Mervin Smucker. From Imagery Substitution to Imagery Rescripting: Therapeutic Applications of Imagery from Janet’s 19th Century Laboratory to 21st Centure CBT Clinical Practice.

Invited Keynote Address presented at the 33rd AACBT National Conference, Melbourne, Australia

Since the mid-1990s, the use of imagery in CBT treatments has become more commonplace, especially as a means of treating PTSD and other anxiety disorders.  However, the use of imagery as a therapeutic agent is actually not a recent discovery, but has a long history that parallels the development of psychotherapy itself and shows up in the early works of Janet, Charcot, Freud, and Jung.  Later Reichian and Gestalt Therapists also made use of imagery in ways that created a powerful experience for clients, but which were difficult to integrate within an academic framework.  What is new about the emerging approach to imagery in the past decade or so is the use of CBT as a framework for theoretically integrating linguistic techniques with imagery interventions.  This visual-verbal cognitive interface is reflected in Beck’s early writings in which he contended that images were “visual cognitions” subject to examination and modification just as verbal cognitions are.

This talk examines the historical roots of imagery rescripting interventions in psychotherapy, and discusses how an expanded cognitive model has “liberated” CBT therapists to use imagery-based interventions in a scientific manner and to empirically validate their imagery treatments.  Imagery Rescripting & Reprocessing Therapy, the first and still the only manualized CBT Imagery-based treatment, is presented as an outgrowth of this historical framework, especially in the context of Beck’s developing work with imagery modification as part of his cognitive therapy model.  In particular, this address emphasizes refinements of both the imagistic and linguistic elements of IRRT— the use of skillful questioning, Socratic rather than guided imagery, and the importance of having the patient take the lead in the process of transforming traumatic imagery to adaptive imagery.

Mervin R. Smucker