Oxford Guide to Imagery in Cognitive Therapy (Oxford Guides in Cognitive Behavioural Therapy)

Imagery is one of the new, exciting frontiers in cognitive therapy. From the outset of cognitive therapy, its founder Dr. Aaron T. Beck recognised the importance of imagery in the understanding and treatment of patient's problems. However, despite Beck's prescience, clinical research on imagery, and the integration of imagery interventions into clinical practice, developed slowly. It is only in the past 10 years that most writing and research on imagery in cognitive therapy has been conducted. The Oxford Guide to Imagery in Cognitive Therapy is a landmark book, which will play an important role in the next phase of cognitive therapy's development. Clinicians and researchers are starting to recognise the centrality of imagery in the development, maintenance and treatment of psychological disorders - for example, in social phobia, agoraphobia, depression, PTSD, eating disorders, childhood trauma, and personality disorder. In the fields of cognitive psychology and cognitive neuroscience, researchers are identifying the key role that imagery plays in emotion, cognition and psychopathology.The Oxford Guide to Imagery in Cognitive Therapy has been written both for clinicians and researchers. For clinicians, it is a user-friendly, practical guide to imagery, which will enable therapists to understand imagery phenomenology, and to integrate imagery-based interventions into their cognitive therapy practice. For researchers, it provides a state-of-the-art summary of imagery research, and points the way to future studies. Written by three well-respected CBT researcher-clinicians, it is essential reading for all cognitive therapists, who have recognised the limitations of purely 'verbal' CBT techniques, and want to find new ways to work with clients with psychological disorders. Cover 1 Contents 18 Index of Illustrations 24 Foreword 26 Preface 28 Invited essay: From ancient shamanic healing to twentyfirst century psychotherapy: the central role of imagery methods in effecting psychological change 34 From ‘animal magnetism’ to psychotherapy 35 Trauma reliving in the twentieth century 36 Metaphoric imagery and imagery journeys 38 Psychodrama, Perls, and the humanistic movement 40 Imagery in behavioural and cognitive psychotherapy 40 Imagery within contemporary integrative approaches 41 Case vignette: Finding a frightened child behind a case of (adult) panic disorder 44 Part 1 Imagery in context 46 1 Imagery in the tradition of Beckian cognitive therapy 48 Beck’s early research 48 An integrative approach 49 Dual belief systems 49 The scientist–practitioner approach 50 Conclusion 51 Case vignette: Developing a realistic image of the future (to allay anxiety) 52 2 The phenomenology of imagery in clinical practice 54 Introduction 54 General features of imagery 55 Specific content of imagery across disorders 61 Metacognitive appraisals of imagery 68 Definitions and terms used in this book 68 Conclusion 71 Case vignette: Imagery as chronic pain catastrophizing: a flash-forward to the ‘worst’ possible outcome 72 3 Experimental research on imagery: implications for clinical practice 74 Introduction 74 The impact of imagery on emotion 75 Imagery and perceptual representations 79 Imagery and autobiographical memory 80 Imagery’s special relationship with emotion: summary of possible theoretical accounts 81 Experimental psychology and clinical psychology models: the distinction between imagery and verbal modes of processing 81 Imagery’s influence on the perceived probability of events 82 Links between experimental research and imagery techniques in clinical practice 83 Future possible innovations from experimental research for imagery techniques 85 Conclusion 87 Case vignette: Using imaginal exposure to reduce intrusive memories of a negative life event in depression 88 4 The effective components of imagery interventions in clinical practice 90 Introduction 90 The purpose of imagery interventions 91 Key components of imagery change techniques 92 Conclusion 101 Case vignette: Transforming an image to reflect a more positive future 103 Part 2 Preparation for imagery interventions 104 5 Establishing the platform for imagery interventions: general principles and practices 106 Introduction 106 Planning/preparation