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AN OVERVIEW OF PSYCHO-IMAGINATION THERAPY:

JOSEPH SHORR:
THE PSYCHOLOGISTS IMAGINATION AND FANTASTIC WORLD OF IMAGERY:
FITHIAN PRESS: SANTA BARBARA: 1998

[In Raymond Corsini (Ed.), Innovative psychotherapy. New York: Wylie Interscience (1980).]
Psycho-Imagination Therapy is a phenomenological and dialogical process with major emphasis
on subjective meaning through the use of waking imagination and imagery. Emphasis on the
therapeutic interaction itself has to do with the question of one's identifying oneself and
separating one's own view of oneself from the attributed self as defined by the significant others
in one's childhood.
It was developed by Joseph E. Shorr in 1965 and is still growing at the present moment.
Theoretically it represents the interpersonal school of psychoanalysis stemming mainly from the
work of Harry Stack Sullivan.
HISTORY: Human beings have always been intrigued by their imaagination although it has
variously been granted prominence or relegated to insignificance. The concept of imagination
has served as an explanation of human behavior; as an agent of causality; as a source of physical,
emotional, and mental disease -- even death. (185)
In the history of psychotherapy, imagination has played many roles with diverse implications.
Eighteenth century thought ranged from ascribing the effects of Anton Mesmer's hypnotic
technique to imagination through Italian Muratori's concept of imagination being comprised of
dreams, visions, delusions, idees fixes, and somnambulisms.
During the nineteenth century, actions once attributed to imagination were deemed the products
of suggestions or auto suggestion. Sigmund Freud, however, as early as 1892 attempted a
"concentration technique" which utilized the patient's imagery.
I inform the patient that ... I shall apply pressure to his forehead, and I assure him that all the
time the pressure lasts, he will see before him a recollection in the form occurring to him, and I
pledge him to communicate this picture or ideal to me, whatever it may be ... Having said this, I
then leave go and ask quietly, as though there were no question of a disappointment: "What did
you see?" or "What occurred to you?"
This procedure has taught me much and has also invariably achieved its aim. Today I can no
longer do without it. (Breuer and Freud, 1953)
My expectations were fulfilled; I was set free from hypnotism ... Hypnosis had screened from
view an interplay of force which now came in sight and the understanding of which gave a solid
formation to my theory. (Freud, 1959)
Despite much enthusiasm, Freud later abandoned the concentration technique for free
association. Jerome L.
Singer (1971) suggests: Freud may have erred in not insisting on imagery alone rather than
allowing patients to shift to free verbal association. He might have gotten more powerful
uncovering more rapidly from his earlier technique. Undoubtedly (186) individual practitioners
have sensed the importance of fostering greater emphasis on concrete imagery by patients and
have found themselves impatient with the apparent glibness of defensiveness that often
characterizes verbal free association.
One can only imagine what enormous changes would have occurred in the field of
psychotherapy if Freud had proceeded with "free imagery." True, Carl Jung's concept of "active
imagination" had an important influence on European intellectual thought.
The twentieth century saw a resurgence of interest in imagery in Europe. Carl Jung and Sandor
Ferenczi redefined and revitalized imagination and imagery. But in America the use of
imagination and imagery as psychotherapeutic tools followed a difficult path. Although E. B.
Titchener worked with problems related to imagination and introspection, J. B. Watson,
America's first star of behaviorism, turned the mainstream of psychological investigation away
from a concern with man's inner images -- his daydreams, dreams, and fanciful ruminations --
toward concepts of conditioning. The psychoanalysts of the period still viewed fantasies and
dreams as relevant areas of analytic investigation, but the free use of imagination was not
encouraged since, to many, it reeked of resistance.
Freud believed fantasy and imagination were essentially limited to the person's defenses. Anna
Freud (1946) also considered fantasy a defense mechanism. The adaptive function of
imagination was largely ignored except for Heinz Hartman in 1958. Neither Hartman's work nor
an earllier emphasis by Erich Fromm (1955) were given much attention. Fromm voiced a plea
for moving beyond the conventional free association procedure into therapist-initiated situations.
He advised analysts to make fullest use of their own imagination and to suggest active imagery
methods to improve the flow of the patient's free associations.
Alberta Szalita (1968), too, suggested a "daring" needed to reach a patient and elicit a response.
I don't see any discrepancy in this kind of activity on the part of the analyst with the
psychoanalytical tenets. It does not differ (187) from the analysis of a dream. Perhaps that is why
dream analysis is so useful in that it gives a legitimate opportunity for the analyst to use his
imagination.
By and large, American psychologists have tended to regard reverie and imagination as
unproductive, impractical, and completely unempirical.
The return of the image in American psychology has, oddly enough, been given impetus by the
same theoretical framework which delayed its emergence -- behaviorism. The behaviorists'
emphasis on visual imagery during systematic desensitization is such an example. T. G. Stampfl
(1967) uses powerful negative imagery in Implosive Therapy. Although the behaviorists have
helped reintroduce imagery in therapy, they do not show a keen interest in the patient's inner
experiences or fantasies, and they generally leave unconscious processes uninvestigated.
The Gestalt therapists use imagination in conjunction with dreams, but have limited the
possibility of the interpretive value of images and have shown disinterest in the imagination as it
relates to past experience. Those doing Psychodrama -- especially in the role-reversal technique
use imagination, but the systematic emphasis on imagery is lacking.
European psychotherapists draw heavily from the work of Robert Desoille, Hanscarl Leuner,
Carl Happich, Roberto Assagioli, Andre Virel, Gaston Bachelard, et al -- investigators who share
an interest in using imagery and imagination in the psychotherapeutic experience.
