Imagery Rescripting and Reprocessing Therapy

1. Introduction

Version followed: the current German-language IRRT as published by the developer and his institute: Schmucker & Köster, Praxishandbuch IRRT (Klett-Cotta, 2014; 3rd ed. preface 2017; later edition 2021 cited in the literature), operationalised in the official IRRT cue cards (IRRT-Merkkarten, v1.7, Köster, Schmucker & Heer, 2021, irrt.ch). Earlier English versions (Smucker et al., 1995; Smucker & Dancu, 1999; Grunert et al., 2007 for industrial-accident PTSD) are noted where relevant but their full texts are not drawn on. [source: Praxishandbuch extract; IRRT-Merkkarten 1.7]

Imagery Rescripting and Reprocessing Therapy (IRRT) is an imagery-based trauma therapy developed by Mervyn Smucker (published in German as Mervyn Schmucker), first in the US for adult survivors of childhood sexual abuse with PTSD and later, mainly in German-speaking countries, extended to other trauma, and since about 2007 to depression, anxiety and grief. [source: Praxishandbuch extract pp. 19–27; Ehring et al. 2022 abstract] It grew out of imagery rescripting as used in Beck's cognitive therapy. The developers added an adult-self phase because the traumatised child in the image could not stand up to the perpetrator alone. They added a soothing phase after patients began, without prompting, to comfort the child. A pure re-experiencing phase was put at the front in the 1990s. [source: Praxishandbuch extract pp. 24–26]

How change happens: the client first re-experiences a traumatic scene vividly in the present tense (memory level). The scene is then rewritten symbolically on an "inner stage" (symbol level): the present-day adult self enters, confronts and disempowers the perpetrator, then turns toward the hurt child self and soothes and cares for it. The aim is to change the meaning the memory carries (powerlessness, guilt, self-hatred) and to build a soothing relationship with oneself that the client can carry into daily life (the "outer stage"). [source: IRRT-Merkkarten 1.7, process scheme and debriefing card; Praxishandbuch extract] IRRT is distinct from Arntz-style imagery rescripting (ImRs), where the therapist may also step into the image; Ehring et al. (2022) list IRRT as a separate stand-alone variant. [source: Ehring et al. 2022 abstract; Schaich & Fassbinder 2023 abstract]

2. Framework

Structure of one IRRT imagery run (all within one continuous imagery, eyes closed, with no recovery break between runs) [source: IRRT-Merkkarten 1.7, process scheme and Phase 1–3 cards]:

Session course (manual chapter 5): preparation and choice of the starting scene; Phases 1–3 in various combinations (manual variants "1a", "1b"); debriefing; homework; aftercare and the first follow-up session. The manual also has a therapist protocol, a homework protocol and a post-IRRT questionnaire (not reproduced here or drawn on). [source: Praxishandbuch extract, table of contents pp. 86–127, 401–449]

Variants of the run:

• Full sequence 1a–1b–2–3 for trauma memories.
• "Pure Phase 3": a made-up encounter between the adult and the inner child, with no memory and no other people. The developer teaches it as a stabilisation method too. [source: IRRT-Merkkarten 1.7; Schmucker training schedule 2026]
• Grief variant: an imagined encounter with the deceased. [source: IRRT-Merkkarten 1.7]
• Applications to depression, anxiety, burnout and grief appear in the manual and trainings; how the starting scene is chosen for these is [uncertain]

Session count and format: there is no fixed number. The manual's cases range from a single session to 50 sessions over five years. [source: Praxishandbuch extract, pp. 142, 159] Session length is not given in the sources. One published single case (not by the developer) used eight weekly sessions of 1–2 hours. [source: Ali & Naz case study] Plan for long sessions (about 90 minutes or a double session) so there is time for a full run plus debriefing. [synthesis]

