Images are linked to emotions. Images cause a similar emotional state as real events. Change in the psychotherapy process is more likely to occur when we connect emotions to images than when we only talk about them.
Learn what imaginal rescripting is, what role it plays in schema therapy. Learn about the stages of imaginal rescripting in psychotherapy.
Schema therapy and imaginal work
Imaginal work in schema therapy is a therapeutic method that focuses on the use of imagination in the treatment and minimization of negative schemas. The pioneer of using imagery in therapy was Pierre Janet in 1889. Jeffrey Young has taken this technique and expanded it in schema therapy.
In schema therapy, imaginal work plays a key role at every stage: diagnosis, conceptualization and therapeutic interactions. Work on processing difficult emotions includes work on modes. The most important are: child modes and maladaptive parental modes, such as the inner critic. These are the categories of modes that are most strongly associated with intense negative emotional states, such as self-loathing, low self-esteem, abandonment, loneliness, guilt, shame.
What is imaginal rescripting?
Imaginal rescripting or imaginal rescripting is a therapeutic technique that changes the narrative of memories, heals old wounds and builds the perspective of a more positive future.
Imagery rescripting (ImR) is an experiential technique that aims to reduce the stress associated with painful experiences and change their meaning.
Imagery rescripting ( imagery rescripting or imaginal rescripting) aims to access the emotional part of the patient, without an intellectual component. The technique involves modifying mental images at the level of experiences that the patient has associated with a particular schema. It is designed to help the patient meet his emotional needs, at the subconscious level.
What are mental images?
Mental images are seen as “representations and accompanying sensory experiences, they represent information without a direct external stimulus” (Pearson et al., 2015). The experience during imaging can include several sensory elements: visual, auditory and tactile. Mental images are constructed from elements of what is stored in our memory. During imaging, autobiographical memory plays a key role.
Images do not have to be exclusively about the past; they can also be future-oriented, e.g. fantasies. They can also occur involuntarily (such as intrusive images, memory, dreams, nightmares) .
How does imaginal rescripting help in schema therapy?
How does it break the schema?
Rescripting is an effective therapeutic method that supports and develops the patient at different stages of therapy.
Advantages:
- helps understand the sources of problems,
- helps connect current problems with early developmental periods (connects current problems with negative or difficult childhood experiences),
- helps process painful emotions,
- develops compassion for one’s inner child and ultimately compassion for one’s adult self,
- changes unhelpful core beliefs about oneself, others and the world,
- begins the process of taking care of oneself and one’s own needs.
In what problems is imaginal rescripting applied?
Most often, this type of technique is introduced when cognitive-behavioral therapy does not have the expected effect or when the patient experiences recurrent regressions of illness in his life, such as recurrent depression.
Imaginalwork seems useful in cyclical life problems, especially in the interpersonal area.
Application:
- Chronic depression, dysthymia.
- Anxiety disorders, among others, obsessive-compulsive disorder.
- Persistent social phobia (the tendency to avoid is present in various spheres of life).
- Strong and frequent experience of shame and guilt.
- Unpleasant or unwanted memories.
- PTSD and Complex PTSD.
- Personality disorders (e.g., borderline personality, avoidant personality).
Stages of imaginal work. Imaginal script change
Imaginal work is a flexible technique, adapted to the stage of therapy and the patient’s specific problems. The specified sequence is not an absolute rule.
- Safe Place Technique. This exercise can be used as a separate exercise, but can also serve as a prelude to further imaginal work.
- The phase of scheme modification. The present – creating an emotional bridge. The therapist asks the patient to recall an image of a difficult situation from the present that evokes strong, unpleasant emotions. The psychotherapist asks the patient to erase the current situation, but maintain the emotional experience.
- Past. The therapist asks the patient to recall images from the past guided by emotions and sensations in the body. The main goal is to focus on the child’s emotions and needs.
- Defending the child, the psychotherapist or other helpers appear in the imagery to protect the child so that he feels accepted and safe.
- Realization of the child’s needs. The therapist asks the child what he or she needs until he or she is soothed. Stabilization occurs, the child experiences a sense of security and adaptive attachment.
- Talking about the experience, giving new emotional meanings to difficult painful memories.
Purpose of imaginal work. The purpose of imaginal rescripting
During imaginal rescripting, traumatic or emotionally difficult experiences from the past are altered in the imagination in such a way that the needs of the Vulnerable child (hurt, abandoned, defective) are met.
The purpose of using this technique is, to experience the realization of needs that could not be met in the past. Experiential work helps to change the meaning of experienced traumas in safe conditions. The technique helps the patient build a new, fresh perspective on past events. It is also designed to help identify needs and confront the patient with the past to ensure a healthy grieving process.
Imaginal script shift – key principles for therapists
- We trigger emotional hot spots in the patient’s memory. We look for as early experiences as possible.
- We follow the patient’s imagination and inner world.
- The most important goal, is to protect the child and meet his early needs.
- We do not expect the parents to change in the imaginary. We reject the parents’ behavior without discrediting them as individuals.
- We intervene before the worst happens.
- We leave at least 15 minutes to discuss the exercise.
Bibliography:
Gillian Heath , Helen Startup. CREATIVE METHODS IN SCHEMA THERAPY. Innovations in clinical practice. GWP 2023