Desoille's name stands above all others in the psychotherapeutic use of imagery. His pioneering
work was influenced by E. Caslant (1927). From Caslant's original notion, Desoille (1965)
developed the reve evielle, Guided Affective Imagery Technique. This served as a point of
reference for nearly all psychotherapeutic developments employing imagery as a prime modality.
This method limits formal analysis of the imagery, suggesting, rather, that many problems can
indeed be worked through by means of the symbolic combat, amelioration, or transformation
which takes place in imagery.
The philosophical roots of psychoanalysis are uniquely (188) Freud's -- the concept of psychic
determinism and the matrix of the triplicity of the Ego, Id and Superego. Jung, too, provided his
own philosophical base -- the collective unconscious. A comparable philosophical base
emphasizing imagination and imagery was offered by a nonpist, the phenomenologist, Gaston
Bachelard. Over forty years ago he began an intensive study of man's imagination and his
symbolism. At the Sorbonne he explored Desoille's work as it related to general psychology and
psychotherapy (1943). He broke with the more traditional psychological method of introspection
by calling attention to man's innate capacity for generating imagery and symbolism.
In conjunction with the increased awareness of imagination and imagery, the last decade has
seen a growing emphasis on phenomenology -- the study of how a person sees his world. Shorr
believes that phenomenology requires of a person that he use his imagination as a vehicle by
which to ready himself for all that he uniquely perceives, anticipates, defends and acts upon. The
person imagines how things will be, thereby preparing for whatever action may result. The
integration of phenomenology with the concept and use of imagination is a palpable necessity.
Our world of images reflects and represents our being-in-the-world, and we can only understand
man as an individual, and as a part of mankind, when we grasp the imagery of his experience.
The work of R. D. Laing (1960, 1962) helped to formalize and concretize the phenomenology of
self-other concepts originally developed by H. S. Sullivan. By integrating this stream of thought
with the European studies of imagery through a natural bridge -- psychotherapeutic imagery
productions -- Shorr has organized a systematic and comprehensive theoretical framework to
provide a viable and innovative psychotherapy.
Imagination and fantasy are now recognized as indispensable resources in human life. Full
accessibility to their own private imagery are the hallmarks of creative persons (Dellas and
Gaier, 1970). Vivid imagery does not obfuscate the accurate viewing of the real world (Sheehan,
1966). Jerome L. Singer (1966) has shown that the better able one is to make images, the better
one is capable of fun, the better able to discriminate between fantasy and reality, and to be less
disconcerted by unexpected thoughts and images. (189)
Shorr finds that the intensive use of imagery in psychootherapy heightens therapist motivation
and involvement because of the interesting and dramatic nature of the material that is elicited.
The probability is high that the vividness and intensity of the patient's imagery productions serve
as a catalyst to his or her own therapeutic motivations.
CURRENT STATUS: The Institute for Psycho-Imagination Therapy (IPIT) was founded in Los
Angeles in 1972 by Joseph E. Shorr, a clinical psychologist. Shorr had already spent close to ten
years developing the theory and methodology of Psycho-Imagination Therapy. Some of the basic
work and theoretical structure was presented originally in several journal articles.
Shorr's first book, Psycho-Imagination Therapy, was published in 1972. His second book,
Psychotherapy Through Imagery (1974), contained new material developed during clinical and
research work with Psycho-Imagination Therapy. His third book, Go See The Movie In Your
Head (1977), added material relating-to-self-image imagery. ----
Since its inception the Institute has constantly expanded its field of influence. Seminars are held
several times a year at the University of California at Los Angeles, Immaculate Heart College,
California School of Professional Psychology, and the University of Southern California. The
Institute offers ten- and twenty-week training sessions for professionals in the theory and
methodology of Psycho-Imagination Therapy. In addition, Dr. Shorr has given workshops at
International Mental Imagery Congresses in France, Sweden, Germany and Japan.
The Shorr Clinic was opened in 1976 to provide affordable therapy to a broad segment of
the population. The staff members of the clinic have all had a minimum of four years
training in Psycho-Imagination Therapy.
In 1974 the Institute published the Shorr Imagery Test (SIT). This projective test using
imagery yields both a quantitative conflict score and a qualitative personality (190)
analysis. The SIT is individually administered and has been used in numerous
educational institutions and hospitals throughout the united States.Y It is also used in
several branches of the Veterans Administration and at the Great Lakes Naval Station.
In 1977 the Group Shorr Imagery Test (GSIT) was published. The GSIT makes it
possible to administer the SIT to any number of persons simultaneously.
The Supplementary Shorr Imagery Test (SSIT) (1978) is also a projective test using
imagery and provides both a quantitative conflict score and an in-depth qualitative
personality analysis. It can be used independently or as an adjunct to the SIT to yield
additional information.
The Shorr Parental Imagery Test (SPIT) (1979) focuses on conflicts between parents and
children and is a powerful instrument for diagnosis and treatment in counseling.
Currently under construction is the Shorr Couples Imagery Test (SCIT), a useful tool in
uncovering and exploring the dynamics between spouses or partners.
Current research projects have been done with the various Shorr Imagery Tests in
research projects. Dr. David Tansey (1979) found some confirmation for the thesis that
there is a "criminal personality" and is researching the ability of the SIT to predict
recidivism among felons convicted of violent crimes at Chino State Prison for Men.
Dr. Jack A. Cannella (1978) used Psycho-Imagination Therapy with groups of chronic
benign intractable pain patents at the City of Hope Hospital, Duarte, California. He used
the SIT pre- and post-therapy to evaluate the efficacy of the imagery treatment. Due to
Cannella's findings, the City of Hope Hospital regularly incorporates Psycho-Imagination
Therapy procedures into its treatments and uses the SIT for patient evaluation.
