6 Mental imagery and mental health science: from lab to hospital to a refugee camp?

Abstract

Emily Holmes, PhD, DClinPsych is a Professor in Psychology at the Department of Psychology, Uppsala University, Sweden. She is also affiliated to the Karolinska Institutet’s Department of Clinical Neuroscience, and is a Visiting Professor of Clinical Psychology at the Department of Psychiatry, University of Oxford, UK. Holmes received her degree in Experimental Psychology at the University of Oxford, UK. She is also a clinician and completed a clinical psychology training doctorate at Royal Holloway University of London, and a PhD in Cognitive Neuroscience in Cambridge, UK. Holmes’ work as a clinical psychologist has fuelled her research questions. She is interested in psychological treatment innovation in mental health – both in creating new techniques and reaching more people. Under the wider umbrella of mental health science, her approach brings together psychology, neuroscience, psychiatry, maths and more. Holmes’ research has demonstrated that mental imagery has a more powerful impact on emotion than its verbal counterpart. Her group is particularly interested in understanding and reducing intrusive memories after trauma. This is relevant for people after a traumatic event, whether a severe motor vehicle accident, traumatic childbirth or war. She is an Associate Editor for Behaviour Research and Therapy. She is on the Board of Trustees of the research charity ‘MQ; transforming mental health’. Traumatic events can affect anyone from a road traffic accident, to traumatic childbirth or war-related trauma for refugees. A core clinical symptom for many people who experience trauma comprises intrusive memories to the event. Intrusive memories that ‘flash backwards’ to past trauma occur in post-traumatic stress disorder (PTSD). They take the form of mental imagery, that is, an experience like perception in the absence of a percept, such as ‘seeing in our mind’s eye’. Indeed, intrusive, affect-laden mental images can cause distress across mental disorders. Mental images allow us to time travel, and can also ‘flash forwards’ to the future such as those can occur related to suicide or in bipolar disorder. My clinical research group has an interest in understanding and treating maladaptive mental imagery via psychological therapies. To do this, we are curious about what we can learn from cognitive psychology and neuroscience to inform novel treatment development. I will discuss recent work concerning intrusive memory encoding, and a mechanistically informed intervention aiming to disrupt memory re-consolidation via dual task interference, thereby to reduce the frequency of intrusive memories. Recent work on tackling mood instability via focused imagery techniques will be discussed. A broader vision for science-informed psychological treatment innovation will also be explored from working hospitals (Iyadurai et al, 2018, Molecular Psychiatry) to further afield with refugees (Holmes, Ghaderi et al, 2018, Lancet Psychiatry).