Brightening the Day With Flashes of Positive Mental Imagery: A Case Study of an Individual With Depression

Abstract

This article presents a case example of an individual with current major depression engaging in a positive mental imagery intervention, specifically a computerized cognitive training paradigm involving repeated practice in generating positive imagery in response to ambiguous scenarios. The patient's reported experience of the intervention suggests the potential of the positive imagery intervention to "brighten" everyday life via promoting involuntary "flashes" of positive mental imagery in situations related to the scenarios, with associated beneficial effects on positive affect, future expectations, and behavior. Enhancing this aspect of the training-i.e., involuntary positive imagery in contexts where it is adaptive-may hold particular promise for reducing anhedonic symptoms of depression. Developing simple computerized interventions to increase the experience of positive mental imagery in everyday life could therefore provide a useful addition to the drive to improve treatment outcomes.

Keywords: anhedonia; cognitive bias modification; depression; involuntary memories; mental imagery.

Figure 1

Illustration of (a) an example training stimulus from one of the computerized positive imagery training tasks; (b) the lack of positive mental imagery that characterizes depression. In one version of the training task, participants view a series of ambiguous photographs paired with a positive caption. Their task is to generate positive mental image that combines the photo with the caption. In this example (1a), the participant might imagine the clouds clearing and enjoying a sunny day. The possibility suggested by the case illustrated in this article is that the positive images generated during the training may “pop back” or “flash” to mind during their everyday life, so that the individual's experience becomes more like the person on the right‐hand side of (1b) rather than the person on the left. Figure 1b is reproduced with permission from the Annual Review of Clinical Psychology, Volume 12 © 2016 by Annual Reviews, http://www.annualreviews.org

Figure 2

Illustration of one route via which a computer‐based positive mental imagery training program could have beneficial effects in depression, via reexperiencing of the images generated during training in everyday life “popping” or “flashing” into mind. Associated increases in positive affect, expectation of positive outcomes, and behavioural engagement could lead improvements in depression over time via, for example, reductions in anhedonia (loss of interest in and enjoyment from activities) and increases in behavioural activation.