An Exploratory Study of Trainee Therapists' Experiences of Mental Imagery in Therapy

Abstract

The consideration and utilisation of imagery in therapy has a vast and rich history and has contributed to the development of psychodynamic, humanistic, and cognitive behavioural therapy traditions. Experimental research has substantiated the importance of imagery in therapy, with findings that suggest imagery has a strong relationship with both memory and emotion, has a greater effect on emotions than verbal processing does, and plays a role in information processing. Yet the psychotherapeutic literature has focused mainly on clients’ experiences of imagery in therapy and how imagery can be used as a therapeutic tool, with little consideration of therapists’ experiences. The existing research on therapists’ imagery, albeit limited, suggests that therapists commonly experience imagery in therapy, and these experiences can inform, enrich, and transform therapeutic processes. However, they can also be challenging and disruptive to therapeutic processes and there is minimal research and training in this area. This thesis investigated trainee therapists’ experiences of imagery when working with clients in therapy: the ways in which they understood these experiences; the impact that these experiences had on the trainee therapists or on the therapeutic processes if any; and the trainee therapists’ learning needs in this regard. The investigation involved two studies. The first study involved the collection of quantitative and qualitative data through an online self-report questionnaire that 37 trainee therapists completed. The second study involved follow-up semi-structured interviews with 15 of these trainee therapists and an additional two trainee therapists. Data analysis took a qualitatively driven mixed methods approach, and a method of thematic analysis was used to analyse the qualitative data. The majority of the trainee therapists reported experiencing imagery. However, many expressed confusion about imagery and their own experience of it. After reflecting on their imagery as part of their participation in this study, they reported finding it helpful in therapy. They conceptualised their imagery as a way to process client material and gain insight into their clients, develop empathy and connection with clients, and gain insight into their own personal experiences in therapy. Some also reported experiencing problematic intrusive imagery that was difficult to manage and disruptive in therapy. For most, imagery was not addressed in their training and they reported experiencing the interview as a beneficial reflective process. Overall, this thesis study highlights that trainee therapists value their imagery although it can also be a source of difficulty and therapeutic disruption, which is largely unaddressed in training. This understanding contributes to the existing body of research on imagery in therapy and has important implications for the training and supervision of trainee therapists.