How to improve the effectiveness of psychotherapeutic imagery techniques?

Schema therapists assume that emotions and beliefs related to the aversive childhood experiences can be changed by providing corrective experiences. One way to change these experiences is to use an imaginal treatment technique called “imagery rescription”. This technique has been proven to effectively reduce the severity of personality disorders and other psychological problems, but the verification of possible mechanism of change provided by this method is not possible with the current state of knowledge.

Imagery rescription was created by modification of a classical cognitive-behavioral therapy technique called “imaginal exposure”. Both techniques start with imagery of a negative autobiographical experience that underlies patients’ mental problems. The difference between these two methods is that negative autobiographical imagery is the core and only part of imaginal exposure whereas in the imagery rescription it is followed by imagery of positive ending in which patients imagine their therapist caring for them.

Imagery rescription was created by modification of a classical cognitive-behavioral therapy technique called “imaginal exposure”. Both techniques start with imagery of a negative autobiographical experience that underlies patients’ mental problems. The difference between these two methods is that negative autobiographical imagery is the core and only part of imaginal exposure whereas in the imagery rescription it is followed by imagery of positive ending in which patients imagine their therapist caring for them.

Studies conducted so far have indicated that disrupting expectations concerning the sequence of events can increase the effectiveness and stability of therapeutic change. The change may even be greater when there is a short time break between the memory recall and positive ending, which makes the old memory trace more vulnerable.

The goal of this project is to compare “imaginal exposure” and two versions of “imagery rescription” (with and without a time gap) in order to shed some light on psychological and neural mechanism of the imagery treatment. This project should also answer a question whether the effectiveness of this treatment can be improved, and if yes, to what extent.

Persons experiencing a strong fear of failure will be randomized into three groups, which undergo one of three psychotherapeutic treatments, including: “imaginal exposure”, “imaginary rescription”, and “imaginary rescription with a 10-minute break”.

Researchers will measure psychophysiological symptoms (sweating) and neuroimaging (MRI) to observe brain activity, which will allow them to identify neuronal patterns responsible for the effectiveness of the afore-mentioned imagining techniques.