Pennee Robin, MFCC, used the SIT to do in-depth personalty analyses of persons
interviewed for the book Sexual Jealousy (in press), written with Shorr.
Gail Sobel (1979) employed the GSIT as a tool in a test-retest situation to measure the
degree of conflictual level reduction as a result of participating in a course entitled
"Group Dynamics." (191)
Dr. Clifford Morgan (1979), of the University of New Mexico, has adapted the SIT for
use with disabled persons and with the personnel who treat and/or deal with the disabled.
In 1976 the Institute was the initiating force in founding the American Association for the
Study of Mental Imagery, which held its first annual conference in Los Angeles in 1979.
THEORY: Psycho-Imagination Therapy is a phenomenological and dialogical process
with major emphasis on subjective meaning through the modality of waking imagery and
imagination.
The basic phenomenological proposition of Psycho-Imagination Therapy recognizes the
individual's need to become aware of how he defines himself in relation to others, and
how he feels others define him, e.g.:
How I see myself How I see you
How I see you seeing me How you see me seeing you
This phenomenological "in-viewing" is a synthesis of the self-other personality
development theories of R. D. Laing and Harry Stack Sullivan. Sullivan believed that
personality consists of the characteristic ways in which a person deals with others in his
interpersonal relationships. In order to abolish anxiety -- which is always the direct result
of interpersonal interactions -- a person must develop security operations. When those
security operations are maladaptive they produce the wide variety of interpersonal warps,
emotional discomforts, and behavioral maladjustments which constitute psychiatric
symptoms and psychiatric illnesses (1953).
R. D. Laing sees the basis of human conflict in the disparity between how a person
imagines himself to be and how he is told to be by significant others. One is in the first
instance the person (192) that other people say one is. As one grows older, one either
endorses or tries to discard the ways in which others have defined one. One can decide to
be what it has been said one is. One may try not to be what, nevertheless, one has
practically inevitably come to assume one is, in one's heart of hearts. Or one may try to
tear out from oneself this "alien" identity that one has been endowed with or condemned
to, and create by one's own actions an identity for oneself, which forces others to
confirm. Whatever its particular subsequent vicissitudes, however, one's identity is in the
first instance conferred on one. We discover who we already are. (1962)
The two basic premises of Psycho-Imagination Therapy are: (1) everyone needs to make
a difference to someone, and (2) everyone seeks confirmation of acknowledgment
himself. These needs occur contemporaneously. When are not fulfilled, the child
develops false position a person is not confirmed for his true self, then develops strategies
to secure confirmation for a false self. The security operations he involves himself in
service maintain his identity even in the absence of true judgement.
Shorr's major emphasis in the therapeutic in is on separating one's own view of oneself
from th buted self as defined by the significant others in childhood. Ideally, the "true"
identity is helped emerge while the "alien" identity is eliminated.
The interpersonal and intrapersonal interactions, well as the individual's strategies within
the self-other relationships, are best seen through the systematic use of waking imagery.
A person's imagery can show how he organizes his world, his style of action, and the
marked individual differences to which the therapist should be attuned. Imagery provides
a primary avenue through which thou wishes, expectations, and feelings can be most
effect reactivated and re-experienced.
Imagery, unlike other modes of communication, usua11y has not been punished in the
past and is, therefore, 10 susceptible to personal censorship in the present. Thus (193)
imagery provides a powerful projective technique resulting in a rapid, highly accurate
profile of the individual's personality and conflicts.
Imagination is viewed as the central kernel of consciousness and an important means of
access to the uniqueness of the individual's world. The active introduction and conscious
use of imaginary situations is used as a simulating investigative tool, an avenue to action
possibilities. It allows the patient to explore more safely and openly, to differentiate, to
experiment with and to integrate fantasy and reality, all within the context of a
cooperative therapeutic alliance and encounter.
The theoretical purpose of using imaginary situations is based not only on seeing how the
patient views his world, but also in being able to open up the "closed system of internal
reality" (Fairbairn in Guntrip, 1964). Shorr contends that the better able the patient and
the therapist are to see this "tight little inner world," the easier it will be to deal with the
whole of the patient and his world.
Psycho-Imagination Therapy puts the individual, through his own imagery, into a
particular situation which can evoke a set of interactions that are useful in revealing
major problems in the significant areas of his life, and which also permit him to relive
experiences. J. L. Singer (1974) writes: "Shorr uses an almost infinite varriety of images
geared very much to the specific characteristics of the patient and to specific
developments in therapy. "
S.K. Escalona (1973) suggests that mental imagery offers an opportunity to study the
integration of perception, motivation, subjective meaning and realistic abstract thought.
Shorr emphasizes subjective meaning by recognizing that the patient's images are
uniquely his, coming from his own storehouse of knowledge and experience. In the
process of describing his image, the imager begins to relate it to something of meaning in
his life. Hidden meanings of the events, attitudes, feelings, and motivations attached to
the image are then used to explore further the interpersonal implications.
Shorr has systematically categorized over two thousand Imaginary Situations (IS) which
have proved in the clinical (194) setting to reveal specific information about the patient's
personality, world view, self definition, areas of conflict, and style of defenses. Other
categories are specifically for focusing on change and for facilitating the process.
Furthermore, responses to the categorized imagery usually elicit hidden or repressed
material more efficiently than direct questioning by the therapist. In addition, the imagery
bypasses the conscious censor and is less liable to denial by the imager than imprecise
verbal statements.
The major categories of imagery that are systematically used, with examples, follow:
SPONTANEOUS IMAGERY: These images are generated by suggesting that the
patient report the flow of imagery as it occurs, or report the next five consecutive images
that occur, then another five, etc. In either sequence, certain images usually become
affect laden and then serve as the vehicle for dialogue or release of feeling.
