Janet is a single, 42-year old partner of a major law firm on Bay Street in Toronto. She reports
having a constant feeling of overwhelming dread, which began five years earlier when she
experienced an “out of the blue” panic attack on the open water during a cruise while on vacation
in the Mediterranean. Convinced she was having a heart attack, Janet insisted on being airlifted
to safety. Since then, she has experienced numerous similar attacks and has visited the
Emergency Room several times, but has always been sent home without a medical diagnosis.
She doesn’t trust the doctors and is convinced that the next attack will kill her. She has taken a
leave of absence from work. She spends a lot of time in her house, leaving only to walk her dog
around the block and to sit on her front porch and contemplate what has happened to her life.
Kim is 18-years old and recently dropped out of high school. She feels upset about her failure to
graduate and pursue her lifelong dream of going to university to become a veterinarian. She
reports that she couldn’t handle school because she was unable to focus on her work and could
not sit in class, walk down the halls, or cross the student parking lot without experiencing a panic
attack. She reports overwhelming anxiety in these kinds of situations, feeling that she is the
centre of attention and thinking that others are laughing at her. She spends her days at her
parents’ home surfing Internet chat rooms and feeling isolated, depressed, and lonely.
Tyrone is a 24 year old man who complains of being unable to leave his home in the morning.
He describes an elaborate routine of getting ready for work that includes an hour-long shower, an
hour of shaving, and two hours of getting dressed. He then feels compelled to clip sp