Imagery Rescripting for Anxiety and Worry

What is Imagery Rescripting?

Imagery Rescripting is a therapeutic technique that forms a key part of Schema Therapy. Imagery Rescripting typically involves selecting a key memory from a person’s life, often during childhood or a time when difficulties first developed, and re-imagining it with a therapist. When a client goes back to this memory in their imagination, they can work with their therapist to change and re-write the image in a way that provides a new meaning and an experience of the things that they needed but missed out on at the time.

What is Imagery Rescripting used for?

Imagery Rescripting was initially developed to treat traumatic memories as well as chronic mental health problems. The technique has since been tailored to treat various mental health difficulties including depression, social anxiety, and OCD.

How does Imagery Rescripting work?

Theories suggest that Imagery Rescripting works to update the memory system with more helpful imagery and beliefs. In Schema Therapy, we use imagery rescripting to give us a sense of what we should have experienced if our needs were appropriately met, and we use this as a template for the future.

Is imagery rescripting effective?

Imagery Rescripting has been studied in a broad range of mental health difficulties and found to be effective. Studies have shown that imagery rescripting has effectively improved mental health symptoms, problematic and intrusive memories, and unhelpful beliefs in individuals with PTSD, depression, anxiety disorders, eating disorders, and OCD (Kip et al., 2023; Kroener et al., 2023; Morina et al., 2017).

How is Imagery Rescripting used for anxiety and worry?

Dr Lauren Stavropoulos, Clinical Psychologist at STIA, adapted imagery rescripting to treat anxiety and worry as part of her PhD research. Imagery rescripting was used in two ways. In one study, individuals were guided to rescript images of future worries to more helpful and realistic scenes. In another study, individuals were guided to rescript unhelpful memories that were related to current worries in order to shift underlying unhelpful beliefs contributing to their symptoms.

How does this differ from other treatments for images related to anxiety?

Existing treatments for anxiety address unhelpful images using Imaginal Exposure. Imaginal Exposure involves a therapist supporting a client to imagine future fears until the negative impact of these fear images reduce over time. This is different from imagery rescripting because the image is not changed in the process.

Does Imagery Rescripting work for anxiety and worry?

Lauren examined the benefits of imagery rescripting for anxiety and worry as part of her PhD research. Across several studies, imagery rescripting was shown to be effective at reducing symptoms of anxiety and worry, improving ways of thinking about worries, reducing the negative impacts of problematic images, and developing more helpful beliefs. These studies tell us that imagery rescripting may be a valuable way to address problematic worries in individuals who struggle with anxiety.

Conclusions

Imagery rescripting is a therapeutic technique with strong research support for treating a broad range of mental health difficulties. Recent developments suggest imagery rescripting can also support people struggling with anxiety and excessive worrying. If you are interested in imagery rescripting, you can discuss this with your psychologist to see if it might be the right fit for you.

References

•       Arntz, A. (2012). Imagery Rescripting as a Therapeutic Technique: Review of Clinical Trials, Basic Studies, and Research Agenda. Journal of Experimental Psychopathology, 3(2), 189–208.

•       Brewin, C. R. (2006). Understanding cognitive behaviour therapy: A retrieval competition account. Behaviour Research and Therapy, 44(6), 765–784.

•       Kip, A., Schoppe, L., Arntz, A., & Morina, N. (2023). Efficacy of imagery rescripting in treating mental disorders associated with aversive memories – An updated meta-analysis. In Journal of Anxiety Disorders (Vol. 99). Elsevier Ltd.

•       Kroener, J., Hack, L., Mayer, B., & Sosic-Vasic, Z. (2023). Imagery rescripting as a short intervention for symptoms associated with mental images in clinical disorders: A systematic review and meta-analysis. In Journal of Psychiatric Research (Vol. 166, pp. 49–60). Elsevier Ltd.

•       Morina, N., Lancee, J., & Arntz, A. (2017). Imagery rescripting as a clinical intervention for aversive memories: A meta-analysis. In Journal of Behavior Therapy and Experimental Psychiatry (Vol. 55, pp. 6–15). Elsevier Ltd.

•       Stavropoulos, L., Briggs, N., & Grisham, J. R. (2024). Self‐guided imagery rescripting for worry images: A preliminary experimental investigation. Journal of Clinical Psychology, 80(6), 1213-1230.

•       Stavropoulos, L. (2024). Mental Imagery and Imagery Rescripting in Generalised Anxiety Disorder (Doctoral dissertation, University of New South Wales (Australia)).

•       Stavropoulos, L., Sabel, I., Cooper, D. D., Newby, J. M., & Grisham, J. G. Brief imagery rescripting is equivalent to imaginal exposure in improving response to worry images among high worry individuals. Behaviour research and therapy, 195, 104915.

•       Strachan, L. P., Hyett, M. P., & McEvoy, P. M. (2020). Imagery Rescripting for Anxiety Disorders and Obsessive-Compulsive Disorder: Recent Advances and Future Directions. In Current Psychiatry Reports (Vol. 22, Issue 4).