DIRECTED IMAGERY: At times the spontaneous flow of images seems to go on
endlessly without theme or apparent coherency. The intervention of directed imagery can
be used to capture the flow and bring coherency and integratttion to the production.
Shorr's experience validates those of Horowitz and Becker (1971), who say that the
specificity of instructions for reporting visual images increases the tendency to form, as
well as to report, images.
The therapist is urged to allow the flow of imagery to go as far as the patient will allow it
before offering the new Imaginary Situations. Dialogue should be engaged in when the
flow appears to stop. Certainly, intrusive images that the patient presents should also be
examined for meaning and release of feelings.
The incidental remarks the patient makes while imagining are not to be ignored. For
example, there are persons who are competitively motivated to offer only seemingly
creative sounding imagery. Such persons may say they are offering boring imagery, and
they must be reassured to report all and be told, too, that no imagery is insignificant -- all
have potential meaning.
SELF-IMAGERY: set of attitudes about ourselves and by which we define ourselves.
This system is inextricably bound to our perception of how others see us.
Imaginary Situations which help reveal this self system include: Each of us has a self
system a (195) set of attitudes about ourselves and by which we define ourselves. This
system is inextricably
bound in our perception of how others see us.
Imaginary situations which help reveal this self system include:
(IS) Imagine there are two of you. Imagine kissing yourself (sitting on your own lap,
looking at yourself through a keyhole) .
(IS) Imagine you are in a boat in the middle of the ocean; another you is in the water.
What do you do?
DUAL IMAGERY: Inner conflicts are caused by the opposition of two strong and
incompatible forces, neither of which can be satisfied without exacting pain, fear, guilt,
or some other emotional penalty.
A remarkable phenomenon occurs when a person is asked to imagine two different
animals, dolls, forces, impulses, etc. In the majority of reported imageries there is some
degree of polarization. The contrast becomes more evident when the imager is asked to
assign an adjective to each of the two images. The opposition is further enhanced when
the patient imagines statements and replies from the two images. The degree of conflict
and subsequent feelings are often revealed.
These Dual Images frequently represent two parts of the self in conflict -- self vs. self, or
conflict between self and another. The dialogue which is a natural outgrowth of this
imagery helps the patient become aware of the conflicts and its meaning.
BODY IMAGERY: Empirical evidence indicates that people can sense the body part
core of their identity. They can also identify in which part of the body their anger (fear,
guilt, joy) resides. These images provide clues to self-image, body image, and areas of
conflict. Furthermore, introjection of parental figures is evidenced when persons are
asked to imagine in what part of their body their parents reside. If, in the developmental
(196) process, a person has been falsely defined, the false definition may take on a body
locus. The mother or father who "resides" in a part of the patient's body (chest, heart,
guts, limbs) and appears hostile, is, in reality, the false identity or the neurotic conflict
internalized. When the patient "exorcizes" the bad parental figure, the way is open to a
healthier, more independent identity.
SEXUAL IMAGERY: Clinical experience reveals that people who say they do not have
images will respond when asked to imagine or recall sexual scenes. Sexual themes are
among the most powerful and most frequently occurring images. Many are related to the
strategies of interaction between the sexes that anticipate acceptance or rejection.
Imaginary situations which are most productive in revealing attitudes and feelings
about sex include:
(IS) Imagine walking into the middle of a room. There is a hole in the floor. Look
through the hole and tell what you see. Then imagine going down into the hole and tell
what you do and what you feel.
(IS) Imagine an animal that comes out of a penis and an animal that comes out of a
vagina.
PARENTAL IMAGERY: Parental Imagery is a highly specialized category of imagery
rebating to the interactions of parents and children, or individuals and/or significant
others. Examples are:
(IS) Whisper into your mother's (father's) ear. Have her (him) whisper something back to
you.
(IS) Imagine taking a shower with your mother (father). What do you see, feel and do?
(197)
DEPTH IMAGERY: Images that reveal depth or unconscious forces that almost always
elicit profound reactions. These highly emotionally charged situations should be
employed with caution and with the therapist's awareness of what the patient is ready to
face.
Examples are:
(IS) Imagine you are a child and you are crying. Now imagine your mother (father)
licking away your tears.
(IS) Your parents see you lying dead on a bed. What do you see, feel and do? ~fuat do
they see, feel and do?
UNCONSCIOUS IMAGERY: Although this material can emerge in any Imaginary
Situation, those categorized as Unconscious Imagery achieve their purpose more readily.
Among the most powerful are:
(IS) Imagine a sealed can underwater.
What do you see in the can? What do you do with it? How do you feel about the can and
its contents?
(IS) Imagine reaching into a cave three times, each time reaching deeper than the last.
What do you do, see and feel?
TASK IMAGERY: Task Imagery may reveal the patient's internal conflicts, his style
and manner of approach, his defenses and fears; it also serves as a vehicle for focusing
for, a changed self-concept in the "working through" of the imaginary task.
An important ingredient following the initial flow of imagery is to redo or re-experience
the imagery in a manner that leads to a healthy conflict resolution. But the patient must
be ready to focus for change. The elements determining this readiness are the patient's
awareness of his internal conflicts, the release of feeling connected with contributory
traumatic incidents, cognizance of the
(198)undermining strategies of behavior of significant others, and recognition of his own
counter-reaction strategies.
Examples of Task Imagery include:
(IS) Imagine climbing 1,000 steps to the top.
(IS) Imagine building a bridge across a gorge.
(IS) You are in a tank of the foulest liquid. How does it feel? Imagine getting out of it.
