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Tijdschrift voor Psychiatrie 56 (2014) 9, 568 - 576

New research

Imagery in psychosis: EMDR as a new intervention in the treatment of delusions and auditory hallucinations

C.F. Croes, R. van Grunsven, A.B.P. Staring, D.P.G. van den Berg, A. de Jongh, M. van der Gaag

background Historically, psychotherapy has focused on the treatment of patients’ verbal representations (thoughts) and has proved particularly successful in the cognitive behavioural treatment of psychosis. However, there is mounting evidence that visual representations (imagery) play an important role in the onset and maintenance of psychiatric disorders, including psychotic symptoms. There are indications that heightened emotionality and vividness of visual representations are associated with severity of psychotic experiences. This may imply that a reduction in the vividness and emotionality of the psychosis-related imagery can lessen the suffering and stress, caused by the the psychotic symptoms..
aim To introduce EMDR as a possible type of psychological treatment for patients suffering from psychosis-related imagery.
method Three outpatients who had a psychotic disorder and suffered from auditory hallucinations and delusions were treated with emdr in an average of six sessions. Treatment was performed by three therapists in different psychiatric institutions. All three were experienced in administrating cbt and emdr.
results Treatment with emdr reduced patients’ level of anxiety, depression and the severity of psychotic symptoms. In addition, patients reported less avoidant behaviour and greater cognitive insight.
conclusion The results of the study suggest that emdr reduces the vividness and emotionality of imagery in psychosis which in turn alleviates the patients’ psychotic symptoms. Further research into other possible types of interventions for the treatment of imagery in psychosis is recommended..

keywords EMDR, imagery, psychosis, visual representation