Researchers have demonstrated that psychoanalytic talk therapy is an effective modality for treating panic disorder. In the study, scientists compared 12 weeks of twice-weekly psychodynamic psychotherapy sessions to another well-known approach, applied relaxation training (ART).
Panic disorder remains a common, debilitating condition, accounting for more than 20 percent of U.S. hospital emergency room visits. Patients with the condition are plagued by sudden, uncontrolled symptoms such as panic, dizziness, and heart palpitations, as well as chest and abdominal pain.
“The psychoanalytic strategy was highly effective, achieving nearly double the level of patient response by the end of treatment as compared to ART,” says Dr. Barbara Milrod, the study’s lead author and associate attending physician at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
The findings are significant because the trial, while preliminary, is among the first to prove clinical efficacy for a psychoanalytic therapy for any major psychiatric disorder, Dr. Milrod says.
Her team published their findings in the American Journal of Psychiatry.
“Right now, two therapies — cognitive behavioral psychotherapy (CBT) and the use of antidepressant or anti-anxiety drugs such as selective serotonin reuptake inhibitors (SSRIs) — are the main forms of treatment for panic disorder in the United States,” Dr. Milrod explains.
However, studies suggest that up to half of patients may not respond to either of these approaches. What is more, many patients, such as women during pregnancy, prefer not to take a pharmaceutical therapy, lending urgency to the notion that patients need effective, non-pharmaceutical options in treating panic disorder.
That is why there has been a renewed interest in psychodynamic psychotherapy. “This form of talk therapy has actually been around since the beginning of the 20th century, and it’s still practiced by many psychiatrists and psychologists across the U.S. today,” Dr. Milrod says.
Unlike CBT — which relies on exposure to panic triggers, and a highly structured set of exercises aimed at easing attacks — psychodynamic psychotherapy has a different focus.
“It’s really aimed at getting patients to understand the underlying emotional meaning of their panic, its root psychological causes,” Dr. Milrod says. “Once that is achieved, patients can acknowledge previously unacceptable feelings and ideas, which have led to panic, as they arise.”