Imaginal Feedback Technique: A Brief Description
Imaginal feedback technique (Thompson 2001, 2008) is a therapeutic technique comprising a synthesis of James Hillman’s image focussed therapy (1983) and Henry Krystal’s modified psychotherapy for alexithymic individuals (1988), which is aimed at restoring the stunted alexithymic imagination to a more functional level.
The alexithymia construct is based on the following four factors:
(i) difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal
(ii) difficulty describing feelings to other people
(iii) constricted imaginal processes, as evidenced by a paucity of fantasies; and
(iv) a stimulus-bound, externally oriented cognitive style
(Taylor, Bagby and Parker 1997, p.29)
The constricted imaginal processes of alexithymia refer to a lack of spontaneous imagining (Thompson, 2008, 2009), and to affect laden imagery in particular (Aleman, 2005). Following the lead of James Hillman (1983), imaginal feedback technique posits that spontaneous fantasy images are primary psychological data which present a mental picture of physiological arousal; data which provide higher cognitive thought with the necessary material for concluding and articulating specific feeling states. As stated by Antonio Damasio, the individual senses “a feeling” arising from the activation of emotion, “provided the resulting collection of neural patterns becomes images in the mind.” (1999, p.79)
Lacking these imaginal signifiers, the alexithymic individual is left searching for the meaning of his emotional excitation in the face of numerous environmental and physiological stimuli. To give a hypothetical example: Paul is driving to a party with his girlfriend and notices his heart is racing, and so asks himself, "Is my heart racing because I'm angry at the driver who just cut in front of me without using his indicator? Is my heart racing because I'm anxious about being in a crowded room of strangers at the party? Is my heart racing because I'm in love with my girlfriend and my heart is all a-flutter? Is my heart racing because I'm excited about the music and dancing that we are about to enjoy? Or is my heart racing because I forgot to take my blood-pressure medication before going out? (Etc.). Now in this above scenario there are five distinct possibilities, but it may prove impossible to tell which is the stimulus responsible for his racing heart based on bodily signals or environmental clues alone. In this situation the popular therapeutic proscriptions for biofeedback tend to prove ineffective because the signals being fed back from Paul’s body provide insufficient detail to allow a conclusive evaluation from the variety of equally plausible explanations.
The precision of imaginal feedback on the other hand shows the specific face of emotion, where (to continue with the above example) Paul’s rapid heart beat appears in conjunction with a spontaneous mental image of another driver cutting in front of him without indicating, and he concludes therefore that the beating is of an ‘angry heart’.
The therapeutic cultivation of imaginal feedback is based on the Jungian technique of active imagination, consisting in the deliberate contemplation of spontaneously produced images with the aim of enriching conscious awareness of internal functions. These images can help one identify emotions as they happen, as in the above example of becoming aware of one’s beating heart (biofeedback) but being faced with five competing explanations regarding the emotion involved. In that instance the internal fantasy image of a careless driver cutting in without using his indicator provides Paul with the necessary data with which to identify the emotion being experienced. By accessing imaginal signifiers the absent emotional understanding can be unlocked for the alexithymic individual, allowing for verbal articulation and intelligent modulation of emotional states (Thompson, 2008, 2009). This proposition finds agreement in the words of Greame Taylor who writes:
'...techniques that promote imaginal activity are likely to strengthen referential links between symbolic and subsymbolic elements within a patient’s emotional schemas (Bucci 2002). Increasing referential activity renders the patient more aware of feelings and therefore better able to reflect on and regulate states of emotional arousal.' (Taylor & Taylor-Allan 2007, p.218)
Archetypal Psychology, as elaborated by James Hillman (1983) provides a sophisticated set of guidelines for evoking, and vivifying the patient’s imagination in the therapeutic setting. This method asks the therapist to be guided by questions such as; "How well has the [patient’s] image worked? Does the image release and refine further imagining? Does the therapist’s response 'stick to the image' as the task at hand, rather than associate or amplify into non-imagistic symbolisms, personal opinions, and interpretations?" (Hillman 1983, p.21). The therapist and patient must use these questions to guard against losing the nascent image through intellectual distractions (Thompson 2009). These guidelines hold the therapist to the task of ‘animating the image’, because according to the premises of archetypal psychology the image is the primary psychological datum, in which feelings are as complex as the image that contains them (Hillman 1983). This approach necessitates that therapy "return personal feelings (anxiety, desire, confusion, boredom, misery) to the specific images which hold them. Therapy attempts to individualize the face of each emotion: the body of desire, the face of fear, the situation of despair. Feelings are imagined into their details. This move is similar to the imagist theory of poetry (Hulme 1924), where any emotion not differentiated by a specific image is inchoate, common, and dumb..." (Hillman 1983, p.59).
Imaginal feedback technique also includes technical adaptations suggested by Krystal which take into account the alexithymic individual’s pseudophobia surrounding self-control of one’s emotional life, and in particular of the use of imagination to this end. These are “powers” writes Krystal, “reserved for mother, doctor, God”… but most certainly not for oneself (1988 p.317). Before the work of accessing imagination can procede, the therapist must relieve this pseudophobia so that the individual feels they have “permission” to take self-control of spontaneous imagination and emotion regulation. Krystal writes, "Eventually, the benign mental representations become so secure that the direct use of a security blanket can be given up. Dreams, fantasy, and play can be used… so that self-caring can be carried out" (1988 p.335)
For a more detailed elaboration of Imaginal Feedback Technique see Alexithymia: An Imaginative Approach, Psychotherapy Australia Journal, vol 14, No 4, Aug. 2008
1. Aleman, A. (2005) Feelings you can't imagine: towards a cognitive neuroscience of alexithymia, Trends in Cognitive Sciences Volume 9, Issue 12 , Pages 553-555
2. Damasio. A. (1999) The Feeling of What Happens, Harcourt and Brace
3. Hillman, J. (1983) Archetypal Psychology: A Brief Account. Spring Pub.
4. Hillman, J. Emotion: (1960) A Comprehensive Phenomenology of Theories and their Meanings for Therapy, Northwestern Uni. Press.
5. Krystal, H. (1988) Integration and Self-Healing: Affect, Trauma, Alexithymia. Hillsdale NJ: The Analytic Press.
6. Thompson, J. (2001) Image Focused Therapy, online publication.
7. Thompson, J. (Aug. 2008) Alexithymia: An Imaginative Approach, Psychotherapy Australia Journal Psychoz Pub.
8. Thompson, J. (2009) Emotionally Dumb: An Introduction to Alexithymia, Jessica Kingsley Publishers.
9. Taylor, G.J., Bagby, R.M. and Parker, J.D.A. (1997) Disorders of Affect Regulation: Alexithymia in medical and psychiatric illness. Cambridge University Press
10.Taylor, G.J., & Taylor-Allan, H.L. (2007) Applying emotional intelligence in understanding and treating physical and psychological disorders: What have we learned from alexithymia, Chapter 15 in- Educating People to be Emotionally Intelligent, by Eds. Reuven Bar-On, Kobus Maree, J. G. Maree, Maurice J. Elias. Praeger (2007)
Emotionally Dumb: An Overview of Alexithymia by Jason Thompson (Kindle Edition - May 8, 2009) - Kindle Book