Fine Tuning Imagery Rescripting

By Libby Waite

“Change your mental imagery, and the feelings will take care of themselves.” Maxwell Maltz

Imagery as a Catalyst for Change

Humans have used the power of image as a healing practice for millennia. The Ancient Greeks would call on the Gods to supplant traumatic images with healing ones. When applied therapeutically, imagery can provide lasting and meaningful change for your clients.

Talking about your clients’ experiences will help them to process things cognitively. But linking their emotions to imagery will help guide them to a deeper level of awareness. They will start to recognise the meaning behind their emotions. Imagery Rescripting allows you to work with your clients cognitively, emotionally and somatically. Training in Imagery Rescripting will help you to work at these three levels so you can heal complex trauma quickly and safely.

Imagery Rescripting: Memory and Imagination

Imagery Rescripting is rooted in some of the oldest therapeutic techniques. It has been fine-tuned through various traditions and developed into an empirically-validated practice. These traditions include hypnosis, psychoanalysis and the Gestalt. Some traditions focus on using memory, others on imagination. Imagery Rescripting is distinct in that it uses a combination of both.

Pierre Janet pioneered the use of imagery techniques back in 1889. He called it ‘Imagery Substitution’. Janet used hypnosis to help clients reimagine traumatic events as positive, healing experiences. Despite reporting success with such methods, his techniques were largely ignored. Imagery Substitution disappeared as Freudian psychoanalysis became the more dominant approach.

Within the psychoanalytic world, the power of the image was still championed by Carl Jung. He developed Active Imagination to help clients access unconscious material. Hanscarl Leuner also developed Guided Affective Imagery as part of his therapeutic model. Both techniques are guided by the therapist. Within the Jungian method, the images/symbols come from dreams. Guided Affective Imagery uses specific images to lead the client into a daydream. The varied image-scapes help clients to summon different emotions to work with clinically.

Imagery Rescripting is different because it does not invoke emotions from abstract symbols or imagined places. It works directly with your client’s memories. When this is skillfully done by a trauma-informed therapist, it enables clients to gain a sense of control. They find power in experiences that made them feel powerless. Clients learn how to acknowledge and heal their trauma.

“Engaging with imagery helps lead to new insights” Katrina Boterhoven de Haan

From Gestalt to CBT: Validating Imagery

Imagery was also central to the Gestalt movement. Fritz Perls used imagery to help clients process “unfinished business”. He would start his sessions by welcoming images from dreams or whatever arose in the client’s mind in the moment. Perls would work with the client to identify a figure who could speak from and to what was being imaged. This allowed his clients to acknowledge unmet needs, unvoiced fears and unexpressed meaning.

Beck started adapting Perls’s technique in his cognitive therapy group in the early 1980s. This was the beginning of the use of imagery in more mainstream therapeutic circles. It wasn't till the 1990s though that researchers found ways to test and validate the use of imagery. Such research helped lead to the development of Imagery Rescripting. The method was fine-tuned through its use in cognitive therapy for PTSD, CBT for nightmares and schema therapy for personality disorders.

Imagery Rescripting: Integrate into your practice

Today, we know that Imagery Rescripting is very effective for working with childhood trauma. The beauty of the method is that it doesn’t need to be encased within any rigid therapeutic technique. As history shows, imagery works within a multitude of modalities. You can integrate Imagery Rescripting into your current work. You can also use it alongside other trauma approaches, such as EMDR.

Imagery Rescripting will teach you tools to work directly with trauma. You will learn to skillfully guide your clients into their memories. You will teach them to rewrite the outcomes of traumatic events. By working at the level of memory and combining this with imagination, you will learn to change the meaning of traumatic imagery. This will enable you to make long-lasting changes to your clients’ lives.

“Changing the meaning of traumatic imagery leads to fundamental change”

References: 

Arntz, A. (2012) “Imagery Rescripting as a Therapeutic Technique: Review of Clinical Trials, Basic Studies, and Research Agenda”, Journal of Experimental Psychopathology, 2, pp. 189-208

Arntz, A., & van Genderen, H. (2009) Schema therapy for borderline personality disorder. Oxford: Wiley-Blackwell.

Boterhoven de Haan, K., Lee, C., Fassbinder, E., Voncken, M., Meewisse, M., Es, S., Menninga, S., Kousemaker, M. & Arntz, A. (2017). “Imagery rescripting and eye movement desensitisation and reprocessing for treatment of adults with childhood trauma-related post-traumatic stress disorder: IREM study design.” BMC Psychiatry, 17.

Clark, D. M., Ehlers, A., Hackmann, A., McManus, F., Fennell, M. J. V., Grey, N., ... Wild, J. (2006) “Cognitive therapy vs. exposure and applied relaxation in social phobia: A randomized controlled trial.” Journal of Consulting and Clinical Psychology, 74, pp. 568–578. http://dx.doi.org/10.1037/0022-006X.74.3.568 

Davis, J. L., & Wright, D. C. (2005) “Case series utilizing exposure, relaxation and rescripting treatment: impact on nightmares, sleep quality, and psychological distress.” Behavioral Sleep Medicine, 3, pp. 151–157. http://dx.doi.org/10.1207/s15402010bsm0303_3

Davis, J. L., & Wright, D.C. (2007) “Randomized clinical trial for treatment of chronic nightmares in trauma-exposed adults.” Journal of Traumatic Stress, 20, pp. 123–133. 

http://dx.doi.org/10.1002/jts.20199 

Edwards, D. J. A. (1989) “Cognitive Restructuring through guided imagery” In H. Arkowitz (Ed.), Comprehensive Handbook of Cognitive Therapy, pp. 283-297, New York: Plenum.

Edwards, D. (2007) “Restructuring implicational meaning through memory-based imagery: Some historical notes.” Journal of Behavior Therapy and Experimental Psychiatry, 38/4, pp. 306-316, https://doi.org/10.1016/j.jbtep.2007.10.001

Perls, F. S. (1973) The Gestalt Approach and Eye-witness to Therapy, New York: Bantam Books.