My first panic attack.

This past Spring, I had my first ever MRI…and my first ever panic attack. The MRI was procedural – simply a proactive, preventative measure my doctor advised I take as a follow-up step to some test results.  I wasn’t nervous for the appointment. In fact, I saw the MRI as an opportunity to cozy up, hush my brain, exhale and just relax.

But half-way through the procedure, a curveball struck: for no apparent reason, I found myself suddenly and extremely anxious…an anxiety that quickly escalated to the point that I could not breathe. It was almost as though the layers of air around me were closing in like multiple slamming doors…and I was suffocating.

I squeezed the “button” in my hand I had been instructed to push should I need to alert the tech for any reason…and he swiftly pulled me out.

 I knew I was having the first panic attack of my life. I was equal parts shaken, curious, and confused - because I’d been having no evident, conscious thoughts of fear or any discernable anxiety in the days let alone the moments leading up to my MRI. In fact, I had never been someone who was anxious for anything medically related.

The tech reassured me that panic attacks during MRIs were not uncommon - that even those with no prior knowledge of claustrophobia had similar reactions. He explained they surmised that it was likley due to a primal, survival mechanism that can kick in when our body senses we are a situation that suggests we are physically helpless.

Due to some practical insurance-related realities, I knew that I needed to get back in the machine and complete the MRI that day. Using a combination of grounding and self-soothing tools - humming to myself and focusing on recent moments of levity – I managed my way through the final 10 mins…and I was particularly grateful for the sense of safety I felt as a result of the tech gently yet firmly holding my ankle to help ground and soothe me.

When I was done, I experienced a wave of relief that brought me to tears…and made me feel as though going back into the MRI machine to complete the process had been one of the biggest most courageous accomplishments of my life – even in spite of the logic of my left-brain chiding me that this hardly qualified as résumé-worthy.

EMDR: A proven protocol for panic attacks

I left that experience with a newfound depth of empathy for friends, family members and clients who suffer from panic attacks…as well as the gnawing question: “…why had this happened to me now? For the first time ever…in adulthood? Especially given I’d never had any medically related anxiety, or “claustrophobia” - let alone full-blown panic attacks?”

And more importantly, given how anywhere from jarring to terrifying the experience has been: “how can I make sure this doesn’t happen again?”

I knew firsthand – both from my work with prior clients and from my own training - that EMDR is an acute therapeutic protocol that could help me get beyond whatever it was that has triggered my panic attack. In a nutshell EMDR is a specialized form of therapy that helps people address and heal from the long-term emotional distress and acute symptoms (like panic attacks) that can result and persist from prior adverse or disturbing life experiences.

If you’d like to get straight to what EMDR is and how it works, feel free to scroll down now. However, if you are someone who is curious to understand more how our brains can misinterpret benign situations as threat-worthy, read on for some of the basics on the mechanics of trauma.

Where trauma originates... and waits.

Clients I have worked with who suffer from debilitating anxiety and panic attacks can often make a connection with an explicit traumatic memory of an event that in turn triggers them. In other instances like mine, where one can’t identify the “why” or any particular past event or phobia, it may well be triggered by what’s referred to as an implicit memory - one that we can’t consciously recall but that shapes our feelings and behaviors.

These traumatic memories can get “stuck” in our subconscious brain, and then later re-activated.  Reactivation happens when our five senses encounter something similar from the past experience (for example, a smell or sound), and in an effort to protect us from the overwhelm and fear that previously occured, our survival brain triggers the same fight-flight-or-freeze response it originally activated to protect us way back when.

This can be an awfully inconvenient and incredibly confusing and scary false-alarm -  especially when one is simply amid their day-to-day doing something routine. Something like oh say an MRI. :-)

Trauma 101: It takes less than you think.

When we hear the word “traumatic,” we can often assume it means something extreme like being caught in a tsunami or physically assaulted. But technically trauma can occur in any moment when we perceive our a situation as something that is beyond our ability to cope with it. The result is that we feel a sense of overwhelm, be that physical helplessness and/or emotional hopelessness.

These adverse experiences can range from things like having a scary encounter with an aggressive dog, to being in a close-call car collision, to being the victim of abuse or involved in combat. Additionally, trauma can happen as a result of things we even just witness as bystanders, be that seeing a baby deer hit by a car to watching The Twin Towers crumble, or even just witnessing one’s parents have a loud and scary fight.