for imagery interventions 106 Experiencing/enacting imagery interventions 109 Observing, reflecting, and following up imagery interventions 114 Troubleshooting: difficulties which might emerge 115 Conclusion 117 Case vignette: Transforming an image of the ‘hereafter’ 118 6 Assessment of imagery 120 Introduction 120 Observing the presence of imagery and encouraging exploration 121 Examining the imagery closely 122 Identifying the encapsulated meanings 123 Assessing metacognitive beliefs about having imagery 124 Assessing the overall impact of the imagery 126 Assessing the client’s response to the imagery 126 Tracing the historical roots of the imagery 127 Bringing the information together and moving towards the formulation 127 Conclusion 128 Case vignette: Using an image to explore the meanings of death and life 129 7 Micro-formulation of imagery 132 Introduction 132 Formulation in cognitive therapy 132 Micro-formulation of imagery 133 Steps in imagery micro-formulation 133 Extending micro-formulation to other types of imagery 135 Conclusion 137 Case vignette: Imagery rescripting to change the significance of an image in OCD 138 Part 3 Imagery interventions: removing and transforming negative imagery 140 8 Working with intrusive day-time images 142 Introduction 142 Socialization 143 Evocation and assessment 144 Micro-formulation 145 Manipulation 145 Discrimination 148 Transformation 151 The ‘emotional bridge’ technique: making a bridge to the past 153 Creation 155 Conclusion 155 Case vignette: Using imagery transformation to reduce anxiety: ‘sticks to roses’ 156 9 Using imagery to work with upsetting memories 158 Introduction 158 Socialization 159 Evocation and assessment 160 Micro-formulation 165 Manipulation 167 Discrimination 168 Transformation 171 Making an ‘emotional bridge’ to the past, to even earlier memories 177 Creation 178 Conclusion 179 Case vignette: Imagery and imagery rescripting as spontaneous processes 180 10 Working with night-time imagery 182 Introduction 182 Socialization 184 Evocation and assessment 185 Micro-formulation 188 Manipulation 188 Discrimination 189 Transformation 190 Making an emotional bridge to the past 192 Creation 192 Conclusion 193 Case vignette: Imagery rescripting in the treatment of horror-based flashbacks 194 11 Working with metaphorical imagery 196 Introduction 196 Socialization 197 Evocation and assessment 198 Micro-formulation 200 Manipulation 203 Discrimination 204 Transformation 205 Extending the work with metaphorical images 207 Making an emotional bridge to the past 209 Creation 210 Conclusion 210 Case vignette: Using metaphorical imagery to deal with a process issue in therapy 211 Part 4 Imagery interventions: creating positive imagery 212 12 Positive imagery: creating goals, developing new skills, and problem solving 214 Introduction 214 Socialization 217 Micro-formulation 218 Goal setting using positive imagery: image construction and mental simulation of strategies 218 Skills training using positive imagery: the importance of imagery rehearsal 221 Problem solving: checking, appraising, and adjusting through mental simulation 222 Conclusion 222 Case vignette: Use of strengths-based imagery 224 13 Positive imagery: creating ‘new ways of being’ 226 Introduction 226 Socialization 228 Formulation 228 Compassionate mind training 229 The old system/new system approach 235 COMET interventions 237 Issues and difficulties in ‘new ways of being’ work 240 Conclusion 241 Case vignette: Using Perfect Nurturer imagery to work with shame-based memories 242 Part 5 Concluding comments 244 14 Future directions in working with imagery in cognitive therapy 246 Case vignette: Imagery rescripting: reducing the sense of threat 250 References 252 Index 270 A 270 B 270 C 271 D 271 E 272 F 272 G 273 H 273 I 273 J 274 K 274 L 274 M 274 N 275 O 275 P 275 R 277 S 277 T 278 U 278 V 278 W 278 Y 278 9780199234028 Oxford University Press Cover......Page 1 Contents......Page 18 Index of Illustrations......Page 24 Foreword......Page 26 Preface......Page 28 Invited essay: From ancient shamanic healing to twentyfirst century psychotherapy: the central role of imagery methods in effecting psychological change......Page 34 From ‘animal magnetism’ to psychotherapy......Page 35 Trauma reliving in the twentieth century......Page 36 Metaphoric imagery and imagery