Catathymic imaginative psychotherapy (Guided Affective Imagery)

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Hanscarl Leuner · 1955 · Göttingen

What it is

Katathym Imaginative Psychotherapie (KIP), first called Katathymes Bilderleben (KB), also "Symboldrama", and in English Guided Affective Imagery (GAI), was developed by the Göttingen psychiatrist and psychoanalyst Hanscarl Leuner (1921–1996), who introduced it in 1955. It is a psychodynamic,…

Format

• KIP is not a fixed-session protocol; it is a technique embedded in psychodynamic short-term, depth-psychologically based, or analytic therapy. Bahrke & Nohr's three cases illustrate the range: a 21-session short-term therapy, a 50-session psychodynamic therapy and a 620-session analytic therapy.
• Session format. Pre-talk, brief relaxation, imagery of about 20 minutes on average (varies with age and motif), closing questions and return to the here-and-now; interpretation is not done the same day but by the patient at the next session; patients draw an image between sessions. Imagination…

Who practises it, and how they are trained or regulated

• Phase A: first contact, history, indication. Detailed history and current complaints first. The indication is set by asking which psychodynamic working model applies (conflict, developmental/structural deficit, or trauma), using structural diagnosis (OPD axis 4), and whether the goal is insight, managing external conflict, building structure, or stabilisation. Where benefit is foreseeable, one imagery sequence may…
• Phase E: Oberstufe (higher level). Motifs: cave, swamp hole, volcano, folio (old book). Reserved for highly qualified therapists who have completed higher-level training and personal therapy. In Ullmann et al.'s two-step scheme, everything beyond the basic motifs falls under the Aufbaustufe.
• Criteria for moving between levels. No explicit published criteria are given here. Move from Grundstufe to Mittelstufe motifs when the patient (a) can stay in an imagination and report it with affect, (b) tolerates frightening figures with the therapist's help and can return calmly, (c) can link images to life themes in the next-session talk; use Oberstufe motifs only with Oberstufe training and stable structure.…

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

• refusals or perfectionism; treat as material.
• strong resistance can appear after only a few imaginations.
• dried-up, blocked or dangerous water; avoid forcing contact.
• a guide leading into overwhelming scenes; stop and stabilise.
• acute regression; return to orientation and a resource image.

Problems the guide addresses

• Screening and contraindications
• No images, or images will not come
• Stuck, repetitive or as-if imagery
• Resistance and premature ending
• Overwhelm and dissociation during imagery
• Trauma and memories
• Frightening figures
• Non-adherence (painting, attendance)
• Ruptures and transference
• Suicidality and crisis

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.