Imagery Rescripting in Posttraumatic Stress Disorder

This article provides an overview of methods of working with imagery to change meanings and ameliorate posttraumatic stress disorder (PTSD). It opens with a description of phenomenology in this disorder, usually characterized by a small number of recurrent images of the trauma, each representing a moment that warned of a threat to the physical or psychological integrity of the client. These intrusions are vivid, distressing, sensory fragments, which appear to signal current threat. Theoretical models of maintenance of PTSD are discussed, highlighting the importance of imagery as a target in therapy. Assessment and possible spontaneous cognitive change is then outlined, followed by an account of methods of prompting for additional shifts in meanings associated with the "hot spots" in memory. These include methods of updating the memories by incorporating corrective information, and also identifying and expressing trauma-related emotions. Finally, there is a description of methods of working with childhood memories that have colored the experience of adult trauma.