No abstract

The objective of this study is to examine the role of imagination, playfulness, and creativity in healing or coping with trauma. A range of evidence-based trauma-focused treatments use imagination effectively, though often without theoretical references. This article provides an up-to-date, nonsystematic literature review, exploring the presented objective and focusing on the role of imagination in the treatment of posttraumatic stress disorder (PTSD). A computerized literature search, defined inclusion criteria, and synthesis aim to promote understanding in the field. We review brain overlaps pertaining to imagination and PTSD, presenting a hypothesis that the hippocampus and the default mode network play an important role in both. Creativity is presented as a significant predictor of resilience after traumatic exposure. Moreover, we discuss how resilience to, and coping with, a traumatic event is enabled by using playfulness. Finally, we discuss the gap between the frequent use of imagination in the treatment of PTSD and the lack of intended understanding of its mechanisms that bring about change. The fantastic reality model is presented as a theoretical and applied concept used in the utilization of imagination and playfulness to support therapeutic change. SEE FAR CBT protocol is presented as a therapeutic integrative approach that combines body and cognition, accommodating imagination and playfulness as sources of recovery. It interweaves imagination as part of the renarration of trauma, allowing wishful/fantastic elements to foster healing and promote resolution.

Fantastic reality ability (FRA) is defined as the capacity to use imagination in response to stress or trauma. With the emergence of COVID-19 and associated social restrictions, there has been an uptick in imagination use as a coping strategy. This has allowed us to further validate the Fantastic Reality Ability Measurement (FRAME) Scale at this time of stress and uncertainty. Initial exploratory factor analyses (EFA) suggested that FRAME responses are measured by four first-order factors. Using confirmatory factor analyses (CFA), this study set out to confirm this finding and to ascertain if: First-order factors are correlated; or map onto a second or higher-order, fantastic reality ability latent construct. Also, FRAME responses are compared to established scales to demonstrate concurrent and discriminant validity. In accord with previous research and theory, CFA results indicate that each four factors (coping, control, transcendence, playfulness), contribute significantly to the measurement of a higher-order FRA latent construct (N = 437 Israeli adults). We also report robust correlations between FRAME and measures of resiliency and imagination abilities of complexity, directedness and frequency. Both adaptive and maladaptive applications of imagination use in relation to stress are discussed with focus on those who could foster resiliency. The FRAME enables one to briefly measure imagination use in response to stress and could serve as part of questionnaire batteries measuring individual differences and clinical research. Future research should assess the stability of this instrument across different populations over extended periods, specifically those at risk for trauma.