EMDR on imagery in psychosis: Results of a pilot study on the effect of EMDR on psychotic symptoms and further findings on working mechanisms in psychosis


Study 1: Summary: 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 psychotic symptoms.

Aim: To introduce EMDR as a possible type of psychological treatment for patients suffering from psychosis-related imagery.

Method: Sixteen outpatients who had a psychotic disorder and suffered from auditory hallucinations and delusions were treated with EMDR in an average of 11 sessions. Treatment was performed by four therapists in different psychiatric institutions. All four 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 in the treatment of imagery in psychosis is recommended.

Study 2: Summary: Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder (PTSD). A meta analysis showed that, recall alone of aversive memories in PTSD was inferior to recall combined with eye movements (EMs) in the reduction of vividness. But how does EMDR work? EMDR is currently studied on imagery in other types of psychopathology to find an explanation.

Aim: To prove the working memory theory in people with psychosis.

Method: In this study, 20 patients with psychotic disorders received EMs while recalling psychosis related memories. In one EMDR session, patients recalled the memories in two conditions: recall only and recall + EMs. Two competing hypotheses were tested: 1) EMs are better than recall only, 2) EMs are as effective as recall only. The order of conditions was balanced; each condition was delivered three times. Level of memory vividness and emotionality served as outcome measures.

Results: The data support hypothesis 1 over 2: EMs outperformed recall only.

Conclusion: The findings add to earlier findings in laboratory and clinical (PTSD) samples showing that recall+ EMs is more effective to recall only, and gives support to the working memory hypothesis in people with psychotic disorders. More information Speaker(s) pasfoto Carlos Croes GGZ Centraal Location(s) plattegrond Kilimanjaro.






Carlos Croes

Original Work Citation

Croes, C. (2016, June). Results of a pilot study on the effect of EMDR on psychotic symptoms and further findings on working mechanisms in psychosis. In Researchtrack - EMDR & psychosis: above and beyond - latest research and developments (Antonio Onofri and Tineke van der Linden, Chairs). Presentation  at the at the 17th EMDR Europe Association Conference, The Hague



“EMDR on imagery in psychosis: Results of a pilot study on the effect of EMDR on psychotic symptoms and further findings on working mechanisms in psychosis,” Francine Shapiro Library, accessed October 30, 2020, https://emdria.omeka.net/items/show/23875.

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