Abstract
This chapter aims to provide an update on the relation between mental imagery and psychopathology, with particular reference to post-traumatic stress disorder and bipolar affective disorder. Current evidence is provided to give an overview of the strengths and limitations of existing cognitive behavioural therapies for these two psychological disorders. Clinical vignettes are used to illustrate how imagery interventions may be incorporated into cognitive behavioural therapy to enrich the array of treatment strategies and possibly enhance its efficacy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Psychiatric Association (2000) American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, vol. 4th edn (Text revision). American Psychiatric Association, Washington DC
Arntz A, Tiesema M, Kindt M (2007) Treatment of PTSD: a comparison of imaginal exposure with and without imagery rescripting. J Behav Ther Exp Psychiatry 38:345–370
Arntz A, Weertman A (1999) Treatment of childhood memories: theory and practice. Behav Res Ther 37:715–740
Arvay MJ (2001) Secondary traumatic stress among trauma counsellors: what does the research say? Int J Adv Couns 23:283–293
Beck AT (1976) Cognitive Therapy and the Emotional Disorders. New York: Penguin.
Berntsen D (2010) The unbidden past: Involuntary autobiographical memories as a basic mode of remembering. Curr Dir Psychol Sci 19:138–142
Bisson JI, Ehlers A, Matthews R, Pilling S, Richards D, Turner S (2007) Psychological treatments for chronic post-traumatic stress disorder – systematic review and meta-analysis. Br J Psychiatry 190:97–104
Blackwell SE, Holmes EA (2010) Modifying interpretation and imagination in clinical depression: a single case series using cognitive bias modification. Appl Cogn Psychol 24(3):338–350. doi:10.1002/acp. 1680
Bonsall MB, Wallace-Hadrill SMA, Geddes JR, Goodwin GM, Holmes EA (2012) Nonlinear time-series approaches in characterizing mood stability and mood instability in bipolar disorder. Proceedings of the Royal Society B: Biological Sciences 279(1730):916–924
Bourne C, Frasquilho F, Roth AD, Holmes EA (2010) Is it mere distraction? Peri-traumatic verbal tasks can increase analogue flashbacks but reduce voluntary memory performance. J Behav Ther Exp Psychiatry 41:316–324
Brewin CR, Andrews B, Valentine JD (2000) Meta-analysis of risk factors for post-traumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 68:748–766
Brewin CR, Dalgleish T, Joseph S (1996) A dual representation theory of post-traumatic stress disorder. Psychol Rev 103:670–686
Brewin CR, Gregory JD, Lipton M, Burgess N (2010) Intrusive images in psychological disorders: characteristics, neural mechanisms, and treatment implications. Psychol Rev 117:210–232
Bromet EJ, Finch SJ, Carlson GA (2005) Time to remission and relapse after the first hospital admission in severe bipolar disorder. Soc Psychiatry Psychiatr Epidemiol 40:106–113
Bryant RA, Moulds ML, Guthrie RM, Dang ST, Nixon RDV (2003) Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder. J Consult Clin Psychol 71:706–712
Conway MA, Meares K, Standart S (2004) Images and goals. Memory 12:525–531
Conway MA, Pleydell-Pearce CW (2000) The construction of autobiographical memories in the self-memory system. Psychol Rev 107:261–288
D’Argembeau A, Raffard S, Van der Linden M (2008) Remembering the past and imagining the future in schizophrenia. J Abnorm Psychol 117:247–251
Deeprose C, Holmes EA (2010) An exploration of prospective imagery: the Impact of Future Events Scale. Behav Cogn Psychother 38(2):201–209.
