It is a gentle form of therapy for people who tend to be easily intimidated by typical forms of therapy, such as Exposure Therapy, traditional talk therapy, and even EMDR (Eye Movement Desensitization and Reprocessing).  All of these require the client to revisit the event that is troubling them in some degree of detail.  Image Transformation Therapy (ImTT) enlists the body to help work through the issue(s) that the mind won’t or can’t get a grasp of.  By visualizing a color in the body that represents the trapped pain or fear, it removes the burden of the client to revisit a painful memory or situation and helps to resolve it.  

What It's Good For

It can be especially important for clients who suffer from addictions and compulsions, who would otherwise drop out of therapy due to its intensive focus on consciously working through the basis of one’s out of control behavior.  For example, practicing EMDR with a recovering addict can be very helpful as it seeks to focus on the addictive behavior and the possible traumas that underlie it.  It can be very time consuming, however; and the addictive behavior continually beckons to an addict or person whose behavior is out of control.  With Image Transformation Therapy there is no need to revisit the possible traumatic events that gave rise to the person’s addictive behavior.  Instead, the person visualizes a color in their body related to the original trauma or ‘feeling state’ that gave rise to the behavior, and progressively releases the color from various parts of the body.  The image that relates to the event that gave rise to the addiction is likewise released from the body without any re-experiencing of the event.  This saves a lot of time and can help short-circuit a client’s tendency to want to drop out of therapy prematurely because it saves so much time that could otherwise be given over to their own ambivalence and giving them more time to just dropout and relapse.

It's Advantages

This is also a form of therapy health insurance companies would want to flock to.  Granted, it is new and lacks much empirical support; but it allows clients to make progress in such a relatively short period of time and with minimal risk to the client they should want to train every clinician on their panels to use it.  Think of how much people could transform their lives by having an easy-to-use therapy to help resolve emotional pain and fear.  Instead of spending hours and hours talking about problems of theirs before they experience some relief from troubling emotions, they can simply use the visualization and breathing technique of Image Transformation Therapy to help remedy the problem.  There’s nothing wrong with talk therapy, but it can take a lot of time, especially considering people can spend a lot of time in therapy ‘talking around’ an issue they need to work on-- if they ever get to talking about it at all.  

Be aware as well that in traditional talk therapy there’s a lot of focus on what’s happening from the neck up, when there’s a lot of other things happening with the client in their bodies.  Image Transformation Therapy uses the body to register the pain or fear of an emotional experience and sequentially ‘breathe it out’ of the body.  This allows a clinician to help treat the ‘whole person’ better than in traditional forms of talk therapy.

It's Also Helpful For Suicidality

This is also an obvious treatment for suicidality, inasmuch as it is a result of what Dr. Frank Jobes called ‘psychache.’  Dr. Jobes is an expert in suicidality and first used this term to describe the psychological suffering individuals go through as part of their prompting symptoms for suicide.  Image Transformation Therapy specifically targets the ‘psychache’ and can relieve it, so the person experiencing it no longer has any reason to kill themselves.  To the extent someone feeling suicidal is suffering from depression as well, ImTT can help resolve the emotional pain or fear that may underlie the person’s depression to help prevent future suicide attempts or ideation.  

I have personally seen how effective this method can be, having worked in group therapy settings with the predecessor to this technique with an older adult population.  Almost to a person the individuals who I do this with report relief from emotional pain stemming from events in their lives.  Even without the IDP or Image Deconstruction Protocol there is marked relief from emotional pain connected with events, both recent and in the distant past.  The only problems have occurred when people started getting back into reliving the memories or they connected the event with a sound instead of a color.  

It Can Help Kids, Too!

I see a lot of promise in working with adolescents and children, particularly with adolescents, who don’t want to talk a lot in therapy.  All they have to do is visualize a color associated with a painful or fearful event in their lives, then breathe it out of different parts of the body in a progressive manner.  That’s it.  They don’t have to ‘talk it out,’ which can be a hard thing to do for an adolescent boy who is already not wanting to talk to adults, let alone an adult psychotherapist.  And for younger children, they are good at visualizing things and can gain a better awareness of their bodies by focusing on breathing color out of various parts of their bodies.

