Suicidal people often report repetitive intrusive suicide-related images and thoughts. These images may both be distressing and comforting (final emergency exit) and efforts to stop these intrusions appear to have a counterproductive effect, increasing their frequency and intensity rather than decreasing them, which renders feelings of uncontrollability. At this point, people are continuously and obsessively thinking about and visualizing their suicide. The feelings of uncontrollability may lead to the wish to stop consciousness altogether, prompting the last motivation for suicide: to escape from unbearable and unstoppable ideation and imagery. A novel perspective on how suicidal intrusions may be addressed is provided by evidence from experimental and clinical studies showing that vividness of both negative and positive intrusive images may be reduced by dual task interventions taxing the working memory. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based dual task treatment for trauma-related intrusions, and is recommended across guidelines worldwide. The intervention has recently been applied effectively, easily, and safely in severe psychiatric disorders, such as psychosis. In this presentation, the content, frequency, and intensity of vivid intrusive suicidal imagery will be discussed, as well as the use of EMDR to reduce these aspects of suicidal thoughts.
Ad Kerkhof is a Professor of Clinical Psychology, Psychopathology and Suicide prevention at the VU University in Amsterdam, the Netherlands. His research group investigates evidence-based practice guidelines for assessment and treatment of suicidality, gatekeeper training in suicide prevention, multicultural screening for adolescent suicide risk, e-learning suicide modules for teachers, collaborative care for personality disordered chronic suicidal patients, psychotherapy for suicidal patients and online self-help for suicidal thoughts. He was one of the members of the Steering Committee of the WHO / Euro Multicenter Collaborative Study into Suicidal Behavior, was Editor in Chief (1992-2004) of Crisis the journal of crisis intervention and suicide prevention, has been involved in advising the Ministry of Health on suicide prevention policy, and was one of the authors of the Dutch practice guidelines for the assessment and treatment of suicidal patients. He has obtained grants in excess of 6 Million Euro, published over 150 scientific articles in peer reviewed journals and 15 books on suicide prevention. He also has a private psychotherapy practice where he treats depressed and suicidal people, suicide survivors, as well as partner relationship problems.