Kyoto Hall - Marinela

The Problem of Traumatic Psychosis: A clinical case of a CBT and EMDR Integrated Treatment

Exposure to stressful events at an early age makes the brain less resistant to the effects of subsequent stressful events.

In the brains of young adults mistreated or neglected in childhood, it is possible to observe specific changes in key regions both inside and adjacent to the hippocampus. These changes can make subjects much more vulnerable to the onset of depression, PTSD and addictions (Martin Teicher, 2013).

In literature, the causal relationship between trauma and psychotic symptoms is well known.  In particular, auditory hallucinations - both in psychotic patients and in the general population - are associated with traumatic experiences. About 70% of adults who hear voices refer that they appeared after a trauma or highly emotional event (Romme, 1989; Honig, 1998; Simon McCarthy, Longden, 2015).

Although the psychotic disorder is often accompanied by at least one other disorder, comorbidity is diagnosed very rarely.

As a result, the role of trauma in psychotic symptoms and post-traumatic stress disorder (PTSD) that may follow often are not recognized (Miriam J. J. Lommen Æ Kathleen Restifo 2009). Despite this, there are several studies that highlight the correlation between trauma ( especially determined by a sexual abuse) and the risk of developing psychosis.    

According to the international guidelines both TCC and EMDR there are two therapeutic approaches indicated for the treatment of trauma (Sarin, 2011; Kumari, 2011; Turner 2014).

Nowadays, the EMDR represents a new development in psychotherapy linked to information processing based on a physiological process (Pagani, 2012).

There are currently some anecdotal cases and pilot studies that would support the efficacy of EMDR even in patients with psychoses previously exposed to traumatic events (Van der Berg, 2012).

In this K-note a clinical case of a patient suffering from paranoid psychosis will be presented and exposed in the past to unresolved trauma, which has been treated with TCC and EMDR.