In these moments, our survival mechanism often knocks the conscious, rational part of our brain offline to direct all energy towards efforts towards the “fight, flee or faint” survival mechanism - whichever our primal instincts subconsciously deteremine will give us the best chance of surviving. When that happens, our primal brain encodes and remembers everything our five senses can take in –and keeps it “on file,” so that should it ever encounter that “threat” situation again, it will signal the brain to fight-flee-or-faint once again. This automatic alerting system is something all mammals have. 

The problem? When our conscious logical brain is knocked offline, it’s not available or able to do what it typically does - which is to store this as a memory of something that happened in the past. Instead, it stays stuck in the unconscious brain – a place that cannot tell time. Which means later in life, if it senses anything that reminds it of that prior distressing moment – a sound, a smell, an expression on someone’s face - it may believe that same event is happening again and posing that same threat in the present.  This automatically sounds the alarm that triggers our body into fight, flight or freeze.

EMDR: An empirically proven way to get “unstuck.”

Eye Movement Desensitization and Reprocessing (EMDR) therapy (aka “Reprocessing Therapy”) is an evidence-based therapy that’s been used by therapists in 130 countries around the world to help treat millions for situations like those I’ve mentioned above and more. It recognizes that our bodies subsconsciously remember and react in ways that may not make logical sense to our conscious brain.

People seek out EMDR for conditions ranging from various forms of anxiety, depression, and panic attacks. Many military service personal and first responders have sought out the protocol. In fact, the U.S Department of Veterans Affairs and Department of Defense note that EMDR has official approval from the World Health Organization (WHO) and government organizations and agencies in the United Kingdom, Australia and Germany, among others for its effectiveness in treating symptoms from trauma and PTSD and other conditions. EMDR is also recognized as an effective form of treatment for “trauma” and “other disturbing experiences” by organizations such as the American Psychiatric Association.

In a nutshell, the EMDR-trained therapist facilitates a structured, multi-phased approach to help a client “re-process” the stuck memory - which aims to significantly ease or eliminate altogether the distress related to that memory. The first phases involve the therapist getting some initial history and background, and ensuring the client feels safe, grounded, and well resourced to conjure up past instances of the undesired state. Once that foundation of security and resourcing is in place, the therapist companions the client through the process of gently and generally revisiting the memories of distressing experiences – though not necessarily having to relive or recount the event in detail. 

At the same time as the client is holding a general image of the past distressing episode, the therapist facilitates a form of “bilateral stimulation” for the client - typically left-to-right eye movements, or different alternating actions such as a client tapping their own shoulders in a back-and-forth cadence. This bi-lateral stimulation is the neurological mechanism associated with “re-processing” a past event and easing the distressing emotion associated with a “stuck” trauma-memory.

The reprocessing of the memory effectively decouples the strong negative association one’s brain has linked to that memory. Once decoupled, the therapist then continues using the bi-lateral stimulation to introduce a new positive association - typically a thought or belief that is contrary to the original negative cognition. This “reprocessing-and-replacement” ultimately eases the brain’s instinct to trigger the “fight-flight-freeze-or-faint” mechanism that technically occurs with anxiety or panic attacks. Instead, the client can consciously recognize that a situation may remind them of a previous memory that was difficult or disturbing, but they will not be “hooked” by it- they won’t be triggered into the dramatic often debilitating survival response they previously were. They’ll instead be able to recognize and tolerate it as “just a memory that happened in this past,” and carry on with more ease. And in fact they likely experience the more pleasant emotions evoked by the new, positive association that I mentioned above. 

Next month: practical insights from my own EMDR experience

Given that I know I will need to undergo MRIs in the future, I recently started my own EMDR treatment.  In an effort to “demysify” this type of therapy for others, I plan to keep a journal of the experience so I can share a play-by-play of the experience with anyone who is curious! My hope in doing so? To educate others on the type of practical steps, process, and results one can anticipate if they feel EMDR is an approach they are curious to explore as a means to moving beyond debilitating anxiety or panic attacks.  

Now that I am trained in and facilitate EMDR for others, I am excited to take this journey so that I will be able to know and testify firsthand to the process, potential and power that I already believe EMDR has to help those seeking a holistic and somatic approach to greater well being…stay tuned!