Using Mental Imagery in Counselling and Psychotherapy

A Guide to More Inclusive Theory and Practice

Valerie Thomas

• Publisher: Routledge
• Year: 2015
• eBook ISBN: 9781317375548
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The therapeutic potential of working with clients' mental images is widely acknowledged, yet there is still little in the counselling and psychotherapy literature on more inclusive approaches to the clinical applications of mental imagery. Using Mental Imagery in Counselling and Psychotherapy is a unique, accessible guide for counsellors and psychotherapists who wish to develop their expertise in this important therapeutic practice.

Contemporary practitioners have at their disposal a large repertoire of imagery methods and procedures comprising the contributions from different therapeutic schools and clinical innovators. Valerie Thomas identifies some of the common features in these approaches and offers a transtheoretical framework that supports integrative practitioners in understanding and using mental imagery to enhance therapeutic processes. The book:

• Examines the development of the theory and practice of mental imagery within a wider context of the history of imagination as a healing modality;
• Describes the different ways that mental imagery has been incorporated into therapeutic practice and evaluates recent developments;
• Reviews explanations of the therapeutic efficacy of mental imagery and considers how recent theoretical concepts provide a means of understanding the role that mental images play in processing experience;
• Includes reflections on ways to develop more inclusive theory and proposes a model that can inform integrative practice.

Using a wide range of clinical vignettes to illustrate theory and cutting-edge research, Valerie Thomas proposes a new integrated model of practice. Providing clear and detailed guidance on applying the model to clinical practice, the book will be essential reading for psychotherapists and counsellors, both in practice and training, who wish to harness the therapeutic efficacy of mental imagery.

Chapter 1

Introduction

The original pioneering geniuses of psychotherapy, Freud and Jung, helped to re-establish the faculty of imagining, expressed in the form of mental images, as a source of valid knowledge about the self and its operations. Since that time, mental imagery has gone through cycles of neglect and rediscovery; these rediscoveries have been made either by individual clinical pioneers who went on to develop idiosyncratic systems or by particular therapeutic schools where mental imagery comprises a set of techniques harnessed to a particular paradigm.

Shorr underscores the fundamental role that imagination plays in talking therapies when he poses the rhetorical question:

Is there a psychotherapeutic procedure that does not depend on the patient’s ability to recall and recreate situations and persons, real or imagined, which are a central part of a person’s inner world regardless of whether they are verbalised in a therapy session?

(1983: 464)

And yet, surprisingly, there is little general treatment of this subject in the field, apart from some notable exceptions such as Singer (2006; Singer and Pope, 1978) and Sheikh (2002). Why, despite its ubiquity, has the theory and practice of mental imagery in counselling and psychotherapy not followed the more usual recent trajectory of theoretical convergence? How can integrative counsellors and psychotherapists find a way of developing a coherent approach that can draw on radically different practices? It is important to note here that this integration needs to include approaches that would appear to be completely incompatible in practice – such as depth psychology’s commitment to following the image without attempting to interpret or change it and cognitive behavioural therapy methods where mental images are reshaped to rational curative ends. How can more inclusive frameworks be developed for this practice? This book is an attempt to answer these questions.

The premise of this book

The patchwork development of the theory and practice of mental imagery within counselling and psychotherapy makes more sense when viewed in the light of wider historical and cultural contexts. In premodern Western Europe, imagination was a healing modality – viewed both as a cause of physical maladies and also as a potential cure. This role rapidly came to an end with the advent of Cartesian dualism in the 17th century. From this point on, if the faculty of imagining was understood to be purely a mental function then it could not be implicated in physiological processes. Furthermore, as a mental function it was compared unfavorably with rational thought and viewed as an inferior or ‘primitive’ type of thinking. This narrow view of imagination, one that conflates it with illusory thinking, has had a profound impact on Western culture and mental imagery as a subject has suffered as a consequence – academic psychology did not begin to consider mental images as worthy of investigation until the 1950s.

This historical and cultural context shaped the development of mental imagery as a therapeutic application in talking therapies through the 20th century. Although clinical experience consistently demonstrated the therapeutic potential of working with clients’ mental images, developments in theory and practice were piecemeal and mainly informed by the paradigms espoused by particular therapeutic schools or clinical innovators. In the first decades of the 21st century it is evident that our thinking about mental imagery in counselling and psychotherapy has not followed the trajectory of theoretical convergence that is now commonly seen in the field. Instead the development of more inclusive theory has been stalled and two factors appear to be significant. First, Western thinking is still fundamentally shaped by Cartesian dualism and this means that, in popular culture, imagination as a valid healing modality continues to be automatically deprivileged. Second, the relational turn in counselling and psychotherapy has led to less interest in therapeutic methods that focus on the client’s subjective processes. It is no coincidence that the main site for developing new therapeutic procedures with mental imagery is contemporary cognitive behavioural therapy (CBT) – the school least committed to intersubjectivity.

