Emily A. Holmes
Medical Research Council Cognition & Brain Sciences Unit, 
Cambridge and Karolinska Institutet, Stockholm.

Emotional, intrusive memories “flash upon the inward eye” causing distress across mental disorders. They can flash back to the past or flash-forward to the future.  Intrusive memories of trauma, in there most extreme form “flashbacks”, are the hallmark of post-traumatic stress disorder (PTSD).  “Flashforwards” to future suicidal acts or manic pursuits occur in bipolar disorder¹.

Flashbacks and flashforwards take the form of mental imagery. Mental imagery recruits similar brain areas to perception, enhances memory and learning, and has a powerful impact on emotion².

We discuss two areas introducing an imagery approach to psychological treatment innovation via experimental psychopathology.

• Imagery vividness can be dampened by imagery-competing tasks. After experimental trauma, using a cognitive blockade of memory reactivation plus the computer game “Tetris”, reduced the frequency of intrusive memories³. Brief cognitive task protocols may provide a “cognitive vaccine” after trauma.
• We have hypothesized that bipolar disorder is characterised by an excessive use of mental imagery. Tackling such imagery may help improve overall mood stability.