Imagery rescripting for schema memories

Revisit a difficult childhood memory in imagination and rewrite it so the child’s needs are met.

Why it works

Imagery rescripting (IR) works by re-activating the emotional memory associated with a schema and, while it is active, providing a new input — the healthy adult or therapist entering the scene, intervening, and meeting the child’s need. This is thought to update the emotional memory through reconsolidation: memories are malleable when reactivated, and new information introduced during the reactivation window can alter the stored emotional content.

How to do it

1. Choose a specific childhood memory that seems connected to your core schema.
2. In imagination, return to the scene as if it were happening now — notice what the child is feeling and needing.
3. Invite your present-day, healthy adult self to enter the scene.
4. Let the healthy adult do what should have happened: intervene, comfort the child, tell the abusive or neglectful figure to stop, take the child somewhere safe.
5. Linger with the child once they are safe, and ask what they need to hear. Tell them.
6. Do not use this for highly traumatic memories without a trained therapist present.

Evidence

Imagery rescripting has a growing evidence base for PTSD, painful memories, and body dysmorphia, with several RCTs supporting its effectiveness. As a component of schema therapy for personality disorder, it is part of protocols that show RCT-level effectiveness. An updated meta-analysis (Kip et al., 2023) pooling controlled trials finds imagery rescripting efficacious for the aversive-memory-linked disorders it targets, strengthening the effect estimate over earlier reviews. (rct)

Imagery rescripting for traumatic memories should be done with a trained clinician. Self-guided IR for mildly difficult (not traumatic) memories is reasonable; for significant trauma, go to a therapist trained in IR or EMDR.

Sources

• Arntz & Weertman (1999), treatment of childhood memories, Behaviour Research and Therapy
• Romijn et al. (2021), imagery rescripting meta-analysis, Journal of Anxiety Disorders
• Arntz, A., & Weertman, A. (1999). Treatment of childhood memories: theory and practice. Behaviour Research and Therapy, 37(8), 715-740.
• Morina, N., Lancee, J., & Arntz, A. (2017). Imagery rescripting as a clinical intervention for aversive memories: A meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 55, 6-15.
• Kip, A., Schoppe, L., Arntz, A., & Morina, N. (2023). Efficacy of imagery rescripting in treating mental disorders associated with aversive memories - An updated meta-analysis. Journal of Anxiety Disorders, 99, 102772.

Common mistake

Rescripting the memory as it should have happened without first fully activating the original emotional experience — the rescripting only updates the emotional memory when the original emotion has been re-accessed.