fogel, Alan, 2009, Body Sense: The Science and Practice of Embodied Self-Awareness
  • Hillman, James; Roscher, Wilhelm Heinrich, 1972, Pan and the Nightmare
  • Hollis, James, 1996, Swamplands of the Soul: New Life in Dismal Places
  • Jung, C.G., 1973, Letters Volume 1: 1906-1950
  • Najavits, Lisa M., 2002, Seeking Safety: A Treatment Manual for PTSD and Substance Abuse
  • Payne, Peter, 2015, Somatic experiencing: using interoception and proprioception as core elements of trauma therapy
  • Shapiro, Francine, 2001, Eye Movement Desensitization and Reprocessing (EMDR): Basic Principles, Protocols, and Procedures
  • Shedler, Jonathan, 2010, The Efficacy of Psychodynamic Psychotherapy