Imagery rescripting

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Arntz, Weertman · 1999

What it is

Imagery rescripting (ImRs) is an experiential technique, and also a stand-alone trauma treatment. The client brings an aversive memory (usually from childhood) vividly to mind in the present tense. At the worst moment (the "hotspot") the course of events in the image is changed: first the…

Format

• Format (Arntz 2025 version). Individual, 12 sessions (or another fixed number) in a restricted period; sessions about 60 minutes (the original trials allowed up to 90). In the IREM trial: 12 sessions of 90 minutes, twice weekly, completed within 6 weeks (8 at most); in the qualitative study…
• Readiness and screening. The developers do not use a separate stabilisation phase; treatment starts after one preparation session. Before starting, check:

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Lingering high arousal or dissociation at the end (extend calming, see 5.3).
• Grief that surfaces in any rescript is normalised and supported; avoiding it can keep symptoms going.
• Difficulty closing the eyes, imagining, or accepting help; these preview later problems (see section 5).
• Don't push or suggest content (4.11); treat whatever appears as an image to work with, not as proof of a past event.
• Some clients and therapists found this step redundant; it is part of the protocol, but keep it brief if the child is already settled.

Problems the guide addresses

• Avoidance and stuck clients
• Resistance to the method
• Overwhelm and dissociation
• Non-adherence and attendance
• Ruptures and the relationship
• Modality-specific difficulties
• Risk issues not addressed in the sources

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.