Exploring the mechanism of change in EMDR and prolonged exposure in a sample of patients with a psychotic disorder and co-morbid PTSD

Assessing traumatic experiences is crucial for creating an individual case formulation within the treatment of psychotic symptoms. It enhances insight and reveals relevant targets for treatment with EMDR. Yet, trauma histories are often very extensive and cognitive impairments and/or disorganization may complicate the assessment. The Two Method Approach1 is a highly structured procedure for questioning in the preparation phase of EMDR. Its purpose is to select the most relevant memories that need to be processed to achieve symptom relief. Psychotic symptoms may be directly associated with certain life events (First Method). Negative core beliefs about oneself (e.g. ‘I am guilty’) and others (e.g. ‘Other people are untrustworthy’) may form a cognitive link between traumatic life experiences and psychosis (Second Method).

Mental imagery is highly prevalent in psychosis; e.g. images of feared catastrophes (often in paranoia) and visualizations of the perceived origin or content of a symptom (often in voices)2. A Third Method can be added to detect the mental images that are associated with the occurrence and maintenance of hallucinations and delusions. EMDR can be used to process these images that keep intruding into awareness as well. In this workshop we offer guidelines to select the most relevant targets for EMDR in psychosis. We demonstrate how EMDR can be used in a comprehensive treatment approach for psychotic patients.

Conference

English

van der Vleugel, B., de Bont, P., & van den Berg, D. (2014, June). Exploring the mechanism of change in EMDR and prolonged exposure in a sample of patients with a psychotic disorder and co-morbid PTSD. In EMDR & psychosis clinical symposium (Ad de Jongh, Chair). Symposium presented at the 15th EMDR Europe Association Conference, Edinburgh, Scotland