journeys......Page 38 Imagery in behavioural and cognitive psychotherapy......Page 40 Imagery within contemporary integrative approaches......Page 41 Case vignette: Finding a frightened child behind a case of (adult) panic disorder......Page 44 Part 1 Imagery in context......Page 46 Beck’s early research......Page 48 Dual belief systems......Page 49 The scientist–practitioner approach......Page 50 Conclusion......Page 51 Case vignette: Developing a realistic image of the future (to allay anxiety)......Page 52 Introduction......Page 54 General features of imagery......Page 55 Specific content of imagery across disorders......Page 61 Definitions and terms used in this book......Page 68 Conclusion......Page 71 Case vignette: Imagery as chronic pain catastrophizing: a flash-forward to the ‘worst’ possible outcome......Page 72 Introduction......Page 74 The impact of imagery on emotion......Page 75 Imagery and perceptual representations......Page 79 Imagery and autobiographical memory......Page 80 Experimental psychology and clinical psychology models: the distinction between imagery and verbal modes of processing......Page 81 Imagery’s influence on the perceived probability of events......Page 82 Links between experimental research and imagery techniques in clinical practice......Page 83 Future possible innovations from experimental research for imagery techniques......Page 85 Conclusion......Page 87 Case vignette: Using imaginal exposure to reduce intrusive memories of a negative life event in depression......Page 88 Introduction......Page 90 The purpose of imagery interventions......Page 91 Key components of imagery change techniques......Page 92 Conclusion......Page 101 Case vignette: Transforming an image to reflect a more positive future......Page 103 Part 2 Preparation for imagery interventions......Page 104 Planning/preparation for imagery interventions......Page 106 Experiencing/enacting imagery interventions......Page 109 Observing, reflecting, and following up imagery interventions......Page 114 Troubleshooting: difficulties which might emerge......Page 115 Conclusion......Page 117 Case vignette: Transforming an image of the ‘hereafter’......Page 118 Introduction......Page 120 Observing the presence of imagery and encouraging exploration......Page 121 Examining the imagery closely......Page 122 Identifying the encapsulated meanings......Page 123 Assessing metacognitive beliefs about having imagery......Page 124 Assessing the client’s response to the imagery......Page 126 Bringing the information together and moving towards the formulation......Page 127 Conclusion......Page 128 Case vignette: Using an image to explore the meanings of death and life......Page 129 Formulation in cognitive therapy......Page 132 Steps in imagery micro-formulation......Page 133 Extending micro-formulation to other types of imagery......Page 135 Conclusion......Page 137 Case vignette: Imagery rescripting to change the significance of an image in OCD......Page 138 Part 3 Imagery interventions: removing and transforming negative imagery......Page 140 Introduction......Page 142 Socialization......Page 143 Evocation and assessment......Page 144 Manipulation......Page 145 Discrimination......Page 148 Transformation......Page 151 The ‘emotional bridge’ technique: making a bridge to the past......Page 153 Conclusion......Page 155 Case vignette: Using imagery transformation to reduce anxiety: ‘sticks to roses’......Page 156 Introduction......Page 158 Socialization......Page 159 Evocation and assessment......Page 160 Micro-formulation......Page 165 Manipulation......Page 167 Discrimination......Page 168 Transformation......Page 171 Making an ‘emotional bridge’ to the past, to even earlier memories......Page 177 Creation......Page 178 Conclusion......Page 179 Case vignette: Imagery and imagery rescripting as spontaneous processes......Page 180 Introduction......Page 182 Socialization......Page 184 Evocation and assessment......Page 185 Manipulation......Page 188 Discrimination......Page 189 Transformation......Page 190 Creation......Page 192 Conclusion......Page 193 Case vignette: Imagery rescripting in the treatment of horror-based flashbacks......Page 194 Introduction......Page 196 Socialization......Page 197 Evocation and assessment......Page 198 Micro-formulation......Page 200 Manipulation......Page 