This article presents an integrative approach for working with images in psychotherapy. This approach builds upon contemporary neurobiological understandings of the interconnection of the image-making mind with the workings of self, emotion, and body. Through detailed case material and through following the work of neuroscientists such as Damasio and Panksepp, we will arrive at an appreciation for the brain’s innate propensity for play, association, and metaphor. And as the clinical material will show, these image-based processes act as a portal through which patient and therapist are able to experientially engage with the systems of self-representation, self-maintenance, and self-restoration.