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Imagery in Therapy: an Information Processing Analysis of Fear – Republished Article Available online at www.sciencedirect.com ScienceDirect Behavior Therapy 47 (2016) 688–701 www.elsevier.com/locate/bt Imagery in Therapy: An Information Processing Analysis of Fear – Republished Article Peter J. Lang University of Wisconsin An analysis of fear imagery in behavior therapy is developed from the combined perspectives of information processing theory and psychophysiology. Recent thought on imagery THE ROLE OF IMAGERY in therapy poses a perplexing processing and storage is considered, and it is argued that question for a natural science of behavior. Philos- affective images are best viewed as propositional structures ophers tell us that images are private events, rather than as iconic or holistic sensory representations. A available only to human introspection. As their method is presented for manipulating the image through observation cannot be shared or their dimensions instructions, and an image taxonomy of stimulus and measured by any instrument, they cannot be data in response components is described. The usefulness of a scientific analysis. The founder of systematic bioelectric measurement is emphasized throughout, and desensitization therapy, Joseph Wolpe, recognized this is illustrated in an experiment derived from the this limitation of the subjective construct. Thus, he "constructive" concept of imagery. The implications of proposed an alternative view, that images were this approach are then developed for behavior modification "specific neural events" which formed part of the research: Desensitization and flooding are analyzed, com- pattern or neural sequence previously evoked by parisons are made among media, imaginal, and in vivo fear specific external stimuli. As they shared a common treatments, and the significance of image analysis is neurophysiology, the image could "stand in" for an elucidated for both overt and covert modeling. In conclu- objective stimulus, and the consequences of its sion, a general model for fear processing is described and manipulation were held to be similar to those that directions for future research are outlined. might be occasioned by the object itself. Speaking of desensitization, he states that "a basic assumption The use of imagery manipulations in the context of behavioral underlying this procedure is that the response to the treatment was the seminal idea of Wolpe,andmydebttohisthoughtis imagined situation resembles that to the real gratefully acknowledged. The writing of this paper was supported in part situation" (Wolpe, 1958, p. 139). However, the by NIMH Grant No. MH I0993. Some of this material was presented at the Association for Advancement of Behavior Therapy meetings in San initiating stimulus in therapy is not the "neural Francisco, December 1975, and in a lecture delivered at the Institute of events"; it is a set of instructions, which include the Psychiatry, Maudsley Hospital, London, February 1976. I have admonition to adopt an imaginal set and a discussed these ideas with a number of investigators, and their comments and criticism have been of great assistance. I would like to thank description of the things to be imagined. Further- particularly Victor Broekema, Isaac Marks, Richard McFall, Barbara more, we are unable to manipulate directly the Melamed, Arne Ohman, Stanley Rachman, my students at Wisconsin, complex neurophysiology implied by Wolpe's Cyril Franks, and the anonymous referees of Behavior Therapy. Requests for reprints should be sent to Peter J. Lang, Department of analysis. Thus, while the neural image may be an Psychology, University of Wisconsin, Madison, WI 53706. ultimate reality, the practical utility of the concept is This article is a reprint of a previously published article. For limited. Nevertheless, we should not be wholly citation purposes, please use the original publication details; Behavior Therapy, 8 (1977), pp 862-886. dismayed. As it is not a knowledge of chemistry DOIoforiginalitem:http://dx.doi.org/10.1016/ which guides the chef to a good bouillabaisse, but S0005-7894(77)80157-3. knowing which fish to use and how to cook them, 0005-7894/© 2016 Association for Behavioral and Cognitive Therapies. so in trying to understand the practical effect of Published by Elsevier Ltd. All rights reserved. desensitization, the primary task may not be imagery in therapy: an information processing analysis of fear 689 facilitated by reductionism, but by a direct analysis Imagery Processing and Storage of the information content of the image and the There are two basic ways in which the imaginal act manner of its functional processing. has been conceptualized. From the first viewpoint, A starting place for this enterprise is found in a sensory images are presumed to be the primary study of systematic desensitization conducted by products of external observation. They are stored in Lang, Melamed, and Hart (1970). They noted several the brain as primitive, nonreducible units, having a consistent relationships between physiological reac- fundamental geometric (if visual) or iconic repre- tivity to fear imagery and successful therapeutic sentation in storage. The act of imagining involves outcomes. Subjects who profited from desensitiza- the scanning, inward perceiving, or interpreting of tion had faster heart rates during scenes said to evoke this raw harvest of sensory observation. Advocates fear than during scenes they did not find frightening. of the second viewpoint do not assume that the Furthermore, successful subjects reported scenes to brain is such a silo of unprocessed appearances; the be unusually fearful during sessions when their tonic brain stores knowledge (to use the philosophic heart rates were relatively high. Finally, subjects who terms). We have information about objects or improved with treatment showed a systematic events, not pictures or representations of them. reduction in heart rate with repeated scene presenta- We are culturally conditioned to speak of "seeing" tion, which was in turn associated with fewer fear images in the "mind's eye," but this is no more than signals. This covariation between verbal report and a compelling metaphor. The phenomenal image cardiac activity was not found for those who failed to masks a more fundamental code. This alternative show improvement with treatment. These data view begins with the assumption that the image in suggest a relationship between the physiology of the brain is more like an elaborated description, an instructionally evoked imagery and emotional be- integration of specific affirmations about the world. havior change. More specifically, they imply that the The image is a functionally organized, finite set of psychophysiological structure of imagined scenes propositions. Such propositions are assertions may be a key to the emotional processing which the about relationships, descriptions, interpretations, therapy is designed to accomplish. labels, and tags, which prompt percept-like verbal In the following pages an information processing reports, but which are more basically the units of a analysis of emotional imagery will be described. An preparatory set to respond. effort will be made to show that the image can be a It will be argued in this paper that behavior meaningful psychophysiological construct, that it therapists and researchers in psychopathology can be defined in terms of measurable response should not adopt the picture metaphor, but should events, and that these responses are controlled by embrace the propositional conception of informa- identifiable external stimuli. In the first part of this tion storage, retrieval, and processing. We are paper, consideration is given to the recent thought guided in the following argument by an excellent of cognitive psychologists, as they have reexamined theoretical paper by Pylyshyn (1973), whose issues of imagery processing and storage. It will be explication of this problem is commended to argued that affective images are best conceptualized serious students of cognitive imagery. as propositional structures, rather than as reper- ceived raw, sensory representations. We will show Pictures in the Head that the former view logically permits experimental For many psychologists, the verbal report of an manipulation of the image through instructions and image is viewed as a product of perceptual development of an imagery taxonomy of stimulus processing in the absence of an external stimulus. and response components. An experiment will be The mental image is a kind of picture in the head, described which illustrates the utility of this which may be faint and fleeting, or in the case of approach. In the second half of the paper the idetics it may be so vivid as to ape an external implications of image analysis for an understanding observation. As Pylyshyn points out, "The whole of behavior therapy process and outcome are vocabulary of imagery uses a language appropriate elucidated. The importance of psychophysiological to describing pictures and the process of perceiving measurement in therapy is emphasized. Differences pictures. We speak of clarity and vividness of are examined between flooding and desensitization, images, of scanning images, of seeing new patterns the therapeutic processes initiated by exposure to in images, and of naming objects or properties objective fear stimuli and those prompted by depicted in images" (p. 8). imagery procedures are compared, and therapeutic The implications of this language are that object modeling is analyzed in terms of the propositional representations are stored in the
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