Mental Imagery Plays Role in Psychiatric Disorders


Though those results were observed in a non-clinical sample, the role of intrusive imagery in clinical cases — especially those involving post-traumatic stress disorder (PTSD) — is well-known by both researchers and clinicians. The degree to which people are able to vividly imagine such scenarios may influence their prognosis following a traumatic event.

In a 2013 study from the Journal of Behavior Therapy and Experimental Psychiatry, participants were assessed on measures of mental imagery before and after viewing videos involving a traumatic car accident.5 Results show that participants who had more lifelike imagery before watching the video had more frequent and vivid intrusive images soon after and five days following the viewing, and this finding was independent of the participants’ levels of trait anxiety and depression. Study co-author Nexhmedin Morina, PhD, a clinical psychology professor at the University of Amsterdam, said that there are two ways in which vivid imagery could be linked with such intrusive memories following a stressor.

“First, individuals with very vivid imagery may generally process information about the traumatic event less in a verbal way and thus when they remember the event again, they have more images of the event — and we know that strong intrusive memories lead to strong physiological responses,” he says. Second, lifelike intrusive memories can heighten the sense of “nowness” of such memories, leading the individual to perceive it as if it is occurring in the moment.

“When people have strong physiological responses and the perception of threat upon remembering a stressful situation, they tend to avoid memories of the event, and this can increase the likelihood of having those memories again,” he added.

While spontaneous, intrusive memories can worsen outcomes, other studies show that imagery can be put to use in treatment when used the right way. A simple shift in perspective may help reduce the negative impact of distressing imagery, according to findings reported earlier this year in the Journal of Cognitive Neuroscience.6

Researchers used functional magnetic resonance imaging (fMRI) to investigate neural and behavioral differences as participants imagined painful situations from different vantage points. Those who took a first-person visual perspective, versus a third-person point of view, had higher pain ratings and showed increased activity in brain areas involved in bodily and emotional awareness. These findings suggest that taking a third-person perspective of one’s painful memories or other imagery could lessen their distressing impact.