How Does Imagery and Imagination Enhance Psychotherapy?

I have been using imagery and imagination in therapy with my clients for many years (see my article: Using the Imagination as a Powerful Tool For Change).

Imagery and Imagination in Psychotherapy

The Imaginal Realm: Working With Visual Mental Imagery

I recently attended an advanced AEDP (Accelerated Experiential Dynamic Psychotherapy) seminar called "Imaginal Realm: Working With Visual Mental Imagery in AEDP" which was a deep dive into using imagery and imagination (see my article: What is AEDP?).

When I refer to "imagery", I'm not only referring to visual imagery. Aside from visual imagery, many people get non-visual imagery in sessions. 

For instance, some clients get mental representations through sound (hearing music in their mind), scents that can trigger old memories, kinesthetic experiences (feeling movement), tactile experiences, and an embodied or felt sense of conceptual/verbal imagery such as thinking of concepts or having an internal dialog.

During therapy sessions, I sometimes get visual images in my imagination or a song comes to mind. Over the years, I have learned to appreciate these experiences as messages from my unconscious mind because they often tell me what is going on for the client or what is going on between the client and me.

It's not unusual for me to have an image, song or a word in mind and then a few seconds later the client mentions the same image, song or word (see my articles: Synchronicities - Part 1 and Part 2).

Over time, I have learned that these experiences occur when I feel especially attuned to the client. Other therapists, especially therapists who are experiential therapists like me, have told me that they have similar experiences in therapy (see my article: The Psychotherapy Session: A Unique Intersubjective Experience).

The Use of Metaphors in Psychotherapy

Over the years, I have heard clients use many metaphors unprompted by me, including: 

• "It's like searching for the Holy Grail."
• "I'm no longer jumping into the vortex of other people's drama."
• "I feel like I'm trapped in a cage."
• "I'm no longer putting up walls."
• "I walked on eggshells with my ex."
• "I'm drowning in paperwork."
• "I keep hitting my head against a wall."
• "He swept me off my feet."
• "A weight has been lifted off my shoulders."

Metaphors are beneficial in therapy because they can:

• Enhance clients' communication by allowing them to express feelings they might otherwise have a hard time articulating

• Deepen insights that can lead to a reframing of a problem, a relationship or an idea

• Bypass rational defenses offering a way to talk about sensitive subjects and break rigid and unhealthy thought patterns

• Strengthen the therapeutic alliance between client and therapist

How Imagery and Imagination Enhance Psychotherapy

Imagery and imagination can enhance therapy by engaging the emotional brain. This allows clients to access and process unconscious emotions.

It also helps clients to make behavioral changes through mental rehearsal.

Imagery and Imagination in Psychotherapy

An example of how to use mental rehearsal is a client who wants to become more confident to give presentations at work. This client can vividly imagine their "Future Self", who can exist at any time in the future. They can imagine a self who has all the confidence, qualities and skills they would like to have (see my article: Experiencing Your Future Self).

Using imagination in this way can strengthen neural pathways and prepare the brain for success.

Clients can also see and feel themselves walking into the presentation room feeling prepared and confident, speaking with passion and receiving applause after the presentation. They might even imagine their boss coming over and praising the presentation. 

AEDP Portrayals

One of the main components in AEDP is doing "portrayals" in therapy sessions.

AEDP portrayals are active experiential and imaginative enactments in the therapy session.

To set up doing a portrayal an AEDP therapist prepares the client prior to doing the portrayal by:

• Establishing Safety and a Therapeutic Alliance: The therapist establishes an attuned connection with the client to ensure the client feels safe and to prevent them from feeling overwhelmed.

• Identifying the Core Material: In collaboration with the client, the therapist identifies a memory or a part of the client's self that still has an emotional charge.

• Inviting Immersion (The Setup): The therapist invites the client to slow down, close their eyes and visualize the scene using as many sensory details as possible (sight, sound, body sensations and so on).

