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Therapy

Can You Change the Past With Psychotherapy?

Imagery rescripting helps change experiences of memories for the better.

What is imagery rescripting? A therapist helps their client imagine a scene from memory or the scary image of a phobia and change the scene by rewriting it. This has a transformative effect on the image and how the brain processes it neurologically.

Source: Josh Hild/Unsplash
Memories are not static.
Source: Josh Hild/Unsplash

I’m sure you’ve heard the old cliché complaint about therapy that goes: “I keep talking about my problems, and I know all about them, but I’m not changing them!” This is a real concern and raises the issue of what happens when a change has to be deeper than the cognitive level. In schema therapy, we talk about the need to have a change also occur at the emotional or experiential level. A wonderful tool for making experiential change happen is by restructuring with images.

People have a lot to say—sometimes grimly— about how we can’t change the past, but we can change the future. And while it’s true that we can’t literally change historical events, with some psychotherapy techniques, it’s possible to change the effect that memories have on you. I would argue that changing memories is essentially as close to actually changing the past as we need to come. We call the technique for doing this imagery rescripting.

First, what are the images, and what is rescripting?

Images play a crucial role in thinking about the past and future, in remembering, and in how we understand ourselves. Each of these activities involves a set of impressions very often associated with images: the image of a memory, the image of a phobia, the image of a traumatic event, the image of self as flawed (such as with eating disorders), the image of a future setting we see ourselves in, or even an image of a part of the self, such as a critic or inner child. Images are incredibly psychologically powerful in the way that they condense a great deal of both thought and emotion into one picture. So often with traumatic or negative image impressions, one image can set the tone for emotion and thought in ways that are hard to overcome.

So when we talk about “rescripting” with an image, we are talking about the psychotherapeutic task of restructuring it. Older models of CBT have focused on restructuring thoughts at the cognitive level. (“What self-sabotaging or scary thoughts come to mind when you imagine public speaking? What core beliefs are behind those thoughts? Let’s reality check those beliefs and see if we can change how you think about public speaking.”) So at the end of therapy, you have restructured how you think about things, which very often helps.

But with imagery, we are talking about rescripting the actual scene connected to an image and adding new or alternate images to the original. By doing so, we can change the emotions connected to an image or memory. That’s restructuring it. We can use imagery to change the story, tone, and feeling around traumatic memories, pictures of ourselves, or aspects of our personality that cause trouble, such as the depressive or abusive internal voice. In therapy, we are both reliving the memory and changing the ending.

Now let’s get into how image rescripting works.

First, it’s important to know that good imagery rescripting work uses the imagination as well as the body and the senses. For quick imagery work, a therapist may just ask a client to close their eyes and take a deep breath, clear their mind, and think of a certain image. With more in-depth imagery work, we will do a mindfulness grounding exercise, which includes deep breathing together followed by a body scan.

An important imagery exercise commonly used in trauma work is the “safe place” exercise. After some mindfulness, the therapist asks the client to imagine a safe, restful, pleasant place they like. For example, the beach.

We then engage the five senses by asking the client to say what they hear, smell, feel, see, and possibly taste. Seagulls and waves, hot sand on the legs, salty tasting wind, the turquoise-colored surf. By engaging the senses and the imagination, we are connecting with parts of the brain not easily accessed through just talking about ideas. By visiting the safe place regularly, it becomes a full sensory experience that occupies our attention and can become a place to go when we are stuck with images that frighten or disturb us. Before ending a tough session, we might return to the safe place as a way of clearing the mind and having a reset.

Schema therapists also use imagery work to get a sense of the most powerful, important memories that stick with a client, called imagery for assessment. We often do this by “bridging” an experience in the current day to a memory by connecting a present feeling to the past. “Hold on to that feeling you had with your boss today, but clear the image of the scene away. Now, holding on to that feeling, think of a time from your childhood when you had this same feeling. What memory comes to mind?” The client may have a memory connected to a parent, which becomes something for us to work with and connects very powerfully with a core feeling.

Once we have an important memory to work with, we can start rescripting or literally “changing the script,” like rewriting a movie scene. Suppose a client has a memory of neglect from her father, which led to self-esteem issues in adult life. We may take several sessions and “workshop” this memory with rescripting.

We start with the memory itself and explore the client’s feelings in the experience. Next, we talk about how her father mistreated her and then imagine how she deserved better treatment. From here, we can go in a lot of different directions, depending on what the client needs.

If the client’s child self isn’t up to it, the therapist will come into the memory and talk to the father, either to mediate or confront. Or the therapist can come into the image and take the client away and console her and bring her somewhere safe. Or the client can practice, as the child self, telling the father what she needs. Or the adult client can go into the image and stand up to the father on behalf of the child self.

Workshopping one pivotal scene from memory with imagery rescripting has incredible therapeutic power. By using imagination to stand up to an abusive parent or change what happens with a phobia or change the picture of our internal critic, we give ourselves permission to break the hold of the past and literally picture a better future.

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