However, this post-Cartesian landscape is changing: a combination of a body of empirical neuroscientific research findings and theoretical developments across a range of disciplines are laying the grounds for a re-integration of body and mind. These developments are relevant to the therapeutic application of mental imagery because the faculty of imagining is now being understood as an embodied process; in particular, Lakoff and Johnson’s (2003) theory of conceptual metaphor points to mental imagery having a mediating role between physiological and cognitive processes. Lakoff emphasises the importance of these developments, when he states with reference to the discovery that the same neurons fire for the action of grasping as when the concept grasp is expressed:

It is hard to underestimate how far the idea that concepts are physically embodied, using the sensory motor system of the brain, is from disembodied Enlightenment reason – from the usual view of concepts as disembodied abstractions, entirely separate from the sensory motor system.

(Lakoff, 2009: 252)

These wider developments indicate that it is time for the field of counselling and psychotherapy to embrace more inclusive approaches to the theory and practice of mental imagery. This book argues that one way of approaching this task is to identify commonalities in its practice across the different therapeutic schools. The general acceptance that mental images operate as a means of communicating between conscious and nonconscious parts of the self offers a potential locus of integration. This book goes on to propose a model that takes the basic distinctions noted in clinical practice between directive and receptive imagery and further differentiates these out into a range of communication functions operating within a therapeutic context. This model provides a potential transtheoretical framework that offers the possibility of integrating the practices and perspectives and techniques with respect to mental imagery across a wide range of modalities. Furthermore, it will also show how using mental images to represent fundamental dimensions of the self, theorised as conceptual metaphors, can be integrated into ongoing therapeutic work. This more inclusive practice recognises the significant role that mental images play in communicating between parts of the self and seeks a fuller and deeper integration of mental imagery within talking therapies to enhance therapeutic processes.

Who is it for and what are its aims?

This book is written primarily for counselling and psychotherapy practitioners with an integrative or pluralistic approach who want to develop their thinking about and practice with mental imagery. It will also appeal to all practitioners who have a particular interest in developing their work with creative imagination-based methods and who view imagery and symbols as an important means of facilitating therapeutic processes. It has been written on the assumption that the reader has a thorough grounding in counselling and psychotherapy theory and practice that would also include some familiarity with the way mainstream approaches make therapeutic use of clients’ mental images.

It has also been written with researchers, counselling educators and academics in mind, in the hope that it will prompt more interest in developing more inclusive theory and practice with mental imagery.

The aims of the book are summarised below. It is intended to:

• shed light on the current state of the theory and practice of mental imagery by setting it within a much wider historical and cultural context;
• consider how more inclusive theory can be developed through identifying commonalities in its practice;
• introduce a potential framework for inclusive practice, i.e. the interactive communicative model of mental imagery;
• provide a detailed guide to using this model in clinical practice working with a set of mental images deemed to represent conceptual metaphors;
• encourage a deeper ongoing integration of mental imagery within talking therapies.

The rational and imaginal perspectives

As Hackmann et al. note, there has been ‘ … a long tradition of psychology models which suggest a contrast between nonverbal/imaginal and verbal modes of processing’ (2011: 36). This distinction has been labeled in different ways, for example, Bruner (1986) refers to the former as ‘narrative’ and the latter as ‘logical-scientific’ or ‘paradigmatic’. Any work that focuses on the therapeutic use of mental imagery will need to explore the relationship and interaction between these two different types of cognitive processing. However, selecting acceptable generic terms for the two different modes suitable for a more inclusive approach has been a challenge. In the counselling and psychotherapy literature these modes have been described and explained in various ways according to the theoretical positions held by the different schools and a range of terms have been used to refer to this difference. Inevitably, each pair of commonly used terms comes with a set of assumptions. Referring to the non-verbal/imaginal mode as the ‘unconscious’, for example, immediately links it to a psychodynamic model of the self. Using older more symbolic terms such as the ‘underworld’ assumes a location that is extra-psychic. I considered borrowing the term ‘cognitive unconscious’ from cognitive linguistics but this would award it a particular ontological status. Basic generic distinctions such as ‘right/left brain’ found in popular culture are unsuitable for similar reasons as well as being too simplistic to warrant serious consideration.