• Role Playing (Doing the Portrayal): The therapist guides the client to talk to the imagined person or part of themself by expressing vulnerable or assertive feelings they couldn't express in the past. This might involve imagining talking to a frightened younger part of themself, talking to a parent in a memory from the past, confronting someone who abused them and so on.

There are different types of AEDP portrayals including:

• Reparative Portrayals: An example might be a client imagining a new outcome to a painful scene in their life. In this type of portrayal the client can offer themself what might have been needed and lacking in real life to repair emotional damage.

• Internal Parts Work (intra-relational portrayals): Having a dialog with different aspects of themself to resolve internal conflict (similar to Parts Work Therapy/IFS).

Imagery and Imagination: Internal Parts of Self

• Relational Attachment Portrayals: Reenacting relationships to process emotions to attachment figures (e.g., parents, siblings, a ex-lover, etc). 

• Feared Portrayals: Actively engaging with a threatening figure from real life or from a dream to process the emotional impact, reduce shame and anxiety, and to feel empowered.

• Longed-For Portrayals: The client imagines receiving the love, emotional support or validation they desired but never received from a significant person in their life.

• Moment-to-Moment Tracking: Moment-to-moment tracking is an essential part of AEDP whether the interaction involves a portrayal or a conversation between the client  and the therapist in session. This involves the therapist staying closely attuned to the client's facial expressions, movements, emotions and defenses. The therapist also monitors her own mental, emotional, imaginal and bodily sensations.

• Metaprocessing After a Portrayal: The client and therapist process the experience together afterward to help the client to integrate the experience by building a bridge between the client's right brain and left brain. Among other things, the therapist explores with the client what it was like to do the portrayal and, specifically, what it was like for the client to do the portrayal with the therapist. The focus is on what might have changed for the client or what was transformative about the experience. Processing helps the client to hold onto and integrate positive experiences (see my article: How Are Emotions Processed in AEDP?).

Using Imagery and Imagination on Your Own

Aside from the use of imagery and imagination in therapy, athletes  also use mental rehearsal, including visualization, to imagine a successful performance, including overcoming potential obstacles they might encounter. This can help them to build confidence, improve focus and enhance performance.

You can also use your imagination in creative ways on your own to have fun and, if you like, achieve goals.  There are endless ways to use your imagination on your own including:

• Using Creative Visualization For a Hoped-For Outcome: This can involve imagining a hoped-for outcome in your personal life, career or in any other part of your life.

Imagery and Imagination: Hoped-For Outcome

• Imagining "What If" Problem Solving: When you encounter an obstacle, including an internal obstacle, you can imagine "What if there were no limits?" and visualize different solutions, including solutions that might seem unattainable at first but might spark a new perspective.

• Using the "Lightstream" Technique: If you're dealing with stress, you can imagine a soothing, healing light flowing through your body to alleviate stress or physical discomfort.

Future Articles

Using imagery and imagination is one of my favorite topics, so I'll write more about it in future articles.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have over 25 years of experience helping individual adults and couples.

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.

Also See My Articles:

The Mind-Body Connection as a Window Into the Unconscious Mind

Using the Mind-Body Connection to Create the World You Want 

Dreams and Embodied Imagination 

Working With Your Dreams to Develop Your Creative Imagination 

What Are Imaginal Interweaves?  

Books: Imagination and Medicine

Using Imagery as a Powerful Tool in Trauma Therapy

In prior articles, I discussed how developing internal and external resources are helpful in processing psychological trauma.

See my articles: 

Developing Internal Resources and Coping Skills, Coping Strategies in Mind-Body Psychotherapy

The Therapeutic Benefits of Integrative Psychotherapy

Understanding Your Shifting Self States).   

One of the many resources that I use when doing trauma therapy is imagery, which is the subject of this article.

Using Imagery as a Powerful Tool in Trauma Therapy

As an integrative psychotherapist, I often combine various treatment modalities when it's beneficial to  the individual client.

The key to being able to combine treatment modalities in an integrative psychotherapy is to have a good foundation in a particular type of psychotherapy and professional training in the other modalities.