Across sessions [synthesis, not specified]: repeat the run on the same scene until distress during Phase 1a stays low and the rescript holds, then move on to the next hot memory. Use pure Phase 3 sessions when the client is not ready for a memory run, or to consolidate the client's relationship with the inner child. The manual names explicit abort criteria (pp. 84) whose content is not drawn on. [uncertain]

3. Guiding principles

• Co-driver, not helmsman. Schmucker describes the therapist as a front-seat passenger (Beifahrer), not the one steering. In practice: the client decides what happens in the image; you ask, you do not script. [source: Praxishandbuch extract p. 23]
• The client's words, not the therapist's. The authors say that wording given by a therapist blocked Schmucker in his own experience. In practice: never put rescripting content in the client's mouth; offer only questions. [source: Praxishandbuch extract p. 22]
• Socratic and collaborative stance. In practice: guide by questions, check how the client experienced your accompaniment, and treat the work as joint discovery. [source: Praxishandbuch extract pp. 65–67; Merkkarten debriefing card]
• Deliberate question technique: open vs. closed questions, eliciting the action wish (Handlungswunsch), repetition and paraphrase. In practice: use open questions to open up the image, closed ones to pin down a decision, and repeat the client's own words back to strengthen them. [source: Praxishandbuch extract pp. 70–72]
• Subjunctive first, then indicative. In practice: start hypothetical ("what would you say…") when the client hesitates, then switch to the present ("what are you saying now?") once the process is running. [source: Praxishandbuch extract p. 74; Merkkarten grief card]
• Present tense, eyes closed, continuous dialogue. In practice: correct past-tense narration gently and keep talking throughout so the client is never alone in the image. [source: Merkkarten introduction]
• Monitor distress continuously on a 0–10 scale. In practice: ask regularly and especially at pauses and hot spots. [source: Merkkarten introduction, Phase 1]
• Stay in it. In practice: no recovery break between the first run and the repeat; the change is made while the memory is active. [source: Merkkarten Phase 1]
• Work at the hot spot. In practice: bring the adult in at the worst moment in the perpetrator's presence, not at an easier one. [source: Merkkarten Phase 1]
• Imagination has no limits; the figures are inner images. In practice: when the client holds back, remind them it is an inner picture of the perpetrator (or of the mother) on an inner stage, not the real person, and anything is possible there. [source: Merkkarten Phase 2]
• Speak directly. In practice: move the client from reporting ("I'd tell him…") to enacting ("say it to him now"). [source: Merkkarten Phases 2–3]
• Imaginal experiment. In practice: frame hesitant steps as trials ("let's see what happens if…"), including asking what the worst outcome would be. [source: Merkkarten Phases 2–3]
• Reaction and counter-reaction. In practice: after every act, ask how the other figure reacts and how the client reacts to that. [source: Merkkarten Phase 3]
• Inner stage to outer stage. In practice: every session ends by asking what the client takes from the imagery into daily life, including a lasting relationship with the inner child. [source: Merkkarten debriefing card]
• Informed consent and clear indication and abort criteria are part of the method. In practice: obtain consent to the procedure before the first run and keep stopping rules. [source: Praxishandbuch extract pp. 79–85; criteria contents uncertain]
• Respect the form of address. In childhood trauma, ask permission before using the informal "Du" during re-experiencing. [source: Merkkarten introduction]
• Memory is the client's experience, not evidence. In practice: never suggest content, never use the method to "recover" memories, and treat changes in the image as symbolic. [synthesis]

4. Intervention inventory

Sequence and questions follow the IRRT cue cards v1.7 unless marked otherwise. English example wording is mine (illustrative); the few German phrases are short quotes from the cue cards. [source: IRRT-Merkkarten 1.7]

