Does Gestalt Therapy Work for Panic Attacks and Agoraphobia?
Gestalt therapy is a well-known modality focused on awareness, personal responsibility, and present-moment experience. But can it effectively treat panic disorder and agoraphobia? The answer is complex—it depends on how Gestalt therapy is applied.
Gestalt Has the Right Tools—But Lacks Direction
I spent three years training in Gestalt therapy, and while it provides a valuable toolkit for addressing panic, its traditional approach is non-directive. This means that instead of following a structured plan like, Step A → Step B → Step C, Gestalt encourages a more open-ended exploration—essentially, let’s see what comes up. While this method can foster valuable self-awareness, it can also be chaotic and unfocused when treating panic disorder and agoraphobia, which often require structured interventions.
Why Panic Attacks Thrive on Avoidance
One of the core challenges in treating panic disorder and agoraphobia is avoidance. People with panic attacks tend to avoid situations that trigger anxiety, which reinforces their fear and makes the disorder worse. Gestalt therapy emphasizes openness to experience, which is a useful concept for treating anxiety, but without a structured way to actively confront feared situations, it may not be enough on its own.
How Gestalt Can Be Made More Effective
While Gestalt therapy alone might struggle to treat panic attacks effectively, it can work if combined with exposure therapy. Exposure therapy directly targets avoidance by gradually exposing individuals to feared situations until their anxiety response decreases. If we direct Gestalt’s openness-to-experience framework specifically toward panic triggers and incorporate exposure techniques, it becomes a much more powerful approach.
What Works Better for Panic and Agoraphobia?
In my practice, I don’t use Gestalt therapy alone to treat panic disorder. Instead, I rely on Acceptance and Commitment Therapy (ACT) combined with exposure therapy. This approach provides the structure needed to break the cycle of avoidance while fostering psychological flexibility.
Additionally, I integrate techniques like:
Paradoxical intent (welcoming panic to reduce its power)
Personification of panic (giving the panic a “character” to lessen its control)
Using anger instead of fear (anger is an approach emotion that can counteract avoidance)
Final Verdict: Gestalt + Exposure = A Better Approach
Gestalt therapy has valuable tools for addressing panic attacks and agoraphobia, but by itself, it lacks the direction needed for effective treatment. When combined with exposure therapy, it can be adapted into a more structured and practical approach. If you’re dealing with panic attacks, the key is to engage in therapies that directly target avoidance while fostering openness to discomfort.
If you’re struggling with panic disorder or agoraphobia, structured exposure combined with ACT may be the most effective path forward.
