Imagery rescripting

Imagery Rescripting is an experiential therapeutic technique that uses imagery and imagination to intervene in traumatic memories.[1] The process is guided by a therapist who works with the client to define ways to work with particular traumatic memories, images, or nightmares.

Imagery Rescripting helps to redefine and create new neural networks which work to alleviate the symptoms of PTSD and trauma.[2] Within an Imagery Rescripting session, the therapist will guide the client to revisit the memory they are working with. At a key point in the memory, either the client or the therapist will intervene in the image/memory. The intervention may involve regaining control over the event, creating new outcomes, or re-establishing power over the narrative of the event. The aim is to connect to the client's unmet core needs resulting from the memory/experience.[3]

Treatment and application

Imagery Rescripting has been shown to be effective in the treatment of PTSD resulting from childhood traumas.[3]

It is an experiential technique that involves actively working with mental images rather than simply talking about what happened.[4] Imagery Rescripting works directly with causes of trauma to restructure systems of implicational meaning that perpetuate symptoms of PTSD, trigger emotional distress, and cause maladaptive behaviors. When Imagery Rescripting successfully changes the core meaning of traumatic memories, new neural pathways are created which facilitate changes in negative schemas, core belief systems, and behaviors.[5]

Like EMDR, Imagery Rescripting can be an effective trauma treatment without the need for prolonged exposure to traumatic experiences within the therapeutic process.[6]

History

The use of imagery as a therapeutic practice has been developed through various traditions and developed into an empirically validated practice.[7] These traditions include hypnosis, psychoanalysis, the Gestalt, and CBT.

Pierre Janet pioneered the use of Imagery Substitution in 1889.[7] He used hypnosis to help clients reimagine traumatic events as positive experiences.[7] Hanscarl Leuner developed Guided Affective Imagery as part of his therapeutic model.[7] Guided Affective Imagery uses specific images to lead the client into a trance state. The varied image-scapes that appeared in this state helped Leuner's clients to summon different emotions to work with clinically.

Imagery was central to the Gestalt movement.[7] Fritz Perls began his sessions by having the client invoke images from dreams or visualizations.[7] Perls used this imagery to define an aspect of the patient that could communicate from deeper levels of their subconscious.

Aaron Beck adapted Perls's technique in his cognitive therapy group in the early 1980s.[8] This brought imagery into mainstream therapeutic circles. The method was fine-tuned through its use in cognitive therapy for PTSD, CBT for nightmares, and schema therapy for personality disorders.

References
  1. Brockman & Calvert, R & F (2017). "Imagery Rescripting for PTSD and Personality Disorders: Theory and Application". Journal of Contemporary Psychotherapy. 1: 47. doi:10.1007/s10879-016-9329-4. S2CID 23171930.
  2. Arntz, A (2012). "Imagery Rescripting as a Therapeutic Technique: Review of Clinical Trials, Basic Studies, and Research". Journal of Experimental Psychopathology. 3 (2): 189–208. doi:10.5127/jep.024211. S2CID 144841286.
  3. Hackmann, a (2011). "Imagery rescripting in posttraumatic stress disorder". Cognitive and Behavioral Practice. 18 (4): 424–432. doi:10.1016/j.cbpra.2010.06.006.
  4. Boterhoven de Haan, K., Lee, C., Fassbinder, E., Voncken, M., Meewisse, M., Es, S., Menninga, S., Kousemaker, M. & Arntz, A. "Imagery rescripting and eye movement desensitization and reprocessing for treatment of adults with childhood trauma-related post-traumatic stress disorder: IREM study design". BMC Psychiatry.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. Romano, Moscovitch; Huppert, J. D; Reimer, S. G.; Moscovitch, M. (2020). "Journal of Anxiety Disorders". 69: 102169. doi:10.1016/j.janxdis.2019.102169. hdl:10012/15387. PMID 31862574. S2CID 209434926. Retrieved 14 February 2022. {{cite journal}}: Cite journal requires |journal= (help)
  6. Arntz, A; Lancee, J.; Morina, N (2017). ""Imagery rescripting as a clinical intervention for aversive memories: A meta-analysis."". Journal of Behavior Therapy and Experimental Psychiatry. PMID 27855298.
  7. Edwards, D (2007). ""Restructuring implicational meaning through memory-based imagery: Some historical notes."". Journal of Behavior Therapy and Experimental Psychiatry. 38/4 (4): 306–316. doi:10.1016/j.jbtep.2007.10.001. PMID 18005934.
  8. Blackwell, S.E. (2021). ""Mental Imagery in the Science and Practice of Cognitive Behaviour Therapy: Past, Present, and Future Perspectives."". International Journal of Cognitive Therapy. 14: 160–181. doi:10.1007/s41811-021-00102-0. S2CID 257088925.
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