Deeprose C, Malik A, Holmes EA (2011) Measuring intrusive prospective imagery using the Impact of Future Events Scale (IFES): psychometric properties and its relation to risk for bipolar disorder. Int J Cogn Ther 4:186–197
Ehlers A, Clark DM (2000) A cognitive model of posttraumatic stress disorder. Behav Res Ther 38:319–345
Ehlers A, Clark DM, Hackmann A, McManus F, Fennell M (2005) Cognitive therapy for post-traumatic stress disorder: development and evaluation. Behav Res Ther 43:413–431
Ehlers A, Hackmann A, Steil R, Clohessy S, Wenninger K, Winter H (2002) The nature of intrusive memories after trauma: the warning signal hypothesis. Behav Res Ther 40:995–1002
Engelhard IM, van den Hout MA, Smeets MAM (2011) Taxing working memory reduces vividness and emotionality of images about the Queen’s Day tragedy. J Behav Ther Exp Psychiatry 42:32–37
Engelhard IM, van Uijen SL, van den Hout MA (2010) The impact of taxing working memory on negative and positive memories Eur J Psychotraumatol 1:5623. doi:10.3402/ejpt.v1i0.5623
Foa EB, Keane TM, Friedman MJ, Cohen JA (2009) Effective treatments for PTSD: practice guidelines from the International Society for Traumatic Stress Studies. Guilford Press, New York
Foa EB, Rothbaum BO, Riggs DS, Murdock TB (1991) Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counselling. J Consult Clin Psychol 59:715–723
Gregory JD, Brewin CR, Mansell W, Donaldson C (2010) Intrusive memories and images in bipolar disorder. Behav Ther Res 48:698–703
Gregory WL, Cialdini RB, Carpenter KM (1982) Self-relevant scenarios as mediators of likelihood estimates and compliance – does imagining make it so? J Pers Soc Psychol 43:89–99
Grey N, Holmes EA, Brewin CR (2001) Peritraumatic emotional ‘hot spots’ in memory. Behav Cogn Psychother 29:357–362
Grey N, Holmes EA (2008) “Hotspots” in trauma memories in the treatment of post-traumatic stress disorder: a replication. Memory 16:788–796
Gunter RW, Bodner GE (2008) How eye movements affect unpleasant memories: support for a working-memory account. Behav Res Ther 46:913–931
Grunert BK, Weis JM, Smucker MR, Christianson HF (2007) Imagery rescripting and reprocessing therapy after failed prolonged exposure for post-traumatic stress disorder following industrial injury. J Behav Ther Exp Psychiatry 38:317–328
Hackmann A (2011) Imagery rescripting in posttraumatic stress disorder. Cogn Behav Pract 18:424–432
Hackmann A, Bennett-Levy J, Holmes EA (2011) Oxford Guide to Imagery in Cognitive Therapy. Oxford University Press, New York
Hackmann A, Holmes EA (2004) Reflecting on imagery: a clinical perspective and overview of the special edition on mental imagery and memory in psychopathology. Memory 12:389–402
Hagenaars MA, Arntz A. (2012). Reduced intrusion development after post-trauma imagery rescripting; an experimental study. J Behav Ther Exp Psy 43:808–814
Hagenaars MA, van Minnen A, Hoogduin KAL (2010) The impact of dissociation and depression on the efficacy of prolonged exposure treatment for PTSD. Behav Res Ther 48:19–27
Hales SA, Deeprose C, Goodwin GM, Holmes EA (2011) Cognitions in bipolar affective disorder and unipolar depression: imagining suicide. Bipolar Disord 13:651–661
Hirsch CR, Hayes S, Mathews A, Perman G, Borkovec T (2012) The extent and of imagery during worry and positive future thinking in patients with generalized anxiety disorder. J Abnorm Psychol 121(1):238–243
Holmes EA, Brewin CR, Hennessy RG (2004) Trauma films, information processing, and intrusion development. J Exp Psychol Gen 133:3–22
Holmes EA, Arntz A, Smucker MR (2007) Imagery rescripting in cognitive behavior therapy. J Behav Ther Exp Psy 38:297–305
Holmes EA, Bourne C (2008) Inducing and modulating intrusive emotional memories: a review of the trauma film paradigm. Acta Psychol 127:553–566
Holmes EA, Coughtrey AE, Connor A (2008a) Looking at or through rose-tinted glasses? Imagery perspective and positive mood. Emotion 8:875–879
Holmes EA, Geddes JR, Colom F, Goodwin GM (2008b) Mental imagery as an emotional amplifier: application to bipolar disorder. Behav Res Ther 46:1251–1258
Holmes EA, Lang TJ, Moulds ML, Steele AM (2008c) Prospective and positive mental imagery deficits in dysphoria. Behav Res Ther 46:976–981
Holmes EA, Lang TJ, Shah DM (2009) Developing positive interpretation bias modification as a “cognitive vaccine” for depressed mood: imagining positive events makes you feel better than thinking about them verbally. J Abnorm Psychol 118:76–88
Holmes EA, Mathews A (2010) Mental imagery in emotion and emotional disorders. Clin Psychol Rev 30:349–362
Holmes EA, James EL, Killford EJ, Deeprose C (2010) Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial Tetris versus verbal Pub Quiz. PLoS One 5:e13706. doi:10.1371/journal.pone.001370658
