NYC Psychotherapist Blog

power by WikipediaMindmap

Monday, April 13, 2020

Imagine: Using Positive Imagination to Cope - Part 2

In my prior article, Imagine: Using Positive Imagination to Cope - Part 1, I began a discussion about using positive imagination and how it can be helpful during the COVID-19 crisis.  In today's article, I'm providing a clinical example to illustrate the benefits of positive imagination (see my article: Using Imagery as a Powerful Tool).

Imagine: Using Positive Imagination to Cope

Using Positive Imagination, including Imaginal Interweaves, as a Internal Resource
As I mentioned in my earlier article, Attached Focused EMDR therapy, which is a trauma therapy developed by Laurel Parnell, Ph.D., uses a form of positive imagination called "imaginal interweaves" when clients are blocked in terms of processing the trauma.

Imaginal interweaves function as an internal resource or coping technique (What Are Imaginal Interweaves?)

Although the example I'm giving is about psychological trauma, imaginal interweaves can be used whenever you need a way to calm yourself and help yourself to cope.

The Therapeutic Benefits of Imaginal Interweaves: A Clinical Vignette
The following clinical vignette, which is a composite of many different cases, illustrates the use of imaginal interweaves as a form of positive imagination:

During 2003, when Sandy was living and working in Toronto, she and other people in her neighborhood, were forced to self quarantine during an outbreak of severe acute respiratory syndrome (SARS). Sandy had no symptoms of SARS, but she was obligated to follow government regulations to quarantine.

Not only was Sandy fearful of SARS, but since she lived alone and she wasn't allowed to see other people in person, she felt very isolated and lonely during that time.  Her only contact with family and friends in New York City was by phone, so her history of depression and generalized anxiety were exacerbated by the quarantine.

After she assessed to be healthy and she was able to return to New York City, Sandy believed that she would feel better.  But, even though she was able to be with family and friends, she couldn't understand why her depression and anxiety-related symptoms continued.  So, after a few months of struggling on her own, Sandy sought help from a psychotherapist in Manhattan.

During their initial consultation, her therapist explained how Sandy's social isolation and loneliness while she was in quarantine, as well as earlier traumatic experiences as a child, exacerbated Sandy's depression and anxiety (see my article: Coping With Loneliness and Social Isolation).

Her psychotherapist recommended that they use  EMDR therapy to deal with the trauma related to the quarantine as well as the earlier unresolved trauma (see my article: EMDR Therapy When Talk Therapy Isn't Enough).

She explained to Sandy that, as part of the preparation work to do EMDR therapy, she would help Sandy to develop internal resources and coping strategies that she would use either in session or between sessions.

During the preparation phase of EMDR therapy, Sandy's therapist talked to her about imaginal interweaves and how they could be helpful if Sandy got blocked in the EMDR processing and they needed to find a way to undo the block (i.e., being "blocked" means the client's emotion or thought creates an obstacle to continuing to do the work).

She explained to Sandy how powerful the imagination can be and that using imaginal interweaves engages the mind and the body so that Sandy experiences what she is imagining as if it were actually occurring.  She explained that, of course, Sandy would know that she was still using her imagination, but she would get the beneficial effects of the interweaves (see my article: Mind-Body Oriented Psychotherapy: Healing With New Symbolic Memories).

As part of the imaginal interweaves, Sandy's therapist asked her to choose three people who are either real or imaginary ("real" means someone that Sandy knew from any time in her life and "imaginary" means someone from a TV program, book, movie, and so on) for the qualities of:
  • Nurturing
  • Powerful
  • Wise
The therapist acknowledged that these categories are intentionally vague and explained that Sandy should interpret nurturing, powerful and wise as whatever it meant to her.  So, for nurturing, Sandy chose her current best friend. For wise, she chose her godmother, who always gave Sandy good advice.  And, for powerful, Sandy couldn't think of anyone in her real life, so she chose a superhero, Wonder Woman.

After they completed the preparation phase of EMDR therapy, which also included learning a Relaxing Place meditation, they began processing Sandy's experience of being quarantined and how it was affecting her now.

As part of the work, they also did a process which is called a "Float Back" in EMDR and which is the same as an "Affect Bridge" in clinical hypnosis where the client goes back to the earliest time when she had the same emotions as in the current memory.

The Float Back is an important part of EMDR therapy because it gets to the earliest memory when the client had the same emotional experience (even if what happened in that memory was different).  The important part is that the client has a similar emotional experience.

So, for instance, if, as an adult, the client has an experience of feeling helpless and overwhelmed, the Float Back goes to the earliest experience of feeling the same way--even if the people and circumstances in the earlier memory were different.

Getting to these earlier memories enables the client and the therapist to see what earlier memories are being triggered by the present experience so that they don't continue to be triggered in other similar circumstances in the future.

At one point in the processing of the trauma using EMDR, Sandy became blocked and couldn't go any further in the trauma work.

Even though, logically, she knew she deserved to feel better, on an emotional level, a big part of her felt that she didn't deserve to feel better.

Sandy was surprised that she could experience such a contradiction between what she experienced logically and what she felt emotionally.

She also said that if someone else had told her this, she would be much more compassionate with that person than she was with herself.

This negative emotional response was so powerful that regular EMDR processing was blocked, so her therapist asked Sandy to imagine what her nurturing person, her best friend, would have said and done if she knew that Sandy felt this way.

In response, Sandy imagined her best friend being with her, and her therapist heightened that experience by having Sandy slow down so she could have a felt sense of her best friend's nurturing quality.

Sandy was able to take in what she imagined her best friend would say and do--that she cared about Sandy and she deserved to feel better.  She was able to feel her friend's compassion on a visceral level and, as a result, she felt much more self compassion).

The felt sense of her friend being compassionate and developing her own self compassion undid the block, and Sandy and her therapist were able to continue with EMDR processing.

Gradually, over time, Sandy and her therapist processed the present, past and anticipatory anxiety about the future.

The fictional vignette provided above focuses on how trauma therapy, specifically EMDR therapy, using imaginal interweaves, which is a form of positive imagination.

Using your imagination is a powerful tool--whether it's used during trauma therapy, like EMDR therapy, or you use it as your own individual coping strategy.

So, even if you're not in therapy, you can use imaginal interweaves on your own to cope with current problems.

Getting Help in Therapy
If you're feeling overwhelmed, you're not alone.

Rather than suffering on your own, you can seek help from a licensed psychotherapist.

Many therapists, including me, are providing online therapy, which is also called teletherapy, telemental health and telehealth (see my article: The Advantages of Online Therapy When You Can't Meet With Your Therapist in Person).

By being proactive now, you can work through your problems and go on to live a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I am currently providing online therapy during the COVID-19 crisis.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.