Blog by: Randy Kasper, LCSW, BCD

It’s simple, not always easy. I say this to my clients and students and to myself. As Clinical Social Workers, familiar with empowering skills and techniques, we may think what we’re doing seems clear and simple but navigating thought and behavioral patterns is often anything but easy.

Tales, stores, narratives—they are how we shape our world and how we make sense of it. Years ago, I would share my travails and troubles with my mentor who would casually say, “Well, that’s an interesting story”. How dismissive! This was my life we were talking about! Little did I know that 25 years later I would be teaching M. White’s Narrative Therapy to aspiring clinicians. Changing narratives can shift perspective; per my mentor, Dr. Gerald Epstein, M.D.: belief creates experience. He never tried to argue or reason with his students; instead he introduced them to (and taught countless clinicians about) creating shifts through the use of mental imagery.

Changing one’s storyline is tricky. Intellect and logic almost always conflict with emotion and personal history. I call it mental isometrics: one set of stories pushes against another, while you end up with a headache, complicated by anxiety. Enacting new narratives requires a leap of faith. For many of the marginalized or just plan discouraged, hope can be limited. Cognitive Behavioral Therapy (CBT) can lead to identification and replacement of distorted thinking; Motivational Interviewing (MI) can help the client (and ourselves) discover incentives and hopes; Psychodynamic Therapy offers the opportunity to establish new, functional ways of relating.

“Imagination can take us where intellect never can,” said Einstein. I have found task-focused, short mental imagery exercises to be an invaluable addition to my practice. Capitalizing on the tool of imagination, mental imagery can reveal and shift one’s perspectives and beliefs in an easy, nonthreatening way. It takes our stories and creates internal ‘graphic novels’—pictures are worth a thousand words. Discipline is required though—as well as rapport, engagement, and trust in both the client and oneself. It is effective in overcoming intrapersonal and interpersonal rough spots. Long used with athletes, it is now being used widely to bring about hope, better follow-through, and improved mood. I have used mental imagery with individuals, couples, and groups to enhance teamwork. It’s simple, not always easy.

Many modalities (EMDR, stress and pain management, desensitization) incorporate visualization. Have you used mental imagery as a freestanding technique? Under what circumstances do you think it might be helpful?

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