Holmes EA, Deeprose C, Fairburn CG, Wallace-Hadrill SMA, Bonsall MB, Geddes JR, Goodwin GM (2011) Mood stability versus mood instability in bipolar disorder: a possible role for emotional mental imagery. Behav Res Ther 49:707–713
Horowitz MJ (1969) Psychic trauma: return of images after a stress film. Arch Gen Psychiatry 20:552–559
Jaycox LH, Foa EB (1996) Obstacles in implementing exposure therapy for PTSD: case discussions and practical solutions. Clin Psychol Psychother 3:176–184
Johnson SL (2005) Mania and dysregulation in goal pursuit. Clin Psychol Rev 25:241–262
Kavanagh DJ, Freese S, Andrade J, May J (2001) Effects of visuospatial tasks on desensitization to emotive memories. Br J Clin Psychol 40:267–280
Kemps E, Tiggeman M (2007) Reducing the vividness and emotional impact of distressing autobiographical memories: the importance of modality specific interference. Memory 15:412–422
Kolb D (1984) Experiential Learning Experience as the Source of Learning and Development. Prentice Hall, Engelwood Cliffs, NJ
Krans J, Näring G, Becker ES (2009) Count out your intrusions: effects of verbal encoding on intrusive memories. Memory 17:809–815
Krans J, Näring G, Holmes EA, Becker ES (2010a) “I can see what you’re saying”: intrusive images from listening to a traumatic verbal report. J Anxiety Disord 24:134–140
Krans J, Näring G, Speckens AEM, Becker ES (2011) Eyewitness or earwitness: the role of mental imagery in intrusion development. Int J Cogn Ther 4:154–164
Krans J, Woud ML, Näring G, Becker ES, Holmes EA (2010b) Exploring involuntary recall in post-traumatic stress disorder from an information processing perspective: intrusive images of trauma. In: Mace JH (ed) The Act of Remembering: Toward an Understanding of How We Recall the Past. Wiley-Blackwell, Oxford
Kuyken W, Moulds ML (2009) Remembering as an observer: how is autobiographical memory retrieval vantage perspective linked to depression? Memory 17:624–634
Lam DH (2006) What can we conclude from studies on psychotherapy in bipolar disorder? Br J Psychiatry 188:321–322
Lam DH, Hayward P, Watkins E, Bright J, Wright K, Kerr N et al (2005) Outcomes of two-year follow-up of a cognitive therapy of relapse prevention in bipolar disorder. Am J Psychiatry 186:324–329
Lam DH, Jones SH, Hayward P (2010) Cognitive Therapy for Bipolar Disorder. A Therapist’s Guide to Concepts, Methods and Practice, 2nd edn. Wiley-Blackwell, Chichester
Lam DH, Watkins ER, Hayward P, Bright J, Wright K, Kerr N et al (2003) A randomised controlled study of cognitive therapy for relapse prevention in bipolar affective disorder: outcome for the first year. Arch Gen Psychiatry 60:145–152
Lam DH, Wong G (2005) Prodromes, coping strategies and psychological interventions in bipolar disorders. Clin Psychol Rev 25:1028–1042
Lang TJ, Blackwell SE, Harmer CJ, Davidson P, Holmes EA (2012) Cognitive bias modification using mental imagery for depression: developing a novel computerized intervention to change negative thinking styles. Eur J Pers 26:145–157
Lazarus RS, Alfert E (1964) The short-circuiting of threat by experimentally altering cognitive appraisal. J Abnorm Soc Psychol 69:196–205
Mace JH (2007) Involuntary memory: concept and theory. In: Mace JH (ed) Involuntary Memory. Blackwell Publishing, Malden, MA
May J, Andrade J, Kavanagh D, Penfound L (2008) Imagery and strength of craving for eating, drinking and playing sports. Cogn Emot 22:633–650
May J, Andrade J, Panabokke N, Kavanagh D (2004) Images of desire: cognitive models of craving. Memory 12:447–461
McCann L, Pearlman LA (1990) Vicarious traumatization: a framework for understanding the psychological effects of working with victims. J Trauma Stress 3:131–149
McIsaac HK, Eich E (2004) Vantage point in traumatic memory. Psychol Sci 15:248–253
Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfield RM, Petukhova M et al (2007) Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry 64:543–552
Morrison AP (2004) Use of imagery in cognitive therapy for psychosis: a case example. Memory 12:517–524
Murray G, Johnson S (2010) The clinical significance of creativity in bipolar disorder. Clin Psychol Rev 30:721–732
National Institute for Clinical Excellence (2005) Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care (No. CG026). London National Institute for Clinical Excellence, London
Newman CF, Leahy RL, Beck AT, Reilly-Harrington NA, Gyulai L. (2002). Bipolar Disorder: A Cognitive Therapy Approach. American Psychological Association, Washington, DC
Patel T, Brewin CR, Wheatley J, Wells A, Fisher P, Myers S (2007) Intrusive images and memories in major depression. Behav Res Ther 45:2573–2580
Pearson DG, Ross FDC, Webster VL (2011) The importance of context: evidence that contextual representations increase intrusive memories. J Behav Ther Exp Psychiatry 43:573–580
Pearson DG, Sawyer T (2011) Effects of dual task interference on memory intrusions for affective pictures. Int J Cogn Ther 4:122–133
