Flashforward treatment in psychosis

Various studies suggest that visual mental representations or imagery play an important role in the development and maintenance of psychopathology. Generally, the higher the vividness of the imagery, the more credible or truthful it is perceived. Imagery also predicts the severity of hallucinations and delusions. With psychosis symptoms, research on imagery in delusions showed that people fear certain ‘worst case scenarios’ or ‘flash forwards’. People with delusions for example fear the outcome of being caught by their perpetrators. People with auditory hallucinations experienced similarly aversive images. These images may be part of the process of making sense of the voices. Often an unrealistic voice power belief is attributed to the hallucination (i.e. the voice of God or Devil) and the patient feels he has to obey. Mental representations can symbolize the attributed power or identity of the voice or represent the worst case scenarios depicted by the voices.

This pilot study aimed to reduce the burden in psychosis targeting psychosis-related imagery with EMDR. We developed a method of finding imagery treatment targets, conceptualizing an individual’s psychosis symptoms. Twenty outpatients with auditory hallucinations and delusions were treated within an average of eleven sessions of EMDR. Symptoms were measured at baseline and at post treatment. All twenty patients completed the EMDR intervention. There was improvement in their levels of psychotic symptoms, anxiety and depression. In addition, patients reported less avoidance behaviour and greater cognitive insight. Further research into other possible types of interventions for the treatment of imagery in psychosis is recommended.

Conference

English

Carlos Croes

Croes, C.  (2016, June). Flashforward treatment in psychosis. Presentation at the at the 17th EMDR Europe Association Conference, The Hague