Exploring the Effects of Mental Imagery in the Solution Focused Approach

This study examined the effects of mental imagery in the solution-focused approach by evaluating the impact of positive self-image about the future on emotional states using the time machine question (which is a questioning technique used in the solution-focused approach). We compared the change in the emotional state of 270 participants, using the Japanese version of the Positive and Negative Affect Schedule (PANAS), before and after the intervention. The intervention conditions included: verbal description of one’s positive future on a worksheet (the language description condition), and imagining one’s positive future (the imagery condition). The results of the experiment showed that after the intervention, the scores of the imagery group on the positive and negative affect scales of the PANAS were significantly higher and lower, respectively, than those of the language description group. We also found that the amount of change in the scores of the positive and negative affect scales of the PANAS was significantly larger in the imagery group as compared to the language description group. These results indicate that interventions involving the imagining of one’s future via the time machine question of the solution-focused approach have a more direct impact on emotional states than interventions using a language description. This suggests that mental imagery plays an important role in interventions carried out within the framework of the solution-focused approach.

Fearful imagery induces hyperventilation and dyspnea in medically unexplained dyspnea

Background Medically unexplained dyspnea refers to a condition characterized by a sensation of dyspnea and is typically applied to patients presenting with anxiety and hyperventilation without underlying cardiopulmonary pathology. We were interested to know how anxiety triggers hyperventilation and elicits subjective symptoms in those patients. Using an imagery paradigm, we investigated the role of fearful imagery in provoking hyperventilation and in eliciting symptoms, specifically dyspnea. Methods Forty patients with medically unexplained dyspnea and 40 normal subjects matched for age and gender were exposed to scripts and asked to imagine both fearful and restful scenarios, while end-tidal PCO2 （PetCO2） and breathing frequency were recorded and subjective symptoms evaluated. The subject who had PetCO2 falling more than 5 mmHg from baseline and persisting at this low level for more than 15 seconds in the imagination was regarded as a hyperventilation responder. Results In patients with medically unexplained dyspnea, imagination of fearful scenarios, being blocked in an elevator in particular, induced anxious feelings, and provoked a significant fall in PetCO2 （P〈0.05）. Breathing frequency tended to increase. Eighteen out of 40 patients were identified as hyperventilation responders compared to 5 out of 40 normal subjects （P〈0.01）. The patients reported symptoms of dyspnea, palpitation or fast heart beat in the same fearful script imagery. Additionally, PetCO2 fall was significantly correlated with the intensity of dyspnea and palpitation experienced during the mental imagery on one hand, and with anxiety symptoms on the other. Conclusions Fearful imagery provokes hyperventilation and induces subjective symptoms of dyspnea and palpitation in patients with medically unexplained dyspnea.