European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S772–S846 S783
medications, so EMDR treatment was introduced. We assess neg-
ative cognition: why do I have to die twice? “Subjective unit of
disturbance regarding the traumatic event (SUD) was 9”. Adhering
to the EMDR protocol, the therapist helped the patient to re-process
the traumatic event (the very moment when he was told that
“he was died”). Complete desensitization and reprocessing were
accomplished, SUD was 0, VoC was 7. Patient reached pre-morbid
level of psychosocial functioning, doing his demanding job, and
enjoying his social life.
Conclusion Near death experience has high traumatic potential
with serious psychological consequences. EMDR is efficious treat-
ment for variety of anxiety disorders caused by psychologic trauma
due to physical illness.
Keywords EMDR; Clinical death; Panic disorder
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1162
The use of “pliable media” in
promoting symbolization in the
psychoanalytical psychotherapy of
psychosis
P. Solano ∗, L. Quagelli
1 Clinica Psichiatrica, Neurosciences, Section of Psychiatry, University
of Genova, Genoa, Italy
2 Paris VII-Diderot University, Recherches en Psychanalyse, Paris,
France
∗ Corresponding author.
Introduction In psychosis, the capacity of symbolization is lost
to different extents and patients live in a concrete world of objects.
Moreover, the lack of boundaries between self/other, inside/outside
severely impairs the capacity of these patients to understand and
recognize reality from the delusional dimension.
Objectives Working through psychotic concreteness and acces-
sing a first subjectivation of this experience, that leads to the
development of a first symbolization.
Aims Achieving the possibility to access a first symbolization
and begin a delicate process of appropriation of the emotional
experience with the establishment of the boundaries between
inside/outside.
Methods The use of “pliable media”, such as drawing, as ther-
apeutic mediation allows a partial defraction of the violent
transferential dynamics from the therapist and let unsymbolized
material to emerge less destructively in the treatment fostering a
first figurability.
Results The Squiggle game as “pliable medium” facilitates a first
encounter in the therapeutic relationship and represents a primal
transitional area that allows a gradual working through process
to take place where the establishment of the boundaries between
inside/outside could begin.
Conclusions We suggest that the use of “pliable media” in the
early stages of the psychotherapy of psychotics can significantly
favor a first encounter between patient and therapist and, at the
same time, provides the first experience of a transitional space
where a working through process leading to first representations
can take place.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1163
Interoceptive exposure at the heart of
emotional identification work in
psychotherapy
A. Suchocka Capuano ∗, A. Karar , A. Georgin , R. Allek ,
C. Dupuy , S. Bouyakoub
1 Centre Hospitalier Intercommunal de Villeneuve Saint-Georges,
Consultations de Psychiatrie, Villeneuve Saint-Georges Cedex, France
2 Université Paris 8, Psychology, Vincennes, Saint-Denis, France
∗ Corresponding author.
Introduction Emotional avoidance is a target process, offered by
modern psychotherapies. Emotional exposure is often difficult to
put in place when there is a major cognitive and behavioral avoid-
ance. Education on emotional processes is necessary but often
insufficient during individual follow-up.
Objectives The longitudinal study seeks to verify whether work
on exposure and emotional identification influences the decreased
level of anxiety and depression.
Aims Introduction of interoceptive exposition in psychotherapy
decreases the frequency of emotional avoidance.
Method Group psychotherapy composed of two modules: inter-
oceptive exposure and emotional identification was proposed to
patients with anxiety and depressive disorders. A group of 6 par-
ticipants was evaluated at three times: T0 before the start of the
group, T1 post-module 1 and T2 post-group. Assessments of HAMA
anxiety, MADRS depression, QEC cognitive avoidance, UPPS impuls-
ivity, MCQ-30 metacognition and emotional regulation REQ-21
have been proposed.
Results Significant differences were observed between pre- and
post-intervention scores (Friedman test). The HAMA anxiety rate
(P = 0.006) and the MADRS depression (P= 0.047) decreased. Partic-
ipants in the group were less likely to use QEC thought substitution
(P = 0.009) and urgency in their UPPS reactions (P= 0.03). Moreover,
their external dysfunction REQ. 21 decreases (P = 0.03).
Conclusion Faced with emotional avoidance, work on emotional
identification requires prior interoceptive exposure. It is a first
stage of work that involves sensitizing to the presence of emotional
bodily sensations. Group work facilitates exposure to emotion
and its identification; decentration leading to emotional intensity
decrease. The work on the interoceptive exhibition facilitates the
emotional exposure while participating in the deactivation of the
associative emotional network.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1164
Borderline personality
disorder – dilemmas and therapeutic
challenges
G. Tasic ∗, S. Anakiev
1 Special hospital for psychiatric diseases “Gornja Toponica”,
Department of psychosociorehabilitation treatment, Nis, Serbia
2 Special hospital for psychiatric diseases “Gornja Toponica”, Male
admission department, Nis, Serbia
∗ Corresponding author.
Treatment of borderline personality disorder has some specifics
relative to other disorders, which are deriving from nature and
structure of those people. Treatment is very slow, often with inter-
ruptions, and it presents a special challenge for contratransferal
feelings but at the same time offers a possibility of continuous
learning, for the patient and the therapist. Main characteristics
of this personality disorder are the diffusion of identity, primitive
defence mechanisms concentrated around the cleft and relatively
preserved ability to rest reality. As classical psychoanalysis and psy-
choanalytical psychotherapy did not give results in therapy of this