Five things I’ve learned about aphantasia as a therapist – Dig a Little Deeper, Psychotherapy & Counselling

🌈 Abstract

The article discusses the author's experience as a neurodivergent psychotherapist treating and supporting individuals with ADHD, and their accidental discovery of aphantasia - a lesser known neurodivergence characterized by the absence of the brain's ability to automatically or willfully generate visual images. The article explores the impact of aphantasia on various aspects of life and psychotherapy, and provides insights and tips for both clients and therapists.

🙋 Q&A

[01] Aphantasia and its Impact

1. What is aphantasia and how does it differ from hypophantasia?

• Aphantasia is the complete absence of mental visualization or the mind's automatic conjuring of imagery, while hypophantasia refers to reduced visual imagery.
• The extent to which someone visualizes affects their cognitive processes and emotional landscapes.

2. How does aphantasia impact decision-making and future-oriented thinking?

• Individuals with aphantasia struggle with reasonably predicting the outcome of choices, being reassured by their own imagination of possibilities, and being intrinsically motivated toward imagined future goals.
• This can lead to increased anxiety and discomfort when faced with new experiences.

3. How does aphantasia affect the experience of grief and nightmares?

• People with aphantasia may have a stronger sensory experience of nightmares, with their recall sounding more like PTSD flashbacks.
• They may also struggle with remembering personal experiences and forming a strong sense of self-identity.

[02] Aphantasia and Psychotherapy

1. How does aphantasia present challenges in traditional psychotherapy?

• Many psychotherapy interventions, particularly for anxiety and trauma, rely heavily on visual imagery techniques, which can leave individuals with aphantasia feeling disconnected.
• Therapists may mistakenly interpret the client's pushback or lack of engagement as "resistance" rather than recognizing the underlying issue of aphantasia.

2. What are some neurodivergent-friendly therapeutic approaches that can be helpful for individuals with aphantasia?

• Somatic and embodied techniques, Acceptance and Commitment Therapy (ACT), Interpersonal Psychotherapy (IPT), mindfulness-based approaches, and memory strategies can be more effective than imagery-based techniques.
• Therapists should directly ask clients about their ability to see or manipulate images in their mind and consider using the VVIQ screen for aphantasia.

3. How can therapists and clients work together to address the challenges of aphantasia in therapy?

• Clients should share information about their aphantasia with their therapist to facilitate a collaborative exploration of the impact on their experiences and therapeutic process.
• Therapists should use first-person tense in worksheets and validate the client's discomfort with imagining future scenarios, helping them put their experience in context.