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Intrusive mental images in the form of flashbacks have long been
recognised as a hallmark of post-traumatic stress disorder.
However, clinicians have become increasingly aware that distressing
imagery is a more pervasive phenomenon. There appears to be a
powerful link between imagery and autobiographical memory. The
field of autobiographical memory needs to account for disorders of
remembering in psychopathology, including the reliving of past
experiences in the form of imagery. While the role of mental
imagery in psychopathology has been an under-researched topic,
recently, there has been a surge of interest. This Special Issue of
Memory, Mental Imagery and Memory in Psychopathology, edited by
Emily A. Holmes and Ann Hackmann, presents a novel series of papers
investigating emotional, intrusive mental imagery across a wide
range of psychological disorders. The topics include post-traumatic
stress disorder, other anxiety disorders such as agoraphobia and
social phobia, as well as psychosis, bipolar disorder, body
dysmorphic disorder, and depression. The roles of imagery in
symptom maintenance and in psychological treatment are explored.
Further studies using non-clinical samples address information
processing issues and imagery qualities. These include innovative
approaches to modelling cravings in substance misuse, and the role
of imagery in conditioning aversions. Pioneering work is presented
on vividness, emotionality, and the type of perspective taken in
imagery. This Special Issue begins and ends with theoretical papers
that provide complementary approaches: reviewing findings from a
clinical psychology perspective and an autobiographical memory
perspective. New developments in cognitive therapy require a
conceptual framework within which to understand imagery in specific
psychopathologies. Since the experience of imagery is not abnormal
per se, it is helpful to make links with accounts of 'ordinary'
processing. Conway's work on autobiographical memory may provide
such a framework. According to this model, images are thought to be
forms of autobiographical memory, referred to as sensory perceptual
knowledge that is experience-near. Indeed, although they may be
unaware at the time, patients often later report that images appear
linked to autobiographical experiences. However, despite being a
form of memory, images may be experienced as actual events
happening in the present, or as representing the imagined future,
and project meaning for the self. Images may provide particularly
potent means of carrying emotion and information about the self,
compared to other forms of processing. In this Special Issue,
Conway presents novel insights that suggest imagery is highly
associated with self goals. Imagery can both reflect and maintain
goals linked to psychopathology. An exciting consequence of this
framework is that imagery can be used to resolve dysfunctional
states in therapy. Imagery in psychopathology tends to be highly
intrusive, distressing, and repetitive. It may arise 'out of the
blue', i.e. directly triggered from autobiographical memory. Images
can hijack attention and reflect negative self goals. It may
therefore understandably provoke a variety of cognitive and
behavioural responses. For example, interpreting the image as
representing fact rather than fiction, trying to block it out of
mind, or avoiding triggers for the image. Cognitive behavioural
therapy targets such responses because they are thought to maintain
psychopathology in a vicious cycle. In contrast, responses that
update the image in memory could break that cycle. Further there is
a role for positive, alternative images. Conway suggests that
generating new images can generate new goals and thus ameliorate
distress: an insight that may further enhance therapy. This book
appeals to clinicians and experimental psychologists working in
memory and emotion. It provides a forum to forge links between
experi
Behavioural experiments are one of the central and most powerful
methods of intervention in cognitive therapy. Yet until now, there
has been no volume specifically dedicated to guiding physicians who
wish to design and implement behavioural experiments across a wide
range of clinical problems. The Oxford Guide to Behavioural
Experiments in Cognitive Therapy fills this gap. It is written by
clinicians for clinicians. It is a practical, easy to read
handbook, which is relevant for practising clinicians at every
level, from trainees to cognitive therapy supervisors. Following a
foreword by David Clark, the first two chapters provide a
theoretical and practical background for the understanding and
development of behavioural experiments. Thereafter, the remaining
chapters of the book focus on particular problem areas. These
include problems which have been the traditional focus of cognitive
therapy (e.g. depression, anxiety disorders), as well as those
which have only more recently become a subject of study (bipolar
disorder, psychotic symptoms), and some which are still in their
relative infancy (physical health problems, brain injury). The book
also includes several chapters on transdiagnostic problems, such as
avoidance of affect, low self-esteem, interpersonal issues, and
self-injurious behaviour. A final chapter by Christine Padesky
provides some signposts for future development. Containing examples
of over 200 behavioural experiments, this book will be of enormous
practical value for all those involved in cognitive behavioural
therapy, as well as stimulating exploration and creativity in both
its readers and their patients.
Imagery is one of the new, exciting frontiers in cognitive therapy.
From the outset of cognitive therapy, its founder Dr. Aaron T. Beck
recognised the importance of imagery in the understanding and
treatment of patient's problems. However, despite Beck's
prescience, clinical research on imagery, and the integration of
imagery interventions into clinical practice, developed slowly. It
is only in the past 10 years that most writing and research on
imagery in cognitive therapy has been conducted.
The Oxford Guide to Imagery in Cognitive Therapy is a landmark
book, which will play an important role in the next phase of
cognitive therapy's development. Clinicians and researchers are
starting to recognise the centrality of imagery in the development,
maintenance and treatment of psychological disorders - for example,
in social phobia, agoraphobia, depression, PTSD, eating disorders,
childhood trauma, and personality disorder. In the fields of
cognitive psychology and cognitive neuroscience, researchers are
identifying the key role that imagery plays in emotion, cognition
and psychopathology.
The Oxford Guide to Imagery in Cognitive Therapy has been written
both for clinicians and researchers. For clinicians, it is a
user-friendly, practical guide to imagery, which will enable
therapists to understand imagery phenomenology, and to integrate
imagery-based interventions into their cognitive therapy practice.
For researchers, it provides a state-of-the-art summary of imagery
research, and points the way to future studies. Written by three
well-respected CBT researcher-clinicians, it is essential reading
for all cognitive therapists, who have recognised the limitations
of purely 'verbal' CBT techniques, and want to find new ways to
work with clients with psychological disorders.
Helping therapists bring about enduring change when treating
clients with any anxiety disorder, this invaluable book combines
expert guidance, in-depth exploration, and innovative clinical
strategies. The authors draw on extensive experience and research
to provide a framework for constructing lucid formulations of
complex cases. They identify obstacles that frequently arise during
the early, middle, and later stages of treatment and present a wide
range of practical solutions. The volume demonstrates clear-cut yet
flexible ways to enhance client engagement, foster metacognitive
awareness, facilitate emotional processing, address low self-esteem
and fear of uncertainty, and much more. Reproducible handouts and
forms are included.
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