4.1 Preparation: indication, readiness, consent, choice of starting scene

• Purpose: decide whether IRRT fits now, get informed consent, and choose the first scene. The manual has sections on application criteria, PTSD exclusion criteria and contraindications, exclusions for other indications, abort criteria, informed consent, preparation and choice of starting scene. [source: Praxishandbuch extract pp. 79–87] Their content is not drawn on, so the steps below are my synthesis. [uncertain]
• Steps [synthesis]:
  1. Assess the trauma history and current symptoms (intrusions, nightmares, avoidance, guilt, shame, self-hatred) with a standard structured PTSD measure.
  2. Screen readiness: no acute suicidality, no current violence or ongoing contact with the perpetrator that puts the client at risk, no acute psychosis or intoxication, enough affect tolerance to stay with distress for 30–60 minutes, and the ability to return to the present when asked. With marked dissociation, start with stabilisation, which can include pure Phase 3 (4.15).
  3. Explain the rationale: re-experience the scene once, then rewrite it in imagination with the present-day adult self, then care for the child. Say that the image is changed, not the past, and that the rescript is symbolic, not a claim about what happened.
  4. Get consent to the procedure, to strong emotions during the session, and to the stopping signal you agree on.
  5. Choose the starting scene together: usually the memory behind the most distressing intrusions or the most painful hot spot; note its first and last moments.
• Example language (illustrative): "We'll go into one memory together. You'll tell it from the inside, as if it's happening now. Then we'll replay it, and this time you, as the adult you are today, can step in. Nothing we do changes what happened; it changes how the memory sits in you."
• Watch for: pressure to "get it over with" without stabilisation; plans to testify in court (rescripting may affect how a memory is reported; discuss and, if needed, document the original account first) [synthesis].

4.2 Introducing the run (client instructions)

• Purpose: set the frame so the client can stay inside the image. [source: Merkkarten introduction card]
• Steps: ask the client to close their eyes, picture the start of the scene and describe it aloud in the present tense, going through the whole scene and saying when it ends. Explain that afterwards, with eyes still closed, they will go back to the start and repeat it, and that this time the script will change in a way you will explain when the moment comes. Tell them you will keep talking with them and will ask for their distress rating from time to time. In childhood trauma, ask whether you may use the informal form of address during re-experiencing. Ask for questions, then start.
• Example language (illustrative): "Close your eyes when you're ready. Go to the moment the memory begins and tell me what's happening, as if it's happening right now: 'I'm standing in the hallway…' Tell me when it's over."
• Watch for: past-tense narration ("then he came in"). Redirect gently to the present ("he's coming in").

4.3 Distress scale (Belastungsskala, 0–10)

• Purpose: track activation and change through the run. [source: Merkkarten introduction, Phase 1]
• Steps: before starting, explain the 0–10 scale. Ask for a rating regularly during Phase 1, at pauses and at hot spots, and note the ratings on your protocol. Cue-card wording: "Wo befinden Sie sich jetzt im Moment auf dieser Skala?" ("Where are you on this scale right now?")
• Watch for: a high rating at the hot spot in Phase 1a (enough activation) and falling ratings through Phases 2–3. A rating that stays at 0 in Phase 1a with flat affect may mean avoidance or detachment [synthesis].

4.4 Phase 1a: re-experiencing (Wiedererleben)

• Purpose: activate the memory fully, keep it vivid and find the worst hot spot in the perpetrator's presence. [source: Merkkarten Phase 1]
• Steps:
  1. Let the client narrate in the present tense with eyes closed.
  2. From time to time ask what is happening now, how it goes on and how they feel.
  3. During long pauses ask what is happening in the image, what feelings and thoughts come up and where they are on the scale.
  4. Note the hot spots, especially the worst moment with the perpetrator present.
  5. Near the end ask whether anything else happens, then whether the scene is over.
  6. Do not allow a recovery break. Ask the client to keep their eyes closed and go back to the start (moves to 1b).
• Example language (illustrative): "What's happening now?" / "What do you notice in your body?" / "And then what happens?" / "Is the scene over now?"
• Watch for: skipping the worst moment, switching to an observer view, glazed affect or loss of contact (see Section 5, dissociation). Dosing: one complete run of one scene, then straight into the repeat. [source: Merkkarten Phase 1]