As I've mentioned in other articles, my original postgraduate training is in psychoanalysis and psychodynamic psychotherapy, and I work in a contemporary, dynamic and interactive way.

After using psychoanalysis and psychodynamic psychotherapy for several years, I could see that it had certain limitations--just as all therapy modalities do.

Although my personal experience in psychoanalysis was very effective in helping me to resolve traumatic experiences, that was nearly 20 years ago, times have changed and most clients don't want to come to therapy for multiple sessions per week for several years as I did.

Once a week psychoanalysis/psychodynamic psychotherapy, which is now the norm, lacks the same intensity as multiple sessions per week.  As a result, the transference/countertransference issues are not as intense, and generally it takes longer in once a week sessions to resolve trauma.

This is what prompted me to study EMDR Therapy, clinical hypnosis and Somatic Experiencing.

For many clients, who don't want to wait years for relief from their traumatic symptoms, these therapy modalities work faster than psychoanalysis/psychodynamic therapy in helping clients to overcome trauma.

This doesn't mean that I don't use my psychodynamic understanding while working with a client.  I still listen and pay attention for the client's unconscious process and transference/countertransference issues as I integrate other forms of therapy.

Before I go into how I use imagery, I want to clarify that the client doesn't need to be good at visualizing to use imagery.

Many clients, who say they can't visualize, are able to get a "felt sense" of images and this is just as useful in therapy.  Other clients who have difficulty visualizing have other senses that work, including an intuitive sense of the image, which can be very powerful.

Using Imagery as a Powerful Tool in Trauma Therapy
Imagery is a powerful resource in psychotherapy, especially when working with psychological trauma.

Imagery comes alive when the therapist helps the client to amplify and enhance the imagery.

The following fictional vignette demonstrates how imagery helps to process trauma:

Nick
Nick started therapy because he was having a difficult time asserting himself in his marriage and in his work-related relationships.

Using Imagery as a Powerful Tool in Trauma Therapy

He told his therapist that ever since he was a child, he lacked confidence in himself and this lack of confidence had a profound effect on his life.

In his personal relationships, before he got married, Nick had a hard time asserting himself when he was attracted to a woman.  Throughout college, he had difficulty feeling confident enough to ask women out on a date.  Most of the time, he would go out with women who asked him out.

In his senior year, he met a woman, Jenna, that he really liked. He lacked the self confidence to ask her out, but he soon discovered that she was interested in him when Jenna asked him to go out for dinner.

Jenna was the one who initiated sex and, 10 years later in their marriage, she was still the one who initiated sex and all their activities, including social activities and vacations.  This was causing problems in their relationship because Jenna complained that she was tired of always being the one to take charge.  She wanted him to take charge sometimes.

Nick understood why Jenna was unhappy with his lack of assertiveness, but he didn't know how to change.

Nick was also having problems advancing in his career.  Other people that he trained and who knew less than Nick, were getting promoted into more senior positions because they knew how to advance their ideas and themselves with their superiors.

When Nick discussed his family history with his therapist, he described a neglectful and critical parents.  He was the younger of two sons, and his parents tended to dote on their older son and to ignore or criticize Nick.

They often compared Nick unfavorably to his older brother, John, and generally discouraged Nick.

Over time, Nick felt that he had nothing of value to offer, and he tended to remain quiet while his older brother got all the praise.

He often felt as a child that he was "a mistake" and that his parents didn't really want to have another child.  This was confirmed by his mother in a tactless admission on her part when Nick turned 21 and left home.

Until he began therapy, Nick never associated this critical, neglectful parent with his lack of confidence and assertiveness.  He also never realized that he had been traumatized by these early experiences.

As he discussed this with his therapist, he said this made sense to him, but he asked, "Now that I know this, how can I change it?"

Based on her experience as a trauma therapist, his therapist told Nick that, although his awareness was an important step, it was only the first step.  She recommended that they revisit his memories using imagery as a tool in trauma therapy.