CATHARTIC IMAGERY: Imaginary Situations in which the patient is asked to
imagine the "bad" parent in front of him and openly define himself in a positive manner
can substitute for actual face-to-face confrontations. Obviously this kind of focusing
procedure requires a supportive therapist aligned on the side of the patient and, equally
important, a readiness on the part of the patient to liberate himself from a false identity.
In addition to the Finish-the-Sentence approaches such as: I am not ; I am
; Never refer to me as ; etc., the therapist can suggest:
(IS) Imagine your father (mother) accusing you and then reverse the process by accusing
the accuser to the point of rightfully asserting your true position.
GENERAL IMAGERY: These images cannot be classified as specifically Dual
Imagery, Task Imagery, etc., yet they plumb a vast area of the imagination and often lead
to meaningful dialogue and awareness. They are often the stimulus for focusing and
change. Examples include: (199)
(IS) Imagine an image of a molecule of you (your conscience, Paradise). What do you do
and see and feel?
(IS) Stare into a fire. What do you do and see and feel?
SPECIAL IMAGERY: These images defy ordinary categorization. They have proved to
reveal enormous amounts of information about the patient. Among them are:
(IS) Imagine three boxes, large, medium and small. Imagine something inside each box.
Clinical experience indicates that the three boxes represent the patient's outer conception
of himself (the style with which he deals with the world); the patient's defenses or coping
mechanisms; and the core, or central aspect of himself.
(IS) Imagine three doors (left, center and right). Open each door. What do you see, do
and feel?
This imagery reveals material relating to the patient's concepts and dynamics about
sexual matters or about relationships with the opposite sex; his core conflicts; and the
possible resolution of those conflicts.
PREDICTING IMAGERY: When two persons, intimately involved, are asked to
predict each other's imagery, surprising results may occur. Married couples are asked to
write down five consecutive images. Then each is asked to predict the imagery of the
other. The resulting dialogue following the revelation of the images is often of
therapeutic value. It may heighten the degree of awareness of each for the other.
Increased communication invariably results as the partners see the other's way of viewing
the world. Even those who are poor at predicting the other's (200) imagery now have a
chance for enhanced awareness of the other.
GROUP THERAPY IMAGERY: Psycho-Imagination group therapy emphasizes the
patients' self definitions and the degree to which their self concept permits or constricts
behavior vis-a-vis the other group members. Group interaction crystalizes each member's
awareness of how others in the group define him. In addition, the group becomes an
arena for reenactment of old family interactions which molded the patient's false
positions and negative self images.
The overall purpose of interaction within the group is to help each patient become aware
of his conflicts and then take the risks inherent in focusing for change. While nearly all of
the imagery approaches suggested for individual therapy can be utilized in group therapy,
several facctors must be considered.
First, groups involve interaction between men and women. Some patients find it
considerably easier to express feelings and imagery to members of the same sex.
Difficulties in revealing such material to members of the opposite sex is especially
prevalent among persons with problems relating to exposure of sexual inadequacy.
Overrcoming this kind of reluctance; permitting oneself the free flow of imagery and
emotional expression without the feeling that one is weird, is a barometer of the patient's
growth.
Second, the factors of peer competition and belonging, while not always evident in one-
to-one therapy, may surface in group contact. Disclosing such feelings and coping with
them are part of the group process. Also, basic trust of authority figures and basic trust of
one's peers are areas which may be subjected to considerable emotion and conflict within
the group setting.
By example, by identification, by stimulating one another, by giving increasingly free
play to their fantasias, dreams, imagination and unconscious production, co-patients often
afford the conflicted group member a chance to develop and nurture the courage for new
alternatives. (201)
The use of imagery in group therapy may take the following directions:
1. Imagery subjectively experienced within the person.
2. All the persons in the group engaging in imagery about a single member.
3. That member's reactions and imagery in response to the others' imagery.
4. One person engaging in imagery about every other person in rotation.
5. All of the other people, then, engaging in imagery about that one person in return-
reaction imagery.
6. All of the persons engaging in imagery about the therapist at various points in his past
(present, future) life.
7. The therapist engaging in imagery about each of the group members at various points in
their past (present, future) life.
8. All of the persons interacting in imagery without any directed consecutiveness, but yet
having its own internal consistency in the sequences of reactions, depending upon the
particular group.
Group sessions are not so structured that only imagery is involved. Anything may be
brought up at any time a particularly traumatic situation or decision; carry-over reactions
from previous sessions; thoughts and feelings people have about others in the days
between group meetings. Awareness and feelings patients have gleaned from individual
sessions may be brought up in group situations. Nothing, certainly, should deter
spontaneous behavior unless that behavior is used as a cover-up for some difficult
internal conflict. A fine goal for any group therapist is to keep the structure and the
spontaneity of the group unfettered. (202)
METHODOLOGY:
Psycho-Imagination Therapy uses four techniques, namely:
(1) Imaginary Situation (IS);
(2) Finish-the-Sentence (FTS);
(3) Self and Other Question (S&O); and
(4) Most or Least Question (MIL).
The infinitely varied waking imagery elicited th the Imaginary Situation is the essence of
the phenomenological method. This method involves asking the patient relax, close his
eyes, and trust his images. The th then suggests the appropriate Imaginary Situation to the
desired material. The patient's responses are tl sis of the dialogical aspects of the
therapeutic pro These responses suggest what he is opening for exam n what he is willing
to face, where he is going, wha h ready for, what he appears to deny.
It is not wise to push the patient to image are forthcoming after a long interval. One may
prefer go either to other Imaginary Situations or perhaps current concerns. The patient
must be assured that material is always available to him for awareness and meaning
whether or not he is involved in imagery.
The patient's responses to certain structured situations often accurately bring into the
"here and now of feeling that have their roots in the past. Therapist then stresses the
situation and interpersona1 actions with the patient and encourages him in his of action
within the situation. This ultimately helps him in greater choice of action in his external
reality.