4.5 Phase 1b: repeat and bring in the adult self

• Purpose: re-enter the same scene and, at the hot spot, bring in the present-day adult self (heutiges/aktuelles Ich). [source: Merkkarten process scheme, Phase 1–2]
• Steps: have the client replay from the beginning in the present tense, with ratings. When the hot spot is reached, ask whether they can picture themselves entering the scene as the adult they are today. Then ask what they see as the adult now.
• Example language (illustrative): "Stay right there. Can you picture yourself as you are today, stepping into that room? What do you see as the adult, looking at this?"
• Watch for: the adult "becoming" the child, or freezing (see 4.6 complications). Some clients enter more easily if invited to notice their adult body (size, age, strength) first [synthesis].

4.6 Phase 2: rewriting with the perpetrator (mastery imagery, Um-Schreibung)

• Purpose: the adult confronts and disempowers the perpetrator in imagination, reworking powerlessness, fear and guilt at the symbol level. [source: Merkkarten Phase 2; Praxishandbuch extract TOC "disempowering the perpetrator" p. 403]
• Steps:
  1. Ask what the adult wants to say to the perpetrator or do with him.
  2. Ask them to say it directly to him, or to do it, and how exactly.
  3. Ask how the perpetrator reacts, then what else they want to say or do (reaction and counter-reaction).
  4. When the perpetrator shows signs of losing power: ask what they see in his eyes, why he is afraid, how they react and how he responds.
  5. Before moving on, ask whether there is anything else to say or do to the perpetrator before turning to the child.
• Example language (illustrative): "What do you, as the adult, want to say to him?" / "Say it to him directly, right now." / "How is he reacting?" / "What do you see in his eyes?" / "Is there anything else before you turn to the little one?"
• Watch for: the client choosing the action; your job is only to ask. Working signs: posture, voice and rating shift; the perpetrator shrinks, leaves on the client's terms or shows fear. Complications and the scripted responses are in Section 5.
• Note on aggressive rescripts: the cue cards allow the adult to want to kill the perpetrator in imagination; ask whether they can say this directly and what they want to say or do first. Treat this as symbolic. Separately, assess any real-world risk of violence. [source: Merkkarten Phase 2; risk check synthesis]

4.7 Helper figures and objects

• Purpose: support the adult when they still feel powerless. [source: Merkkarten Phase 2]
• Steps: ask whether an object or a weapon would help. If not enough, ask whether a helper is needed, whom they want to bring in, and what the helper should do to the perpetrator. Then return the lead to the adult self.
• Example language (illustrative): "Is there anything you'd want in your hands right now?" / "Would you like someone with you? Who? What should they do?"
• Watch for: the helper doing everything while the adult stays passive. Bring the adult back to act or speak themselves [synthesis].

4.8 Reconciliation (Versöhnung)

• Purpose: listed in the manual's table of contents under the coping-imagery phase (p. 100). [source: Praxishandbuch extract] How and when it is used is [uncertain]
• Guidance [synthesis]: if the client spontaneously moves toward reconciliation with a figure in the image, follow it as their choice. Do not suggest forgiveness or reconciliation, especially with an abuser, and check in the debrief that it did not come from pressure or self-blame.

4.9 Phase 3: turning toward the child (self-calming and self-nurturing)

• Purpose: the adult self turns to the hurt child self and gives comfort, protection and care, working on shame, self-blame and self-hatred. [source: Merkkarten Phase 3; Praxishandbuch extract p. 101 "self-calming and self-comforting"]
• Steps:
  1. Ask whether the little one took in everything that just happened.
  2. Ask what the adult wants to say to the child or do with the child.
  3. Ask them to say it directly or to imagine doing it.
  4. Ask how the child reacts, then how the adult reacts to that, and keep the loop going.
  5. Ask what they see in the child's eyes and how they feel seeing that look; invite them to say that to the child as well.
  6. Keep asking what else they want to say or do, until the encounter is ready to close (4.10).
• Example language: cue-card question "Was möchten Sie dem KIND jetzt sagen?" ("What would you like to say to the child now?"). Illustrative follow-ups: "How does she react?" / "What do you see in her eyes?" / "Can you tell her that directly?"
• Watch for: distance between adult and child, reluctance, hostility toward the child, or the child turning away (responses in Section 5). Working signs: the child accepts contact, the adult feels warmth, ratings drop, and self-blame softens in the client's own words.

