For a long time it was thought that trauma therapy was not safe or helpful for people with psychogenic vulnerability. However, increasing research shows that this view is incorrect. Recent doctoral research by Simone Burger shows that trauma-oriented treatments, such as EMDR en exposure, People with both psychosis and PTSD can support their recovery – even when symptoms temporarily increase.
Her research Show that trauma is not only common among people with psychosis, but also plays a key role in the onset and persistence of psychotic symptoms. Burger therefore advocates for better access to trauma therapy for people with psychosis.
Trauma and psychosis are strongly interconnected
Many people who experience a psychotic episode have previously traumatic experiences Experienced, often multiple times, and often in the context of interpersonal violence. These experiences can lead to posttraumatic stress disorder (PTSD), with symptoms such as nightmares and flashbacks. Burger shows that the more serious the traumatic experiences, the more serious the psychotic symptoms can be, such as hallucinations and hearing voices.
This underscores the importance of trauma treatment for people with psychosis. Yet trauma is not always recognized or included in treatment as standard practice in clinical practice.
Trauma therapy: emotionally demanding, but effective
Burger investigated various trauma-focused therapies, such as EMDR and exposure therapy, in people who have both PTSD and psychosis. The results are promising. Not only do PTSD symptoms decrease, the therapy also seems to indirectly reduce psychotic symptoms such as hearing voices.
A striking finding is that temporary worsening of PTSD symptoms occurs frequently during treatment. “That can be exciting for both patients and healthcare professionals,” Light Burger admits “but it says nothing about the final result.” People who experienced more symptoms temporarily recovered just as well as others in the long term.
Patients find trauma therapy to be difficult but valuable
Interviews with participants confirm this picture. They describe the therapy as emotionally intense, but also meaningful and helpful. Many participants indicated that they gained more control over their symptoms and developed more understanding of themselves. Confidence in the therapist and good guidance proved to be important prerequisites for continuing the therapy.
Major consequences for mental health care
The findings have clear implications for practice. First and foremost, it is essential to pay standard attention to traumatic experiences in people with psychotic symptoms. Only then can appropriate, trauma-sensitive care be provided.
In addition, the research shows that temporary worsening of symptoms is not a reason to trauma therapy To be avoided. On the contrary: it can be part of the recovery process and requires careful guidance, not reticence.
More access to trauma therapy urgently needed
Burger concludes that trauma-focused therapies should be made more accessible to people with psychosis. Implementation in regular care is crucial to provide this group with appropriate and effective treatment.
At the moment, a large-scale follow-up study is underway in which the previous results are being re-evaluated. This research is further contributing to better-founded care for people with PTSD and psychosis.
Source of article
Free University of Amsterdam, news item about the promotion research of Simone Burger (2026).
