Mental Imagery in the Science and Practice of Cognitive Behaviour Therapy: Past, Present, and Future Perspectives

Abstract

Mental imagery has a long history in the science and practice of cognitive behaviour therapy (CBT), stemming from both behavioural and cognitive traditions. The past decade or so has seen a marked increase in both scientific and clinical interest in mental imagery, from basic questions about the processes underpinning mental imagery and its roles in everyday healthy functioning, to clinical questions about how dysfunctions in mental imagery can cause distress and impairment, and how mental imagery can be used within CBT to effect therapeutic change. This article reflects on the current state of mental imagery in the science and practice of CBT, in the context of past developments and with a view to future challenges and opportunities. An ongoing interplay between the various strands of imagery research and the many clinical innovations in this area is recommended in order to realise the full therapeutic potential of mental imagery in CBT.

Minding my brain: Fourteen neuroscience‐based principles to enhance psychotherapy responsiveness

“…Mental imagery has a long tradition in cognitive-behavioural orientated psychotherapies (Blackwell, 2021). Usually, imagery tasks were used not only to work at symptomatic levels in anxiety, depression and PTSD (Pearson et al, 2015) but also to work with complex trauma, early maladaptive schemas and dysfunctional coping responses (Young et al, 2003).…”

“…Despite being studied for over 20 years, only recently researchers start to unravel the neural structures and mechanisms by which imagery tasks lead to psychological change (Skottnik & Linden, 2019). According to Blackwell (2021), this scientific resurgence may be related on one hand to better neuroscience techniques that allowed researchers to explore neural substrates of imagery (Pearson et al, 2015). On the other hand, experimental work validated the relationship between emotion and imagery (Holmes & Mathews, 2005, 2010, which augmented the clinical interest of the potential applicability of imagery in dealing with psychopathology.…”

Simulating the best and worst of times: The powers and perils of emotional simulation

“…Indeed, therapeutic techniques harness this power through de novo exposure therapyimagining anxiety-related content can extinguish phobias akin to real-life exposures in a range of anxiety disorders, including specific phobia, generalized anxiety, social phobia, and obsessive-compulsive disorder (Craske et al, 2014). Further, engaging with the simulated exposure to increase its specificity and intentionally reframe negative content in a positive, or even benign way, may hold promise in alleviating anxiety, depression, and PTSD (Blackwell, 2021;Holmes et al, 2007).…”

Positive Mental Imagery and Mental Health amongst University Students in Pakistan

“…The present research therefore aimed to investigate the relationship between positive prospective imagery and mental health within a Pakistani student sample, building on and replicating results found in previous (primarily European) samples. While there was no a priori reason not to expect similar associations within a Pakistani sample, cross-cultural transferability of such findings cannot be assumed, particularly given limited cross-cultural research on mental imagery within clinical psychology (Blackwell, 2021). We used a cross-sectional dataset from 1841 university students in Pakistan that included measures of mental imagery as well as different aspects of mental health and socio-demographic variables.…”