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Reflexology and Panic Disorder
Katy Castronovo (FL)
Subject: 31 year old maleSubject’s Occupation: Financial AnalystDates of Case Study: May 4, 2010 – June 8, 2010 What is Panic Disorder:
(source:, Dorland’s Medical Dictionary)
Panic Disorder is an anxiety disorder characterized by recurrent attacks of panic,
episodes of intense apprehension, fear, or terror associated with somatic symptoms
such as dyspnea, palpitations, dizziness, vertigo, faintness, or shakiness and with
psychological symptoms such as feelings of unreality, fear of dying, going crazy, or
losing control; there is usually chronic nervousness between attacks
This case study attempted to determine the possible affects of foot reflexology onsomeone suffering from Panic disorder. The study is presented from two differentperspectives: Subjective: the observations of the subject, and Objective: theobservations of the therapist.
The Subject:
The subject is a 31 year old Male that had been suffering from panic attacksregularly for approximately 8 months before this study took place. The subject hadsuffered two major panic attacks where he ended up in the hospital, and has beenhaving them on and off since. Medical tests ruled out any physical condition, and aPsychiatrist then diagnosed him with Panic Disorder. In the initial intake form, hestates that Sometimes the attacks will occur as a response to some kind of stressful stimuli,but it will often appear out of the blue with no apparent warning. Even withthe cognitive awareness of what is probably happening, symptoms cansnowball and reinforce one another. For example, a numb and tinglingsensation in the hands triggers a feeling that something is seriously wrong;conscious mind wonders if this is a stroke or something similar; body producesadrenaline, heart rate increases; mind notices increased heart rate now fearscardiac event; cycle continues, etc. The subject cited the following life events that seem to correlate with the onset ofthe attacks: the death of a friend of a friend (coming to terms with his ownmortality) and a habit of looking up symptoms/diseases on the internet, whichcause worry. The client is currently seeing a nurse practitioner every few months who specializes in anxiety disorders and is taking .25 mg of Xanax daily, which hesays has lessened the severity and occurrences of attacks. He also takes Quinipril formild hypertension, and has tried working through a workbook based on CognitiveBehavioral Therapy that he has since stopped.
Treatment Plan
The subject came to see me once a week for 6 weeks. The sessions were 1 hour inlength and were all on Tuesdays at 5:30 pm. Each session consisted of the same footreflexology techniques, with a focus on the reflexes of the nervous and endocrinesystems, since these systems together control homeostasis and communication inthe body. Special attention was paid to the adrenal reflex, which among other fightor flight hormones, controls the body’s release of adrenaline. Adrenaline plays amajor role in stress and panic attacks. The Client was also given a journal to write inevery day where he reported the following: Today’s stress level (0-10):Medications: times takenExercise: Today I felt:__anxious __happy __peaceful ____indifferent __scared __worried ___stressful ____energized__tired ___calm ___angry _____excited Week 1:
On the day of the first session, the subject recorded a stress level of 6.5. After the
treatment, he reported having a very stressful week in which, 2 days after the
session, he had a panic attack after feeling a sharp pain in shoulder when running.
In the journal, there were 2 positive adjectives describing how he felt, and on one
occasion he took more than 1 Xanax. The highest stress level was a 9, and the
lowest was 5.
Week 2:
On the day of the second session, the subject recorded a stress level of 6.5. After this
session, the client reported having another bad week. He had two doctor
appointments, and they decided to put him on new medication (Lexapro), which the
subject says was okay for a couple of days, but after a huge panic attack where he
almost went to the hospital, he stopped taking the new medication. He also stated
that his blood pressure was very high, and the doctor switched his blood pressure
medication (ToprolXL) In the journal this week, there were 4 positive adjectives
describing how he felt, and there were no days where he took more than one Xanax,
and one day where he took only ½ a Xanax. The highest stress level was 9.25, and
the lowest was 4.
Week 3:
On the day of the third session, the subject recorded a stress level of 4. He states
that he had a very good week. In this journal this week, there were 5 positive
adjectives describing how he felt, and he took less than 1 Xanax everyday. He starts
to write less in his journal, and he says this is because he is feeling pretty good. The
highest stress level was 5.5, and the lowest was 2.5.
Week 4:
On the day of the 4th session, the client reported a stress level of 3.5. He says that he
had another good week, with no panic attacks, and he has started running again. He
stopped writing in his journal, and he says he forgets to write it in because he is
feeling so good, and he tends to remember more when he is feeling bad.
Weeks 5-6:
The subject no longer wrote in the journal for the last two weeks. He stated that he
hadn’t been experiencing panic attacks, and that he kept forgetting to record his
anxiety because it wasn’t as present as before. He says that his average stress level
now is 1.5, and that he is not sure how the reflexology sessions helped or did not
help in his recovery.
During the First treatment, there were 8 reflex points that the client indicated had
increased sensation. This gradually decreased with each session (2nd session: 6, 3rd
session: 6, 4th session: 5, 5th session: 4, 6th session: 2) When pressure was applied to
those points, along with the invitation to take some deep breaths, the sensation
always decreased. Throughout the six sessions, I noticed that the subject ‘s
breathing got more and more relaxed, and interactions between therapist and
subject were less and less. He seemed to come easier into a relaxed state during the
treatment by the third session.
Both the therapist and subject noted a tremendous difference in the condition by theend of the 6 week study. The subject had not had a panic attack since the third week of treatment. The client reported after each session a feeling of relaxation, which thesubject and therapist both agreed could not hurt in his path to a panic-attack-freelife. It is, however, impossible to tell exactly the role Reflexology played in thisparticular case study, especially because the subject changed medications in themiddle of it. Approximately 6 million American adults 18 years or older suffer fromPanic Disorder, or 2.7 % of this age group in a given year. Many of those people endup on medications and under psychiatric care. Reflexology could offer an alternativeto a lifetime dependence on medication for some of this population. This fact alongwith the significant improvement presented in this study does suggest that furtherstudy is needed and would be beneficial. Katy Castronovo, certified hand & foot reflexologist and licensed massage therapist,graduated from the Academy of Ancient Reflexology, St. Augustine, Florida. She can bereached at [email protected]


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