Clinical uses of Mental Imagery

Author(s): Sheikh, Anees A., Jordan, Charles S.

Journal/Book: Imagery: Current Theory, Research and Application. 1983; New York. Plenum Press. 391-435.

Abstract: A survey of imagery-based psychotherapeutic methods, from Freud to the 1980ies. The essay outlines the main figures in European and American approaches, including pioneers like Freud, Jung, Caslant, Desoille, Fretigny & Virel, Schulz & Luthe, Asagioli, Leuner; and 'behavior and cognitive behavior therapies' in America, including models based on 'systematic desensitization' (Salter, Lazarus), 'cognitive-affective restructuring' (Beck, Gendlin), 'Eidetic psychotherapy' (Ahsen, Sheikh, Jordan), Imagery and hypnosis, Humanistic-transpersonal approaches (Perls, Progoff, Sheikh, eastern 'wisdom sources'). Also group applications, diagnostic applications of imagery and imagry tests are included in the overview. "Overly enthusiastic image therapists perhaps should keep in mind that there were a time in history when the clinical significance of imagery was widely accepted, but that this period regrettably did not last. It is imperative that the creative surge be accompanied by sobering scrutiny, lest the future of imagery in the clinic be written in its past."

Note: This is a very precise and valuable contribution to a historical and systematic understanding of the many ÒschoolsÓ, ÒmodelsÓ and ÒtechniquesÓ involving psychotherapeutic or behavioral use of mental imagery. Compared with Horowitz there are minor differences in the model inclusion, but no major differences in the ÔclassificationsÕ of clinical applications. Sheik & Jordan include a chapter on ÒGroup Applications of Imagery (p. 412-414) and an extensive chapter on ÒImagery and DiagnosisÓ and a few standard imagery tests: The Age projection test (Ahsen), the Eidetic Parents Test (Ahsen), the Imagery Collage (Lipkin), and the Shorr Imagery test. The greatest problem is that reliablity and validity testing (standardization) of the tests is lacking. But also a lot of questions concerning diagnostic examination of different aspects of the imaging process itself are still unaswered. In their conclusion Sheikh & Jordan point to the wellknown paradox, that clinicians claim the effectiveness of mental imagery in the treatment of a whole spectrum of problems, but that controlled outcome studies are rare. Several researchers have attempted to identify Ônon-specificÕ factors of effectiveness found in most approaches or ÔmodelsÕ. The most simple identification is proposed by Meichenbaum (1978): ÒThree psychological processes explaining the effectivenes of imagery-based therapies: (1) the feeling of control which the client gains as a result of monitoring and rehearsing of various images, (2) the modified meaning or changed internal dialogue that preceeds, attends, and succeeds examples of maladaptive behavior; and (3) the mental rehearsal of alternative responses that lead to the enhancement of coping skills.Ó In a Danish meta-theoretical study of ÒPsychotherapy. Theory and ResearchÓ (Hougaard 1996) the idea of non-specific factors in psychotherapy (originally based on Jerome D. FrankÕs book ÒPersuasion and HealingÓ from 1961) is considered unclear and confusing. However, Hougaards encouraging conclusion is that psychotherapy works (!) and - somewhat paradoxical - that the outcome is not primarily a matter of model or technique, bur more of Ônon-specific factorsÕ like the expectations of the client and the quality of the personal relationship between client and therapist (p. 410). This Ôrealistic optimismÕ should not cover up the need for an Ôintegrative theory of psychotherapyÕ. In reaching this ambition we think it will be wise to remember the statement by Sheikh & Jordan, that Óthe non-conscious, the symbolic, and the magical factors, equally emphasized by Jung, the socalled Oneirotherapists (see below), bye eidetic therapists, and by many others cannot be ignored if one aims to fully comprehend the nature and function of therapeutic imagery. The final answer, of course, will have to come from carefully conceived research.Ó (p. 423)

Keyword(s): enactive. lexical. image. history. diagnosis. imagery test. oneirotherapy (waking dream therapy). systematic desensitization

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