It Also Is Helpful For Addictions

As for people who suffer from addictions, this technique offers a much simpler process for dealing with addictions than Robert Miller’s previous Feeling State Addiction Protocol (FSAP).  The FSAP can take a long time due to relatively ingrained ‘feeling states,’ which are the basic kernel, or nugget that gives rise to addictions in people's’ minds and lives.  All one has to do in this situation is to  do a breathing exercise to help eliminate this, and any traumatic material that underlies it can also be sequentially ‘breathed out’ of various parts of the body along with any accompanying imagery that may go with it.  Again considering how prone these folks are to dropping out of therapy prematurely, there is every reason to believe this will help expedite their treatment to allow them to complete therapy before a relapse (or worse!) happens.   

It Helps With 'Killing the Ants'

Perhaps the most notable innovation with this treatment modality is in the way it changes how traditional Cognitive Behavioral Therapy (CBT) works.  In traditional CBT work, the client identifies automatic negative thoughts (ANT’s) that are bothering them.  These create unpleasant emotions in clients, which they are to identify and then refute with positive cognitions.  The last part can be challenging for clients unless they are skilled at identifying the particular variety of distortion involved in the thought.  Dr. Daniel Amen calls attention to the proliferation of ANT’s as something that can threaten brain health, possibly due to how these are closely linked to depression and anxiety disorders.

With ImTT, the client may begin with a painful event and focus on eliminating the pain (or fear) they suffer from in reaction to the event that triggered their ANT’s.  The person then can identify the ANT (and a corresponding image) that goes with it.  ANT’s almost always have an image related to them, if not all the time.  The IDP is then used to eliminate the ANT (and corresponding image that goes with it).  Once this happens new positive cognitions can take the place of the negative one, but since the ANT has been eliminated this is no longer necessary since it is no longer there.  For example, if I have the painful memory of my boss yelling at me and this is tied to the negative belief or ANT that ‘I’m useless,’ I can first do the P/TRP on the pain from the memory of my boss yelling at me.  When I look at my ANT of ‘I’m useless,’ I may relate this to one of my parents telling me this as a young boy.  When I do the IDP on the image and related ANT, the image and ANT are gone.  I can do a positive visualization on top of this with the Miller ImTT model, but the primary work of eliminating the ANT has been done.  Both the painful emotion and the ANT are gone, so positive cognitions can naturally arise, but aren’t necessary since the ANT and what gave rise to it are gone.  

This is especially valuable in the case of negative core beliefs.  These are ANT’s that are particularly strong and can last for years.  I like to refer to these as the ‘radioactive core’ around which a lot of ANT’s and their associated unpleasant emotions can revolve.   Even if I identify the ANT, associated emotion(s), and find a really good rational response (or positive cognition) to combat the ANT, the fact that it is a negative core belief as well (or is associated with one) can render any positive cognition ineffective unless something is done to really get at the ANT in a strong and lasting way.  Even then, if the ANT has an image associated with it, unless I get rid of the image other ANT’s can take it’s place.  Going back to the previous example, unless I have some way of getting rid of the image of my parent’s telling me ‘I’m useless,’ I could have innumerable other ANT’s come in and take it’s place whenever an event that reminds me of this one comes along.  It could be a romantic partner’s disdainful glance or a friend’s unkind jab...conceivably anything.  Up to this point, EMDR offered one of the only means of undoing the images that underlied the pain and fear that can spawn innumerable ANT’s for people suffering from traumatic memories, but with the advent of ImTT, this is made much simpler.  

EMDR can take numerous sessions to accomplish what ImTT does in a matter of one or two.  This makes it much more efficient and cost-effective.  It only needs the research base to help validate it and make it an alternative to an already well-known and effective therapy.

About the author:  Scott Kampschaefer, LCSW is a private practice therapist in Frederick, Maryland.  He has an extensive background in working with depression, anxiety, and bipolar disorder at a clinic for older adults with these disorders in Austin.  He now works with adults and adolescents of all ages in private practice.

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