Patients’ perspectives on imagery rescripting for aversive memories in social anxiety disorder

Abstract

Background:Imagery rescripting (IR) for early aversive memories in patients with social anxiety disorder (SAD) has shown promising results, but no study has investigated the reactions and perspectives of patients who received IR.Aims:This study aimed to gain understanding of patients’ experiences/perspectives on IR as an adjunct to cognitive behavioural therapy (CBT) for SAD.Method:Twenty-five individuals with SAD received one or two sessions of IR over 16 CBT sessions. Contents of recurrent images and linked memories were identified during IR. Outcome measures included social anxiety, image and memory distress and vividness, and encapsulated belief. Patients completed a questionnaire about their perspectives of IR after the session. Thematic analysis was used to analyse the qualitative data.Results:IR resulted in significant within-session improvement in most outcome measures. Linked memories to negative recurrent images in social situations were categorized into nine groups. Common memories were ‘Being criticized by others’, ‘Being made fun of’, ‘Failing or not doing something well’ and ‘Being left out in a group’. Most patients (82%) experienced IR as impressive, and more than half of patients (59%) found IR effective. Themes of reasons of impressiveness and effectiveness were categorized as ‘Results of IR session’ and ‘Processes of IR session’. The theme ‘Results of IR session’ included six subthemes, and the theme ‘Processes of the IR session’ included five subthemes.Conclusions:Regarding patients’ perspectives, although they may experience negative emotions in the process of an IR session, our results suggest that many patients with SAD found IR sessions effective.

Imagery rescripting and negative self-imagery in social anxiety disorder: a systematic literature review

“…3A). Likewise, Takanashi et al (2020) found that median within-session memory vividness scores were lower than median pre-IR scores (p = 0.015), and Wild et al (2007) and Lee and Kwon (2013) found that this decrease was maintained at 1-week (p = 0.004) and 3-month follow-up (p < 0.001), respectively. By contrast, Romano et al (2020a) found that IR, imaginal exposure, and supportive counselling decreased memory vividness over time, but the main effects of condition and time and their interaction were not significant.…”

“…2D). Likewise, Nilsson et al (2012) reported that IR reduced image distress compared with a control group (p = 0.03), and Takanashi et al (2020) found that median within-session image distress scores were lower than median pre-IR scores (p < 0.001). Furthermore, Lee and Kwon (2013) found a decrease in image distress between a pre-IR session and 3-month follow-up (p < 0.001).…”

“…Eight studies examined the impact of IR on image vividness (Knutsson et al, 2019;Lee and Kwon, 2013;Nilsson et al, 2012;Norton and Abbott, 2016;Takanashi et al, 2020;Wild et al, 2007).…”

A Review of Sensory Imagery for Consumer Psychology

“…The intrusive negative images for individuals with depression are commonly memories that recur in ways similar to those who are dealing with anxiety or past trauma (Takanashi et al., 2020). One potential treatment for these individuals is imagery rescripting (Holmes et al., 2016; Strohm, Siegesleitner, Kunze, Ehring, & Wittekind, 2019; Takanashi et al., 2020).…”

“…The intrusive negative images for individuals with depression are commonly memories that recur in ways similar to those who are dealing with anxiety or past trauma (Takanashi et al., 2020). One potential treatment for these individuals is imagery rescripting (Holmes et al., 2016; Strohm, Siegesleitner, Kunze, Ehring, & Wittekind, 2019; Takanashi et al., 2020). Imagery rescripting involves revisiting prior events in three ways: first person as the event occurred, third person as the present observer, and third person as an acting participant who is free to interact with one's prior self.…”