4.10 The six closing questions

• Purpose: close the adult–child encounter in a complete way, letting each side's needs and wishes be expressed. [source: Merkkarten Phase 3]
• Steps: ask each question in turn, letting one reaction and one counter-reaction follow each: (1) anything else to say or do to the child before ending; (2) whether the child needs anything from the adult; (3) whether the adult wishes for anything from the child; (4) whether the child wants to say or give the adult anything; (5) whether anything else should happen in the image; (6) which image they want to end with.
• Example language (illustrative): "Before we let this meeting end, does she need anything from you?" / "Is there an image you'd like to end on?"
• Watch for: closing images that are safe and connected (e.g. the child held, taken somewhere safe). If the closing image is bleak, keep the loop going rather than ending there [synthesis].

4.11 Ending the imagery

• Purpose: consolidate the closing image and return to the present safely. [source: Merkkarten Phase 3]
• Steps: let the image linger; invite the client to take it in and, if they want, to anchor it; let it fade; return to the room at their own pace; open eyes when it feels right.
• Example language (illustrative): "Stay with this picture a moment. Take it in. If you like, find a way to keep it, a word or a gesture. Now let it slowly fade, come back into the room at your own pace, and open your eyes when you're ready."
• Watch for: orientation after eyes open. If the client seems foggy, use brief grounding (naming objects in the room, feet on the floor, date) before debriefing [synthesis].

4.12 Debriefing (Nachbesprechung)

• Purpose: process the experience, check the alliance, make meaning and plan transfer to daily life. [source: Merkkarten debriefing card; Praxishandbuch extract p. 119]
• Steps (in this order): how it was for them (if "good", what was good); how they feel now; anything surprising or unexpected; other remarks, sensations, insights; how they experienced your accompaniment; what the experience means for them; what they learned and are taking away; what they can carry from the inner stage to the outer stage. If there was first positive contact with the inner child: what it would be like to have a lasting relationship with the inner child, and (if positive) how they could build one.
• Example language (illustrative): "How was that for you?" / "Was there anything about how I was with you that helped or got in the way?" / "What does it mean to you that you could protect her?"
• Watch for: the question about your accompaniment is a rupture check; take criticism seriously. Note new beliefs in the client's own words for follow-up.

4.13 Homework

• Purpose: carry the work between sessions. The manual includes a homework section (p. 123) and a homework protocol (p. 449). [source: Praxishandbuch extract] Their content is not drawn on. [uncertain] Whether the current version uses a session audio recording for home listening, as the early English version is widely described as doing, is not established. [uncertain]
• Steps [synthesis]: agree on one or two tasks arising from the debrief, for example a brief daily imagined contact with the inner child using the closing image; noting intrusions, nightmares and distress ratings; or, if session recordings are part of your practice and the client consents, listening to the rescripting part with a rating log. Review at the next session.
• Watch for: home practice that turns into unsupported re-exposure of the trauma part; advise against replaying Phase 1 alone if it raises distress [synthesis].

4.14 Aftercare and first follow-up session

• Purpose: the manual has a section on aftercare and the first follow-up session (p. 124); content is not drawn on. [source: Praxishandbuch extract; uncertain]
• Steps [synthesis]: offer a short contact option (scheduled call or message) within days after a first run. At the next session, review intrusions, nightmares, mood, homework and how the closing image held. Decide whether to re-run the same scene (if Phase 1 distress is still high), move to the next memory, or do a pure Phase 3 session.
• Example language (illustrative): "Since last time, how often has the memory come back on its own, and how did it feel when it did?"
• Watch for: delayed distress or new memories surfacing; treat these as material to plan with, not as evidence of hidden events.