In the end I have decided that the best solution is to follow Hillman’s (1975, 1979) example of referring to these two modes as two different perspectives: the ‘rational perspective’ (a shorthand label for everything associated with this mode i.e. literal, empirical, analytical, conceptual, verbal, linear, etc.) and the ‘imaginal perspective’ (a shorthand for everything associated with this mode, i.e. symbolic, non-linear, emotional, intuitive, etc.) In general I will be using these terms through the text. These terms allow the most freedom from an identified position. However, there are limitations to this shorthand nomenclature and on occasion I have needed to use other terms.

The scope of this book

There is a very wide range of applications of mental imagery across therapeutic and other cognate disciplines. Because the scope of this field is so vast it has been necessary to impose some limitations. The explicit focus of this book is the therapeutic use of mental imagery in counselling and psychotherapy. Therefore, although reference is made in the text on occasion to the following, they are not the subject of significant attention:

• Other modalities that make significant use of mental imagery such as hypnotherapy and art therapy. These are particular ways of working with mental images, each having a set of specific procedures.
• Dreams. This book focuses on mental images that are produced in a conscious relaxed state rather than imagery recalled from unconscious states such as sleeping. This is a somewhat artificial boundary, of course, and in therapeutic practice clients’ dream imagery may well become the starting point for further active work as one would with an image produced in a guided visualisation.
• Transpersonal imagery. Transpersonal therapeutic work makes significant use of imagery and symbols. However, an in-depth consideration of this subject sits outside the remit of this book. The work presented in this book focuses mainly on the use of imagery to represent aspects of the self. However, this does not mean that it is an explicitly secular work as imagery can appear in these settings that incorporates or depicts transpersonal dimensions.
• Self-help and self-development literature. Although this genre includes some excellent guides to using imagery procedures, these techniques are designed for individual creative practices rather than being delivered within a therapeutic setting.

Overview of the contents

The book is divided into two parts: the first part (Chapters 2–6) sets the context and deals with the theory; and the second part (Chapters 7–12) provides a guide to more inclusive practice. Although the second half can be read as a stand-alone guide, it is supported by the preceding theoretical section.

It is important to note this is not designed to be a scholarly text although it does address theoretical matters. Some of the debates concerning mental imagery raise complex epistemological and ontological questions. In order to make the material presented in this book accessible for the general reader I have taken shortcuts wherever it is possible and when it will not undermine the argument.

NB: Part One presents the background to the use of mental imagery in counselling and psychotherapy. In order to do this I have drawn on a wide range of scholarly work by experts in these fields. Any mistakes in the ensuing synthesis are purely my own.

Part one: towards more inclusive theory

Chapter 2 presents an overview of the history of imagination as a healing modality. It starts with a description of the premodern view of imagination as an integral part of healing practices. It then goes on to discuss the impact of Cartesian dualism on Western culture’s approach to illness and health and, in particular, the end of imagination as a healing modality. It discusses the way that mental imagery was also deprivileged within the emerging discipline of psychology until the mid-20th century.

Chapter 3 returns to the late 19th century to trace the way that, beginning with Freud, the psychotherapeutic use of mental images developed as different sets of techniques within the main therapeutic approaches. As it assumes the reader will be familiar with the range of mental imagery methods developed within mainstream schools over the 20th century, these sections will be presented in summary. It then goes on to consider the contributions of clinical pioneers, working outside the mainstream, who developed influential image-based therapies, particularly those from the European waking dream tradition such as Desoille’s (1966) directed daydream method and Leuner’s (1984) Guided Affective Imagery. It ends by discussing the current developments within contemporary cognitive approaches including an account of some of the new imagery approaches for trauma such as rescripting.

Chapter 4 considers how the field has dealt with explaining the therapeutic efficacy of mental imagery. These explanations can be grouped into two types – i.e. empirical models and phenomenological descriptions. It then goes on to consider an attempt from within the field to generate a more transtheoretical explanation, i.e. Ahsen’s (1984) image/somatic/meaning model (ISM). It then describes a particularly important and relevant theory from another discipline, i.e. conceptual metaphor developed by cognitive linguists, Lakoff and Johnson (2003). It discusses how this theory can explain the operations of mental imagery as a bridge between nonconceptual cognitive processing and later emerging higher-order conceptualisation processes. It concludes that conceptual metaphors can provide potential ground for the integration of both the empirical and phenomenological perspectives on mental imagery.

Chapter 5 discusses another way of moving beyond the empirical/phenomenological divide that has characterised the study of mental imagery in counselling and psychotherapy by re...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Acknowledgements
• Preface
• 1 Introduction
• Part I Towards more inclusive theory
• Part II Towards more inclusive practice
• Index