Imagery rescripting of emotional memories A search for underlying mechanisms

Imagery Rescripting (IR) is a promising transdiagnostic psychotherapeutic technique that focuses on the modification of dysfunctional emotional memories. IR has proven to be an effective treatment in a variety of disorders ranging from anxiety and trauma-related disorders to depression and personality disorders. Despite its widespread use, research on the underlying working mechanisms of IR is still in its infancy. Improving our understanding of how and why IR leads to clinically significant change may ultimately enhance treatment effectiveness. The present thesis therefore aimed to investigate the working mechanisms of IR. For this purpose, we systematically studied the effects of IR versus established exposure-based treatments on artificially induced and clinically persistent emotional memories by combining experimental psychopathology with more applied research methodology in a series of studies. Both laboratory and treatment studies seem to support the hypothesis that IR taps into different processes when compared to exposure-based treatments, which may have critical implications for the treatment of emotional memories. Traditional exposure-based therapies induce new inhibitory memories, thereby leaving the original distressing memory unchanged and vulnerable for retrieval. In contrast, IR may provide a means to directly change the original memory through UCS-devaluation, which might lead to more generalizable and sustainable treatment effects. Although the present findings do not yet allow for any definite conclusions concerning the memory processes underlying IR, they advocate that the technique constitutes a valuable alternative therapeutic approach in the treatment of aversive emotional memories.