4.15 Pure Phase 3 (inner-child encounter without a memory)

• Purpose: an imagined meeting between the adult and the inner child (or inner self) with no trauma scene and no other people. The developer also teaches Phase 3 as a stabilisation method and as inner-child work. [source: Merkkarten "reine Phase 3" card; Schmucker training schedule 2026]
• Steps: explain that this is a made-up encounter with oneself on the inner stage, not a memory, with only the adult and the inner child present. Ask the client to close their eyes, let a spontaneous image of the inner child or inner self appear, and say when it does. Ask where the child is, what it is doing, how it feels and how old it is; where the adult is in the image; what the adult wants to say or do. Then continue as in 4.9–4.12.
• Example language (illustrative): "This isn't a memory; it's an encounter we invent. Let an image of a younger you appear. Where is the child? How old? What is she doing?"
• Watch for: good for clients not yet ready for memory work, for self-criticism and depression, and for strengthening a soothing self-relationship. If trauma scenes intrude, return to the present and stabilise [synthesis].

4.16 IRRT for grief: encounter with the deceased

• Purpose: an imagined meeting with a deceased person to say, ask or do what was left open. [source: Merkkarten grief card; Schmucker training schedule 2026 (complicated or persistent grief)]
• Steps:
  1. Ask where an encounter with the deceased could best take place.
  2. Eyes closed, the client imagines meeting the person there and describes them.
  3. Start in the subjunctive: what would they say, ask or do; can they say it directly or imagine doing it; how would the deceased react if able.
  4. Once the process runs, switch to the indicative.
  5. Close with six questions parallel to Phase 3: anything else to say or do; does the deceased need anything; any wish to the deceased; does the deceased want to say or give anything; anything else that should happen; which closing image.
  6. End the imagery and debrief as in 4.11–4.12.
• Example language (illustrative): "Where would be the right place to meet him?" / "What would you want to say to him?" (then) "Say it to him now."
• Watch for: traumatic loss (violent death): the death scene may first need trauma-focused work [synthesis]. Respect religious and cultural views about contact with the dead [synthesis].

4.17 Building a lasting relationship with the inner child (inner to outer stage)

• Purpose: turn a first positive contact into an ongoing self-soothing relationship. [source: Merkkarten debriefing questions 9–10; training schedule "inner-child work"]
• Steps: after first positive contact, ask what a lasting relationship would be like and how the client could build it. Turn the answers into concrete daily practices chosen by the client (e.g. a brief check-in with the child at a set time; responding to self-critical moments with the adult's voice) [practices: synthesis].
• Example language (illustrative): "If you looked after her like that every day, what would that look like on an ordinary Tuesday?"
• Watch for: practices that stay abstract; ask for when, where and how often.

4.18 Documentation: therapist protocol and post-IRRT questionnaire

• Purpose: the manual provides a therapist protocol, a homework protocol and a post-IRRT questionnaire to document the run and the client's experience. [source: Praxishandbuch extract pp. 439–449] Items not reproduced here; obtain them from the manual. During the run, record the starting scene, hot spots, ratings, the client's rescript and closing image, and debrief answers [synthesis].

5. Handling problems

Items marked [source: Merkkarten] are the developer's published responses (paraphrased). Everything else is my synthesis from standard trauma-therapy practice and is marked as such. The manual has sections on complications and blockades in Phase 2 (p. 95) and Phase 3 (p. 104), on abort criteria (p. 84), and the developer's training covers "difficult" patients and suicidality and self-harm; their content is not drawn on. [uncertain]

Phase 2 blockades (with the perpetrator) [source: Merkkarten Phase 2]

