Mental imagery in emotion and emotional disorders

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Abstract

Mental imagery has been considered relevant to psychopathology due to its supposed special relationship with emotion, although evidence for this assumption has been conspicuously lacking. The present review is divided into four main sections: (1) First, we review evidence that imagery can evoke emotion in at least three ways: a direct influence on emotional systems in the brain that are responsive to sensory signals; overlap between processes involved in mental imagery and perception which can lead to responding “as if” to real emotion-arousing events; and the capacity of images to make contact with memories for emotional episodes in the past. (2) Second, we describe new evidence confirming that imagery does indeed evoke greater emotional responses than verbal representation, although the extent of emotional response depends on the image perspective adopted. (3) Third, a heuristic model is presented that contrasts the generation of language-based representations with imagery and offers an account of their differing effects on emotion, beliefs and behavior. (4) Finally, based on the foregoing review, we discuss the role of imagery in maintaining emotional disorders, and its uses in psychological treatment.

Section snippets

What is mental imagery?

We all know what it is like to experience mental images. Images range from sudden memories of past events that intrude into our awareness uninvited, to daydreams in which possible future events are deliberately produced by our own efforts. Whatever their source, images seem to be characterized by their subjective resemblance to sensory impressions, as if “seeing with the mind's eye or hearing with the mind's ear” (Kosslyn, Ganis, & Thompson, 2001, p. 635). This should not be taken as implying

Why is imagery important to clinical conditions and their treatment?

Images can powerfully evoke emotional states. Imagery is the hallmark of post-traumatic stress disorder (PTSD; American Psychiatric Association, 2000) powerful emotions can be evoked by imagery in the form of ‘flashbacks’ to the original traumatic event. Imagery also occurs in many other forms of psychopathology. For example, in people with substance dependencies, related images (e.g. of smoking marijuana) may induce desire or craving for the desired substance (Kavanagh, Andrade, & May, 2005).

Why does imagery have a powerful impact on emotion?

There are several reasons why images should have a particularly powerful affective impact, and a number of mechanisms that provide links between imagery and emotion. We review literature that imagery can evoke emotion in at least three ways: a direct influence on emotional systems in the brain that are responsive to sensory signals; overlap between processes involved in mental imagery and perception which can lead to responding “as if” to real emotion-arousing events; and the capacity of images

Emotional effects of imagery versus language: new evidence from our laboratories

We have assumed that the emotional images reported by patients, so striking in clinical practice, require understanding and explanation. However, clinical psychology has come under fire for making unproven assertions about a special relationship between mental imagery and emotion. For example, Watts has argued that the relative impact of imagery on eliciting emotion may merely be “clinical anecdote” (Watts, 1997) unsubstantiated by empirical evidence. Indeed, our earlier literature search for

Imagery perspective: not all images have an equal impact on emotion

Before reviewing other aspects of imagery important to cognition in psychological disorders, we need to note that the nature of some images makes them more emotional than others. Emotionality is influenced by the perspective from which an image is viewed, and this property has clear relevance to particular psychological disorders. Visual images are typically described as if they were being perceived directly from our own eyes, referred to as the ‘field’ or ‘first-person’ perspective, but

Further reasons why imagery is important in psychological disorders

Having reviewed mechanisms and evidence for the impact of imagery on emotion, we will now turn to other aspects of emotional imagery relevant to cognition in psychological disorders. These include ‘reality monitoring’, the potential to confuse what happened in imagery with reality, and the ability of imagery to persuade us events are more likely to occur. Imagery can also influence behavior more directly. A better understanding of such aspects is essential to a more complete explanation of how

A cognitive model of imagery versus verbal representations, and their impact on emotion, perceived reality and behavior

To summarise the properties of imagery reviewed above, a heuristic model is presented in Fig. 1 that contrasts the generation of language-based representations with imagery. The model offers a descriptive account of the proposed differences between imagery and verbal representation, and their effects on emotion, perceived reality and behavior.

The central section of Fig. 1 indicates that there are two ways in which images can be initiated. In one of them (bottom up), a sensory cue that partially

An unhealthy imagination: imagery in emotional disorders

In these final sections we return to the clinical implications of our line of argument about imagery and emotion. As noted earlier, emotional disorders are often characterized by intrusive and distressing emotional images—or attempts to avoid them—(for reviews see Hirsch and Holmes, 2007, Hackmann and Holmes, 2004, Holmes et al., 2007, Holmes and Hackmann, 2004).

Flashbacks in PTSD consist of vivid emotional trauma memories accompanied by a strong sense of current threat, so that a road traffic

Imagery and emotion: some implications for therapy

In the following section, we offer some (admittedly speculative) suggestions about the therapeutic implications of evidence discussed so far. For an historical review of imagery techniques in therapy up to CBT in the present day see Edwards (2007).

A final word about words

Throughout this review we have consistently argued that emotional effects of imagery are greater than those of alternative language-based representations, and under some conditions verbal processing may even cause deterioration of an existing emotional state. Nonetheless, it is not our intent to claim that language never has emotional effects. Language-based negative rumination can exacerbate and prolong depression (Nolen-Hoeksema, 1991), and language-based worry may similarly prolong anxiety

Conclusions

This review had addressed four areas: (1) we have reviewed literature suggesting that imagery can evoke emotion in at least three ways and (2) empirical evidence confirming that imagery does indeed evoke greater emotional responses than verbal representation of the same information. Next, (3) we considered other relevant characteristics of imagery—the extent it is perceived as representing reality and influences actual behavior. We have presented a heuristic model that contrasts the generation

Acknowledgments

Emily Holmes was supported by a Royal Society Dorothy Hodgkin Fellowship and in part by a grant from the Economic and Social Research Council (RES-061-23-0030).

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