Clinical experience demonstrates that the Fin' "h-t Ill' Sentence technique can uncover the
more complex emotional blockages. However, its effectiveness depends on being woven
into the fabric of the therapeutic dialogue a appropriate moment. For example:
A young man, asked for the body part core of h identity, replied, "My hands ... I am only
what I'm din, ... If I am not doing anything, then I have no identity."
The therapist can follow through by asking him to (203) finish a sentence such as:
(FTS) But for my father (mother) I would have been
(FTS) My identity will suffer if I go towards
(FTS) I feel most hostility towards
Both therapist and patient may be surprised by the response to the question, "I deprive
my wife (husband, father, mother, boss, or other significant person) of the satisfaction of
of ." A variant of the latter refers to any other two significant persons in his life:
"My father deprives my mother of the satisfaction of
Patients who are amnesic about their childhood and who may have difficulty with an
imaginative situation often respond well when asked to supply ten different endings to
the sentence: "I strongly resent ." After the patient selects the item he feels
most strongly about, the therapist can use dialogue to stimulate awareness.
An important way to elicit the patient's conflict areas is by the use of existential
questions, or Self-other questions. An existential question elicits how a person views
himself, and how he feels others define him. It is an effective tool when used in
conjunction with the imaginary situation.
The manner of presenting these questions is of the utmost importance. The timing is
critical and under no circumstances should they be asked routinely or as a series of test
items. This weakens the desired therapeutic effect. Nor should they be posed with
predetermined answers in mind. Do not try to fit the patient in advance into any dogmatic
theory or system of thought.
For example, with one patient it may be appropriate to ask: "How do you make yourself
aware to others when in (294) group therapy?" His answer will probably reveal his inner
consistency in functioning with others in a way that is unique within his self-system. If
the therapist is following a preconceived theory, he may unwittingly try for a "desired"
response and miss the way the patient really sees himself in relation to others.
Furthermore, judgement must be used to decide whether the patient has the ego strength
to handle certain questions at a particular time. There is no substitute for the skill that
comes from experience. In sessions where the patient requires much therapeutic support,
they may have to be eschewed completely.
Following are some examples of Self-and-Other questions:
(S&O) To whom are you accounting?
(S&O) Never refer to me as ?
(S&O) Did (do) you make a difference to anyone?
(S&O) Did (does) anyone acknowledge your existence?
(S&O) How do (did) you make people aware of you?
(S&O) Were (are) you ever believed?
(S&O) What qualities did your parents deny in you?
(S&O) How would you drive somebody out of their
mind?
The Most-or-Least question sharpens awareness of a person's self-image and the concept
of his basic attitudes and values. Typical of this category is, "What is the most immoral
thing you can think of?" Or, "What is the most exciting part of your body?"
Often a person will assume a false identity ascribed (205) to him through the unconscious
strategy of his parents.
This can lead in two directions. The first is what Karen Horney (1945) refers to as "the
idealized image" in which the person is constantly trying to live up to his image and
needs the world to concur with it. The other direction is when a parent, or significant
other, confers a despised image. The person may continuously strive unconsciously to
throw off this false self and live up to his true potential.
To assist the patient to become aware of his own despised image or the rigid need to
sustain the idealized image, and to try to change it, the following questions are helpful:
(M/L) What is the biggest lie you have ever told?
(M/L) What was the most unfair demand put on you?
(M/L) What was the most often repeated statement made to you by your mother (father)?
If the answer to the latter question has been a continual harping on the child's
shortcomings, this will become the despised image which may haunt him as intolerable
all his life.
The Most-or-Least question is an excellent tool to reveal a person's guilt. Inevitably
either of the aspects of false identity is locked into guilt. If someone identifies with the
despised false image, then he feels guilty; if someone falls short of the idealized image,
the guilt will be compounded.
Questions such as, (M/L) "What did your mother (father) despise in you the most?" and
(M!L) "What is the most distasteful thing about you?" are guides to the dimennsions of a
patient's guilt. Also important in this context are: (M/L) "What is the most shameful day
of your life?" or (M!L) What is the most humiliating thing that ever happened to you?" In
a sexual connotation an effective question is, (M/L) "In whose presence would it be most
(least) difficult to have sexual thoughts?" (206)
These four techniques enhance each other as they are combined and interwoven. Singly
they can be valuable, but in combination the whole can be much greater than each of its
parts. The integration of all the specific approaches within the framework of the
individual's phenomenology, so that he can achieve greater awareness of himself, opens
the door to possible ways of change. Here, for example, are some possible ways that each
of the four techniques can be utilized to make the patient aware of a single feeling
reaction:
(FTS) Never call me .
(S&O) What image of yourself can you not allow?
(IS) Picture yourself on a blank screen in a position in which you detest yourself.
(IS) You are walking down a street and a person your own age accuses you of something.
What does he accuse you of, and why?
(M/L) What is the most detestable thing anyone can say about you?
As the patient becomes accustomed to this kind of therapy, it is less and less necessary to
make interpretations for him. With specific cross-checking of the four modalities it is
possible to help focus the patient to greater awareness where he is forced to face the truth
for himself.
APPLICATIONS: Psycho-Imagination Therapy is applicable to a wide range of
problems and situations. It has been used successfully to treat neuroses, emotional
maladjustment, marriage
(207) and family problems, sexual dysfunction, psychosomatic problems, extreme jealousy,
anxiety, and maladaptive behavior patterns.
Psycho-Imagination Therapy techniques have been useful in breaking impasse situations
that arise in conventional therapy. A verbatim transcript of a patient/therapist interview
concerning an impasse situation is included in Shorr (1972).