• Perpetrator leaves too early: ask what the client wants to say or do before he goes.
• Adult feels too weak: remind them it is imagination, where anything is possible; ask what they would say or do if they had the strength and courage.
• Adult feels like the child: point out that the adult is there now; ask what they want to do, knowing that.
• Adult still afraid: remind them this is an inner image of the perpetrator on the inner stage; ask what they would say or do with courage.
• Adult can state the wish but not act: ask what the worst outcome would be; suggest trying it as an imaginal experiment.
• Still powerless: offer an object or weapon; then a helper figure (whom, doing what).
• Adult will not confront the mother out of guilt: remind them it is an internalised image of the mother, not the real person.
• Adult wants to kill the perpetrator: ask whether they can say this directly, what they want to say or do first, and whether they can imagine doing it. Afterwards, check for real-world anger and risk [synthesis].

Phase 3 blockades (with the child) [source: Merkkarten Phase 3]

• Adult is more than about 3 metres from the child: ask whether they can come closer.
• Adult resists approaching: suggest an experiment of moving halfway.
• Adult wants nothing to do with the child: ask why; then ask whether they can come close, look into the child's eyes and say it directly.
• Adult afraid to approach: ask how far away they are and why they are afraid.
• Adult afraid of being overwhelmed by the child's pain: ask them to say this directly to the child, face to face.
• Adult afraid the child will reject them: ask why, and whether they can say it directly.
• Adult feels hate or other strong negative feelings toward the child: ask why, whether they can say it directly, and what the worst outcome would be.
• Adult wants to hurt the child: ask why; then ask them to come close, look into the eyes and say it directly.
• Child rejects the adult or runs away: ask how this lands for the adult and where the child is now. The cue cards read this as a sign of a strong self-hatred schema. Expect several sessions, consider pure Phase 3 work and address self-hatred in the debrief [follow-up: synthesis].

Overwhelm and dissociation during the run [synthesis]

• Signs: distress pinned at 10 with no shift, panic, loss of verbal contact, staring, numbness, the client saying they are "not there" or watching from outside.
• Responses, stepwise: (1) keep talking, slower and warmer; ask for a rating and what is happening now. (2) If contact is still there, shorten the path to mastery: move directly to the hot spot and bring in the adult self (Phase 1b) rather than finishing a full Phase 1a. (3) If contact is lost: ask the client to open their eyes, orient (name the room, date, what they see), use feet on the floor, cold water or a held object, and come back to the work only if they are clearly present. (4) If the run is stopped, still close with a safe image and debrief. Plan the next session with more stabilisation, possibly pure Phase 3 first.
• Abort [synthesis]: stop and do not resume that session with persistent dissociation, emerging psychotic symptoms, a medical event, or emerging acute suicidality.

Avoidance and "stuck" runs [synthesis unless marked]

• Past-tense or observer narration: prompt present tense and first person; ask what they see through their own eyes. [present tense: source: Merkkarten introduction]
• Skipping the worst part: gently ask what happens just before and just after the gap. Accept the client's limit, but note it for planning.
• No images, only words: ask about senses one at a time (sound, smell, body position); allow a felt sense rather than a picture.
• Client asks you to rescue the child: IRRT keeps the action with the client's adult self. Ask what the adult would do if they could, and use the cue-card supports (4.7, Phase 2 blockades) before anything else. A non-developer case report describes the therapist nurturing the child when the adult could not; this departs from the IRRT stance. [source: Ali & Naz case study; uncertain]
• Same scene stays high across sessions: check for a different hot spot or an earlier or linked memory carrying the meaning; check for safety behaviours or ongoing threat in the client's present life.

