Imagery rescripting for PTSD and personality disorders: theory and application

Imagery Rescripting is a psychotherapy technique that has been integrated into Cognitive Behaviour Therapy (CBT) interventions in the treatment of various psychiatric populations including post-traumatic stress disorder (PTSD), personality disorders, specific phobias, depression, obsessive–compulsive disorder, social phobia, and suicide risk. Whilst empirical evidence for imagery rescripting is accumulating, the technical application and theoretical rationale for its use can differ markedly depending on treatment protocol, treatment population, and research group. One such instance is in the case of PTSD and personality disorders where there is significant disparity in the rationale and application of imagery rescripting for the two populations. This paper describes the theoretical and technical differences between protocols for the use of imagery rescripting with these two populations. It will be argued that the differences between these protocols may not necessarily represent meaningful disorder-specific considerations. Instead, choosing between different protocols for the application of imagery rescripting may be better guided by considering the goals of the intervention as well as the individual client’s readiness for mastery in rescripting. Finally, current research limitations in this field are highlighted and the authors suggest future research directions for further clarity in clinical decision-making regarding this intervention.