Clinical experience has shown that obsessive/compulsive patients are helped to cut down
on meanderings and repetitious verbalizations when they are attending to their imagery
productions. The imagery helps to focus attention on the root causes of the obsessive
behavior and to aid in opening up new avenues to behavioral change.
Anxiety, depression, and other neuroses respond favorably to imagery techniques. In
addition, the imagery productions accurately reflect the degree of conflict revolution and
the changes made in therapy. For example, the imagery productions of depressive
patients become more posiitive, e.g., bare trees begin to show leaves, and scenes are more
light and pleasant. Shorr reports that psycho-dramatic confrontation through imagery
often leads to conflict revolution and the lifting of anxiety.
Imagery, especially Dual Imagery, when used in conjunction with psychodrama, has been
of catalytic value and has had a highly therapeutic effect on institutional psychotic
patients.
One of the most dramatic applications of Psycho-Imagination Therapy is in group
therapy, where the interactions of the members through the modality of imagery can be
highly therapeutic.

Sihce sexual conflicts deal with the most vulnerable, the most tender, the most shame-
inducing, and the most guilty feelings, they are the most difficult to disclose to oneself
and to others. The use of imagery bypasses the censorship and offers a vehicle for
dialogue and possible conflict resolution.
The Shorr Imagery rest (1974), Group Shorr Imagery Test (1977), Supplementary Shorr
Imagery Test (1978), Shorr Parent Imagery Test (1979), and the Shorr Couples Imagery
(208) Test (in press), which have been developed and utilized primarily for diagnostic
purposes, are the direct outgrowth of the theoretical structure of Psycho-Imagination
Therapy. Shorr emphasizes the ability of the tests to verify the concepts of Psycho-
Imagination Therapy. Few systems of psychotherapy can utilize a test that appears as a
verification of their system.
CASE EXAMPLE:
The following is a report of a patient, Jim, in group therapy:
JIM: I don't really remember too well, what actually happened. I know that I had been
suffering from extreme stomach pains for two days. Everything had been going
extremely well in school for three weeks. Karen and I had just had the best two weeks of
our relationship. For the first time in my life I felt productive, social, myself, and in love
with Karen at the same time. My fantasy of a "sunshiny winter afternoon" was going very
well, except for some unnknown reason, my neck and shoulders were tightening up
harder than steel -- more than I had ever known.
Back to the stomach pain. At first I thought I had the flu. But I had extreme pains that
were very high in my stomach. At the same time, I felt like vomiting, but I couldn't. I
even stuck my finger down my throat and I couldn't, I wouldn't vomit.
Tuesday morning, I went to work. I talked to Helen (our friend) before I left and she said
it sounded like I had an ulcer. Right then I got extremely depressed, angry, tearful and
alone. I went home and I was really angry. I felt shitty (guilty) for having an ulcer. I felt
shitty that I was still so uptight and fighting and unproductive as to have an ulcer. I was
also really mad and untruthful of group and my last two years in it. I went back and forth,
from guilt to anger. (209)
JIM: Then I called Bill (group member). The one thing I remember from the conversation
was him saying, "I care that you are in such pain," and, "I really like being around you
and Karen when you're happy." When I got off the phone I was wide open. I cried by
myyself and for myself without hesitation. For the first time, I let my guts hurt and I cried
without any thoughts or judgements. I then felt like I wanted to cry "Mommy." I wanted
someone to love me and take care of me. I wanted a mother. But I knew I didn't want my
mother. And it made me angry to realize I never had a mother.
When Karen came home, I was very aware of not wanting to show her my feelings. But I
had called and asked her to come home. That was pretty hard to. ask for. If I ever let it
out to my mother, she used it for false motherings, and to shrink my cock and consume
my balls. By the time I got to group, my stomach was really hurting and I explained that
everything was good but I was dying of pain.
SHORR: What part of you hurts?
JIM: (When Dr. Shorr asked that, all I could do was cry. He asked me several times and it
seemed impossible. It seemed it would be giving the vulnerable and dearest part of me
away.)
GWEN: (Group member) No wonder it hurts so much. It always hurt you and you were
always alone with it.
JIM: My stomach. Right in the middle of my guts.
SHORR: Can you had that part to someone?
JIM: What bothers me is that I never got anything with my pain, and I'm not now.
JOHN: (Group member) You must have gotten something.
Yes, I got to stay home. I didn't have to go to school and compulsively achieve. I got
protection against my father. I didn't have to feel (210) alone at school with the kids. I felt
like I got some love. Even though it was being used to manipulate me into taking care of
her. She had a way in, through my pain, and I had a way in with my pain.
SHORR: (S&O) Who does your stomach belong to?
JIM: To me. It's a good stomach. Good color on the outside. But the inside is all jumbled.
SHORR: (IS) Give that part a name.
JIM: Me.
JOHN: How does the rest of your body feel?
JIM: Fine. Its all mine.
JOHN: Your stomach must not be yours.
JIM: No its not. Its the shit part of me.
SHORR: (IS) In what body part does your mother
belong? JIM: In my stomach.
JOHN: Isn't it true that you still want a mother, and you want to call for her?
JIM: Yes no I want a mother, but I don't want mine.
SHORR: (IS) Reach in and grab her out.
JIM: She's in there with tentacles ... It is all around me ... (pause) ... all through my meat.
SHORR: (IS) Rip her out. Shes scared of you.
JIM: That's really true. That makes a difference. She's goddamned scared of me. I scream
at her and she shrinks like a sea urchin. I'm not really the scared one; she is. (I
remembered the dream where I jacked off on my mother and then I screamed I was going
to kill her). I pulled her out with my right hand, and held her there and talked about her.