203 Discrimination......Page 204 Transformation......Page 205 Extending the work with metaphorical images......Page 207 Making an emotional bridge to the past......Page 209 Conclusion......Page 210 Case vignette: Using metaphorical imagery to deal with a process issue in therapy......Page 211 Part 4 Imagery interventions: creating positive imagery......Page 212 Introduction......Page 214 Socialization......Page 217 Goal setting using positive imagery: image construction and mental simulation of strategies......Page 218 Skills training using positive imagery: the importance of imagery rehearsal......Page 221 Conclusion......Page 222 Case vignette: Use of strengths-based imagery......Page 224 Introduction......Page 226 Formulation......Page 228 Compassionate mind training......Page 229 The old system/new system approach......Page 235 COMET interventions......Page 237 Issues and difficulties in ‘new ways of being’ work......Page 240 Conclusion......Page 241 Case vignette: Using Perfect Nurturer imagery to work with shame-based memories......Page 242 Part 5 Concluding comments......Page 244 14 Future directions in working with imagery in cognitive therapy......Page 246 Case vignette: Imagery rescripting: reducing the sense of threat......Page 250 References......Page 252 B......Page 270 D......Page 271 F......Page 272 I......Page 273 M......Page 274 P......Page 275 S......Page 277 Y......Page 278 Imagery is one of the new, exciting frontiers in cognitive therapy. From the outset of cognitive therapy, its founder Dr. Aaron T. Beck recognised the importance of imagery in the understanding and treatment of patient's problems. However, despite Beck's prescience, clinical research on imagery, and the integration of imagery interventions into clinical practice, developed slowly. It is only in the past 10 years that most writing and research on imagery in cognitive therapy has been conducted. The Oxford Guide to Imagery in Cognitive Therapy is a landmark book, which will play an important role in the next phase of cognitive therapy's development. Clinicians and researchers are starting to recognise the centrality of imagery in the development, maintenance and treatment of psychological disorders - for example, in social phobia, agoraphobia, depression, PTSD, eating disorders, childhood trauma, and personality disorder. In the fields of cognitive psychology and cognitive neuroscience, researchers are identifying the key role that imagery plays in emotion, cognition and psychopathology. The Oxford Guide to Imagery in Cognitive Therapy has been written both for clinicians and researchers. For clinicians, it is a user-friendly, practical guide to imagery, which will enable therapists to understand imagery phenomenology, and to integrate imagery-based interventions into their cognitive therapy practice. For researchers, it provides a state-of-the-art summary of imagery research, and points the way to future studies. Written by three well-respected CBT researcher-clinicians, it is essential reading for all cognitive therapists, who have recognised the limitations of purely 'verbal' CBT techniques, and want to find new ways to work with clients with psychological disorders. Imagery is one of the exciting frontiers in cognitive therapy. From the outset of cognitive therapy, Aaron Beck recognized the importance of imagery in the understanding and treatment of a patient's prblems. Recently, there has been significant developments, both empirically and clinically, showing the importance of imagery in the development, maintenance and treatment of psychopathology. The Oxford Guide to Imagery in Cognitive Therapy is a practical guide for clinicans wishing to understand imagery phenomenology, and intergrate imagery-based interventions into their cognitivetherapy practice. The book is oriented to both the needs of experienced clinicians who wish to bring imagery into their repertoire, and experienced cognitive therapists, who wish to refine and extend their use of imagery in cognitive therapy Imagery is one of the new, exciting frontiers in cognitive therapy. This is a landmark book, which will play an important role in the next phase of cognitive therapy's development, as psychologists start to recognise the centrality of imagery in the development, maintenance and treatment of psychological disorders