One of Nick's touchstone memories was of his father telling Nick to "Be quiet" when he wanted to tell his family about an award he received at school for a science project.

Not only did his father tell Nick to "Be quiet," he also told him that "No one's interested in hearing about your award." Then his father turned to Nick's older brother, John, and asked him how his day went at school, and both his father and mother listened to John with admiration.

As a result of many similar experiences with his parents, Nick felt "I'm not important" and "I'm powerless."  These feelings remained with him as an adult.

Nick's therapist recommended that they use imagery to go back to that touchstone memory to see how Nick's experience of himself might change if he could imagine himself having a powerful ally in that situation.

At first, Nick couldn't think of anyone to be an ally to rework this memory.  Then, he remembered his science teacher, who recommended Nick for the award and who often complimented him on his work.

His therapist asked Nick to go back into the touchstone memory and to imagine what his science teacher might have said if he had been with Nick when his father told Nick to be quiet.  She asked Nick to describe the scene in the present tense.  She also helped Nick to amplify the imagery so he could experience it more vividly.

Nick closed his eyes and imagined himself back at home with his family.  He also imagined that he invited his science teacher, Mr. Ross, to dinner that night and Mr. Ross was sitting next to Nick when Nick brought up his science award, "Mr. Ross is there sitting next to me.  When he hears my father tell me to be quiet, he interrupts my father and says, 'Now wait a minute--this is a very important award at the school and Nick's science project was by far the best project the school has seen in years.  I can't sit here and allow you to be dismissive of Nick and this wonderful honor.  Nick deserves much better than this.  I don't have children but, boy, if I had a son like Nick, I would never tell him to be quiet.'"

Nick's therapist could see that Nick's demeanor changed as he imagined Mr. Ross standing up for him.  His chin was raised, his posture was more erect and he had a smile on his face.

Then he explains to his therapist, "Both of my parents have always had a lot of respect for teachers, and they liked Mr. Ross so they would listen to him.

Then Nick goes back into his memory, "So, when they hear Mr. Ross say this, both of my parents look embarrassed and they look at me in a different way.  Then, my father says, 'I'm sorry for interrupting you, son.  Tell us more about your award."

Nick's therapist helped Nick to amplify the shift he was experiencing and to anchor that new feeling in his body.

Nick and his psychotherapist did many similar exercises in therapy using imagery for other traumatic touchstone memories.

Using Imagery as a Powerful Tool in Trauma Therapy

Gradually, Nick was able to internalize the feeling that he is a worthwhile and lovable person.  Over time, as he gained more confidence in himself.

To his wife's delight, he took more of an initiative in terms of their sex life and social activities together.

With regard to his career, Nick and his therapist used imagery to rehearse scenes with his manager where Nick would be more assertive in advancing his ideas.  This allowed Nick to present himself and his ideas with increased confidence, which resulted in praise and promotion with a substantial pay increase.

Conclusion
Every client is unique and their needs in therapy are different, which is why it's helpful for therapists to have a number of different modalities to use to help clients to overcome their problems.

Imagery can be a powerful tool in trauma therapy.  It is one of many tools that trauma therapists can use to help clients to transform traumatic experiences.

When clients use imagery in therapy to imagine the help of powerful figures, such as mentors, wise people, nurturing people or whatever type of figure would be helpful, this can help to create new neural networks in the brain that facilitate change.

Using imagery can help clients to see themselves in a different way and allows them to transform their unresolved trauma.

Getting Help in Therapy
If you have unresolved traumatic experiences, rather than continuing to suffer on your own, you could benefit from working with a trauma therapist (see my article: The Benefits of Psychotherapy).

Once you're free of your trauma, you will have a greater sense of well-being and lead a more fulfilling life (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

I work in an integrative way depending upon the needs of each client.

One of my specialties is helping clients to overcome trauma, and I use many creative therapeutic tools, including imagery.

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.

See My Other Articles About Psychological Trauma.