Pictet A, Coughtrey AE, Mathews A, Holmes EA (2011) Fishing for happiness: the effects of positive imagery on interpretation bias and a behavioural task. Behav Res Ther 49:885–891. doi:10.1016/j.brat.2011.10.003
Powers MB, Halpern JM, Ferenschak MP, Gillihan SJ, Foa EB (2010) A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clin Psychol Rev 30:635–641
Rubin DC, Boals A, Berntsen D (2008) Memory in posttraumatic stress disorder: properties of voluntary and involuntary, traumatic and nontraumatic autobiographical memories in people with and without posttraumatic stress disorder symptoms. J Exp Psychol Gen 137:591–614
Schacter DL, Addis DR, Buckner RL (2007) The cognitive neuroscience of constructive memory: remembering the past to imagine the future: the prospective brain. Nat Rev Neurosci 8:657–661
Scott J, Colom F (2008) Gaps and limitations of psychological interventions for bipolar disorders. Psychother Psychosom 77:4–11
Scott J, Paykel ES, Morriss R, Kinderman P, Johnson T, Abbott R et al (2006) Cognitive-behavioural therapy for severe and recurrent bipolar disorders: randomised controlled trial. Br J Psychiatry 188:313–320
Shapiro F (1989) Eye movement desensitization: a new treatment for post-traumatic stress disorder. J Behav Ther Exp Psychiatry 20:211–217
Shapiro F (1991) Eye movement desensitization and reprocessing procedure: from EMD to EMD/R – a new treatment model for anxiety and related traumata. Behav Ther (NY) 14:133–135
Shapiro F (1999) Eye movement and desensitization reprocessing (EMDR) and the anxiety disorders: clinical and research implications of an integrated psychotherapy treatment. J Anxiety Disord 13:35–67
Smucker MR, Dancu C, Foa EB, Niederee JL (1995) Imagery rescripting: a new treatment for survivors of childhood sexual abuse suffering from posttraumatic stress. J Cogn Psychother Int Quart J 9:3–17
Smucker MR, Niederee J (1995) Treating incest-related PTSD and pathogenic schemas through imaginal exposure and rescripting. Cogn Behav Pract 2:63–93
Spauwen J, Krabbendam L, Lieb R, Wittchen HU, van Os J (2006) Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness. Br J Psychiatry 188:527–533
Speckens AEM, Ehlers A, Hackmann A, Clark DM (2006) Changes in intrusive memories associated with imaginal reliving in posttraumatic stress disorder. Anxiety Disord 20:328–341
Speckens AEM, Ehlers A, Hackmann A, Ruths FA, Clark DM (2007a) Intrusive memories and rumination in patients with post-traumatic stress disorder: a phenomenological comparison. Memory 15:249–257
Speckens AEM, Hackmann A, Ehlers A, Cuthbert B (2007b) Imagery special issue: intrusive images and memories of early adverse events in patients with obsessive-compulsive disorder. J Behav Ther Exp Psychiatry 38(4):411–22
Van den Hout MA, Engelhard IM, Rijkeboer MM, Koekebakker J, Hornsveld H, Leer A, Toffolo MBJ, Akse N (2011) EMDR: eye movements superior to beeps in taxing working memory and reducing vividness of recollections. Behav Res Ther 49:92–98
Wells A (2000) Emotional Disorders and Metacognition: Innovative Cognitive Therapy. Wiley, Chichester
Williams JMG, Teasdale JD, Segal ZV, Kabat-Zinn J (2007) The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness. Guildford, New York.
Winokur G, Clayton PJ, Reich T (1969) Manic Depressive Illness. CV Mosby, St Louis
Acknowledgements
Roger MK Ng would like to thank Helen Kennerley and Freda McManus for sharing and providing him with directions and guidance in his ongoing research on mental imagery in bipolar disorder. He would also like to thank his research team members, Dr. C.T. Chan and Dr. Jasmine Lau, as well as the staff and patients of the Department of Psychiatry, Kowloon Hospital, for facilitating research on imagery and bipolar disorder.Julie Krans would like to thank Michelle L. Moulds for her comments on a draft. Julie was supported by a Rubicon Fellowship from the Netherlands Organisation for Scientific Research (NWO). Emily A Holmes is supported by the Wellcome Trust Clinical Fellowship (WT088217), The Lupina Foundation, The Medical Research Council, and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre based at Oxford University Hospitals Trust Oxford University. The views expressed are those of the author(s) and not necessarily those of NHS, the NHIR or the Department of Health.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Ng, R.M.K., Krans, J., Holmes, E.A. (2013). Mental Imagery and Psychopathology: Examples of Post-traumatic Stress Disorder and Bipolar Disorder. In: Lacey, S., Lawson, R. (eds) Multisensory Imagery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5879-1_19
Download citation
DOI: https://doi.org/10.1007/978-1-4614-5879-1_19
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-5878-4
Online ISBN: 978-1-4614-5879-1
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)