Can imagination set you free from fear?

Researchers have demonstrated the potential of using imagination for treating anxiety related disorders by showing that imagining a threatening cue activates similar brain processes as real exposure.

If you experience something internally using your imagination, how does this affect your external experience of the world? Can we use our imagination to help us overcome our fears? This is what a recent study, published in the journal Neuron, set out to investigate.

Fear is a human instinct. “We don’t need to learn how to be afraid… but we do learn what to be afraid of,” explained Daniela Schiller, Associate Professor of Psychiatry and Neuroscience at the Icahn School of Medicine at Mount Sinai in New York. People will quickly learn to fear an unpleasant experience, and this fear can be triggered by visual or sound cues associated with that bad experience. This can severely impact quality of life and underlie emotional disorders like phobias, post-traumatic stress disorder and anxiety.

Current methods for treating such disorders are based on repeated exposure to the threatening cues, known as exposure therapy and is an example of cognitive behavioural therapy. By repeatedly experiencing the threatening cues without the negative outcome, the brain can be re-trained and anxieties overcome. But this kind of treatment is not always possible. The cues might be difficult or unethical to reconstruct, or exposure to them might be too overwhelming. Therefore, using imagination in therapy could be life-changing.

But how effective is it to use imagination to unlearn fear? Researchers conducted a study to compare the effectiveness of imagining a threatening cue with being exposed to it in reality. Within one day the process of learning and unlearning fear was simulated. All participants were taught to associate a sound with an uncomfortable electric shock. Then one group underwent the traditional method of ‘real exposure’, so they were repeatedly played the sound without receiving the electric shock. A second group performed ‘imagined exposure’, so rather than hearing the sound in the real world they were asked to hear it in their head. Finally, a third group performed ‘non-specific imagination’, meaning they were asked to imagine sounds from nature like birds or rain. This was an important control because the process of imagination can have general positive outcomes. Finally, all participants were re-exposed to the sound cue to compare the effectiveness of the different approaches.

The results showed that imagination was as effective as real exposure. Not only that, at each stage MRI scans were used to look at the whole brain response. The MRI images showed that both ‘imagined exposure’ and ‘real exposure’ activated the same core network in the brain. The brain activity was not completely identical, but there is a central hub located behind the forehead, which was activated in both groups of participants and is identified as being very important for learning to reduce our defensive responses.

Daniela Schiller suggests that in the future “we could be more sophisticated users of our brain by shear understanding of how it works,” meaning that we could rely less on drugs for treating mental health.

In the age of technology do we get enough opportunity for imagination? What should you do if you want a healthy imagination? The answer: do nothing. “If you are bombarded with external stimulation, this is what captivates the brain. But if you free the brain from external stimulation you would give some room for internal processes”, continued Schiller. “I think we can improve our thought processes, our thought habits through mental action and imagination, but we need to give it opportunity. Imagination really does have an impact on actual brain processes that affect the way we will behave in the future”.