Georgina Brighouse

Investigating aphantasia and how capacities for visual imagery can affect individuals in a mental health setting

There is a wide spectrum of capacities for visual mental imagery between individuals. The majority of the population have phantasia; they have conscious mental imagery. Some individuals have hyperphantasia, meaning their mental imagery is extremely vivid, so much so that it seems just as real as, and almost indistinguishable from, their regular perceptions. A very small fraction of the population has aphantasia, meaning they have no conscious visual imagery whatsoever. 

My research will focus on the implications of this variation between different people’s capacities for mental imagery and its relationship to mental healthcare. While psychiatrists and clinicians have long recognised that a subject’s voluntary sensory imagination might intersect with aspects of mental health and have used techniques to manipulate mental imagery to aid in various mental health disorders, they have not considered how these techniques would affect people with no visual imagery. Many mental health disorders are currently characterized by imagery-related symptoms (such as sensory flashbacks in PTSD, for instance), and most treatments rely heavily on imagery-related techniques, like cognitive behavioural therapy. Visualisation is a large part of mental health treatments. As of yet, little is known about how this affects mental healthcare experiences for individuals with aphantasia, however some studies have been conducted which show that it is likely to lead to misdiagnosis or missed diagnosis, as many mental health professionals are unfamiliar with aphantasia and do not understand the differences in symptoms and for aphants who suffer from mental health disorders such as PTSD, resulting in treatment that is, at best, ineffective, and, at worst, harmful.

I will argue that the vividness of an individual’s conscious sensory imagination is a pivotal factor to consider in mental healthcare, and that it might even be the case that those who have vivid mental imagery tend to suffer more from certain mental health issues than those who have little to no visual imagery. Symptoms such as flashbacks or intrusive thoughts could be particularly disturbing for individuals with hyperphantasia, as they would be extremely vivid and may feel the same as their real experiences. Moreover, the lack of awareness of aphantasia in mental healthcare directly affects individual experiences of people with aphantasia who are suffering from certain mental health disorders, from recognising symptoms and correctly diagnosing their disorder, to how well imagery-based treatment would work for them, and so far, evidence shows it is likely to be less effective or even ineffective on people with aphantasia. For example, an aphant who is suffering from PTSD would experience symptoms related to mood and cognition but would lack imagery-based symptoms like flashbacks. Consequently, they may be misdiagnosed with depression, for instance, and provided with the incorrect treatment. Furthermore, since many treatments for mental health disorders rely on imagery-based techniques, it is likely that they would be ineffective anyway. I would like to explore this area of research in more detail, working with psychologists and cognitive scientists as well as philosophers of perception and mental health, to illuminate this current gap in mental healthcare.

Mental health has always been an important issue but in the last decade especially, it has become far less stigmatized as awareness has increased. As such, it will be an interesting and very relevant topic to research, particularly because investigation into the clinical application of mental imagery manipulation on subjects suffering with mental health problems is a new and burgeoning area of research. Having struggled with anxiety for as long as I can remember, and recently discovering that I am most likely hyperphantasic (have extremely vivid visual imagery), I look forward to discovering more about how mental imagery can be analysed and manipulated to make sense of both my own personal experiences, and the experiences of others, who may also be struggling simply due to a lack of understanding about mental imagery. It could be the case that people who suffer severely with mental health disorders simply have extremely vivid mental imagery which heightens their sensations and makes things like flashbacks or intrusive thoughts seem all the more real, or it could be that they have no visual imagery that has resulted in symptoms being missed and they have slipped through the mental healthcare system and not received appropriate treatment. Knowledge of aphantasia could make a crucial difference in mental healthcare, particularly for diagnosis and treatment.

Mental imagery has a massive influence on our everyday perception, so it stands to reason that it should have an equally significant influence on mental health conditions which involve perceptual phenomenology. It is particularly intriguing that there are varying capacities for conscious mental imagery and also variations in mental health issues on a global scale. It would be interesting to explore further the relationship between the spectrum of capacities for mental imagery and the wide range of mental health disorders that many different people suffer from.

I am honoured to have been awarded the John Lennon Memorial Scholarship to fund this research degree. I plan to make good use of this funding and hopefully make a valuable contribution to the future of mental healthcare.  

Supervisors

Dr Laura Gow & Professor Thomas Schramme

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