When the panic isn't the only thing you've had to manage.
Panic disorder has a way of reorganizing your life around itself. You start choosing routes, restaurants, and situations based on where exits are. You turn down the thing you used to love because the risk of an attack feels too high. By the time you think about getting help, you've already been managing for months.
And if you've been in therapy before, maybe you know this version of the problem too: you spent the first several sessions explaining your relationship structure, your identity, your community, before your therapist would touch the actual panic. That's not therapy. That's homework you didn't sign up for, and it gets in the way of the work you actually need.
Panic disorder is not a sign you're too sensitive, or that you can't handle stress. It's your nervous system doing something it learned to do, probably for a reason. And it responds to treatment. The right treatment, with a therapist who can hold all of you at once.
How we work with panic disorders
At ITG, your therapist starts with the panic. Not a detour through your identity history to decide if you're a "real" client first. Every therapist at ITG was specifically selected for their genuine affirmation of LGBTQIA+, kink, BDSM, and ENM/CNM/poly communities. Many are personally part of those communities. You won't be educating your therapist about your life.
For panic disorder specifically, ITG uses two gold-standard approaches: EMDR and CBT.
Cub Larkin, ITG's founder and Clinical Director, is a Certified EMDR Therapist (EMDRIA) and a Certified CBT Therapist trained at Florida Atlantic University. EMDR works at the level of how your nervous system has stored distressing memories and experiences, reducing the charge that triggers panic responses. It's especially effective when panic has roots in trauma or sustained identity-related stress. CBT for panic identifies and changes the thought patterns that amplify attacks and gradually rebuilds tolerance for situations you've been avoiding. Both are available at ITG, often in combination.
The Safe and Sound Protocol (SSP), offered by Cub and by Martin Avellaneda, LMHC, LPC, addresses panic at the nervous system level through auditory stimulation. It's particularly useful when panic has a somatic or developmental component.
What to expect
Your first session:
Building your approach:
Doing the work:
What changes
You stop organizing your life around the fear. The avoidance shrinks. The things you stopped doing become available again. That's not a promise. It's what treatment for panic disorder tends to produce when it's the right fit.
Your therapist already gets your whole life. You come in and start with the work. The sessions are for you, not for explaining yourself to someone who needs the background first.
Treatment that fits how you actually experience your body and your history. Whether your panic has roots in trauma, identity-related stress, or something harder to name, the approach gets tailored. Not handed to you off a shelf.
Frequently Asked Questions
No. You don't need a prior diagnosis to work with ITG. Your therapist will do their own assessment and work with you whether or not you have a formal label for what's been happening.
Talk therapy for panic often focuses on understanding and reframing the thoughts that feed the cycle. EMDR works more directly on how your nervous system has stored distressing experiences, reducing the alarm response at its source. For panic with a trauma or identity-stress component, EMDR often produces faster and more durable relief. Your therapist will help you figure out which approach makes the most sense for you.
For some people, panic attacks become less frequent over time without treatment. For most, though, the avoidance behaviors that develop around panic tend to compound. The cycle of anticipatory anxiety and avoidance tends to expand rather than shrink on its own. Treatment shortens that timeline significantly and reduces the behavioral impact while it's happening.
Yes, and more often than people expect. Panic disorder frequently develops in people who have experienced trauma, chronic stress, or prolonged periods of feeling unsafe. For LGBTQIA+, kink-involved, and non-monogamous people, identity-related stress and experiences of rejection or discrimination can contribute to the kind of nervous system dysregulation that feeds panic. EMDR is particularly well-suited for panic that has this kind of history behind it.