Non-adherence to homework [synthesis]

• Explore the obstacle first (no private space, fear of the material, low mood). Shrink the task, move practice into session, or switch to a non-trauma task (inner-child check-in, intrusion log). A published case had the client do the homework in session for lack of private space at home. [source: Ali & Naz case study]

Ruptures [synthesis plus source]

• Use debrief question 5 (how they experienced your accompaniment) as a routine check. [source: Merkkarten debriefing]
• If the client felt pushed (for example by the no-break rule) or that you put words in their mouth, acknowledge it, own your part, agree together how to signal a pause next time, and go back to purely question-based guidance. [synthesis]

Safety and modality-specific risks [synthesis]

• Suicidality and self-harm: assess before every memory run with standard risk assessment; build a safety plan; do lethal-means counselling (safe storage and removal) when indicated. Postpone memory runs during acute risk and use stabilisation instead.
• Ongoing contact or danger from the perpetrator: imaginal confrontation does not replace real-world safety planning; address protection first. Remind the client that what the adult did on the inner stage is not a plan for real confrontation.
• Memory status: do not use IRRT, suggestion or imagery to search for or "recover" memories. Treat new details as the client's experience, not as proof. Do not imply that the rescript replaces the facts. Before legal proceedings, discuss possible effects on testimony and consider documenting the client's account first.
• Aggressive rescripts: violent imagery against the perpetrator is part of the published method. Debrief it as symbolic and check for any intent to act in reality.
• Grief variant: watch for spiritual or cultural objections and for a traumatic death scene needing trauma work first.
• Delayed reactions: warn that intrusions or dreams may increase briefly after a run, and give a contact plan (see 4.14).

Sources

Sources:

• Schmucker & Köster, Praxishandbuch IRRT: publisher extract (contents, prefaces, introduction)
• IRRT-Merkkarten A4, Version 1.7 (Köster, Schmucker & Heer, 2021)
• IRRT Ablaufsplan 2026 Teil 2: training schedule, trainer M. Schmucker (Rehaklinik Schwedenstein)
• Ehring, Herzog, Wittekind & Wolkenstein (2022). Imagery Rescripting in der Behandlung der PTBS. Verhaltenstherapie 32(3) (abstract and references only)
• Schaich & Fassbinder (2023). Imagery Rescripting. PSYCH up2date 17(3) (abstract and references only)
• Ali & Naz. An incest case study: suffering from PTSD (secondary case report)

Books and papers cited as further reading (not drawn on in full):

• Schmucker, M., & Köster, R. (2014; 3rd ed. 2017; later ed. 2021). Praxishandbuch IRRT: Imagery Rescripting & Reprocessing Therapy bei Traumafolgestörungen, Angst, Depression und Trauer. Stuttgart: Klett-Cotta (Leben Lernen 269).
• Smucker, M. R., Reschke, K., & Kögel, B. (2008). IRRT: Imagery Rescripting & Reprocessing Therapy. Ein Behandlungsmanual. [uncertain]
• Smucker, M. R., Dancu, C., Foa, E. B., & Niederee, J. L. (1995). Imagery rescripting: A new treatment for survivors of childhood sexual abuse suffering from posttraumatic stress. Journal of Cognitive Psychotherapy, 9(1), 3–17. [uncertain]
• Smucker, M. R., & Dancu, C. V. (1999). Cognitive-Behavioral Treatment for Adult Survivors of Childhood Trauma: Imagery Rescripting and Reprocessing. Northvale, NJ: Jason Aronson. [uncertain]
• Grunert, B. K., Weis, J. M., Smucker, M. R., & Christianson, H. F. (2007). Imagery rescripting and reprocessing therapy after failed prolonged exposure for post-traumatic stress disorder following industrial injury. Journal of Behavior Therapy and Experimental Psychiatry, 38(4). [uncertain]
• Holmes, E. A., Arntz, A., & Smucker, M. R. (2007). Imagery rescripting in cognitive behaviour therapy: Images, treatment techniques and outcomes. Journal of Behavior Therapy and Experimental Psychiatry, 38(4), 297–305. [abstract only]

Uncertainties: the manual's indication and contraindication criteria, abort criteria, homework protocol, aftercare guidance, the reconciliation element, and the English 1995/1999 procedure details (including any audio-recording homework) are [uncertain]. Guidance on these points is marked [uncertain] or [synthesis] above.