She was like a (211) huge, sickly cancer cell. I talked a lot about her, and the more I
talked, the more she was back in my stomach and the more my stomach hurt.
SHORR: (IS) Rip her out and throw her in the fire (a dream I had about the ending of the
world) . Scream at her and tell her to get out.
JIM: (For a long time I didn't feel like I could. I just couldn't reach in and get her out. I
decided to stand up and try it. I had to. My stomach hurt so bad. I couldn't let her stay in.
Thinking of her as scared of me, helped. But I still couldn't do it.)
GROUP MEMBERS: You wont be alone ... were here.
SHORR: Ill be right here.
JIM: I know you all love me and you'll be here. But I'm afraid once I scream, I won't be
able to call for you anymore when I really need you. (This feeling is the same feeling
when I get sick and am scared that I'm all alone and I wouldn't get any help if I really
needed it).
SHORR: You won't have to call for me. I'll be right here with you, anyway. (That did it).
JIM: (AND THEN I SCRARED. I SCREAMED WITH ALL MY MIGHT. WITH ALL
MY PAIN FOR MY WHOLE LIFE. WITH ALL THE ANGER FOR MY WHOLE
LIFE. WITH ALL MY GUTS. I SCREAillD FOR HER TO GET OUT. I SCREAMED
FROM MY GUTS. WITHOUT ANY HESITATION. I SCREAMED FOR MYYSELF.
'CAUSE I WANT TO LIVE FOR ME. 'CAUSE I DEESERVE FOR ME. AND SHE
GOT OUT. YOU'RE DAMN STRAIGHT SHE GOT OUT. AND SHE CAN NEVER
GET BACK IN. SHE'S SCARED. hOW NOW. I KNOW IN MY GUTS. I KNOW WHO
I AM. I KNOW MY STRENGTH, AND I KNOW HER WEAK, SADISTIC,
INHUMAN GAME. I DON'T NEED IT. I DON'T NEED YOU. I'LL NEVER NEED
YOU. SHE'S GONE.)
JIM: (As soon as I screamed, I bent over and clenched my fists. I felt like I was
screaming to hell and back. Dr. Shorr straightened me up and told me I didn't have to
bend over. She couldn't get back in now.) (212)
JIM: (He hugged me and protected my stomach with his belly. It felt good. I really
needed the warmth. I don't really remember what happened after that. I was shaking a lot
and Dr. Shorr stayed next to me and hugged me and sat down next to me. He really cared.
And he was really there. And I didn't have to call for him. And I looked up and people
really looked human and warm. And especially the women looked different. I guess not
so much like my mother. They looked human and fleshy. My stomach actually felt like it
had a wound in it. But it was a clean, fleshy wound. And now it can grow back together
with me. It's mine).
Several months have passed since that group session and the patient has shown
considerable change, being much calmer and most of all, a marked decrease in his strong
suspiciousness. His own analysis, verified in time, strongly suggested that he accounted
his behavior to his mother according to her standards, and felt great guilt if he did not.
Since she was "inside him," the accounting system was acute and ever-present. Just as the
paranoid person is defined by nearly everyone he meets, this man on a lesser scale was
defined by his mother and mother substitutes.
SUMMARY: Psycho-Imagination Therapy believes that any method of psychotherapy
should be firmly rooted in a systematic theory of personality. Psycho-Imagination
Therapy is operationally based on existential concepts and phenomenological foundations
blended with the interpersonal developmental theories of Harry Stack Sullivan and R. D.
Laing. Moreover, the emphasis is on the integration of imagination with existential
phenomenology and the centeredness of the individual -- imagination in the service of
awareness and of the possibility for change.
Many other types of psychotherapy use imagery as a modality; however, only Psycho-
Imagination Therapy uses imagery systematically according to a well-defined (213)
theoretical stance. In addition, Psycho-Imagination Therapy uses other modalities, e.g.,
Finish-the-Sentence, Self-other questions, Most-or-Least questions, and dialogue within
the same interpersonal theoretical framework.
A person's imagery, more than any other mental funcction, indicates how he views his
world. The use of systematically categorized imagery opens up the inner world to both
patient and therapist. Imagery helps the patient to recognize and cast off the conferred
"alien" identity and to redefine himself. It also aids the patient in becoming aware of the
strategies he has developed to maintain his false position and then supports him in
focusing for change, resolving conflicts, and overcoming resistances.
Perhaps the most important factor of imagery is its ability to bypass the usual censorship
of the person. Lowenstein (1956) makes the point that the patient, through hearing
himself vocalize, may control his own reactions to his thoughts; In short, he is verbally
editing, and in so doing attempting to control the reactions of the therapist. Because he
cannot usually tell in advance what effect or meaning the imagery will have, he may
reveal in imagery what he would not ordinarily reveal in verbal conversation. The use of
imagery has a prime value in that it can help break resistances usually found in verbal
transactions.
The verbal process is not relegated to the scrap heap, however; rather, it can be
comingled with imagery to yield a cohesive logic and internal consistency to the
psychotherapeutic process.
A further function of imagery that has special relevance to psychotherapy is the fact that
images can be transformed, re-experienced, and reshaped in line with a healthier self-
concept. The patient's growing awareness of his internal conflicts is one of the most
important products of imagery in therapy.
In the long run it is not enough for a person to be aware of his inner conflicts; a change
must be made in the way he defines himself. The resolution of an internal conflict is more
important than a mere solution. Sleeping pills offer a solution to insomnia, taking a
vacation offers a solution to an unpleasant situation, but in neither case is the actual
problem resolved. Superficial solutions are easily conceived and more easily prescribed,
but it is (214) the duty of the therapist to ignore such temptations and deal constructively
with the problem itself, however difficult it may be to liberate a person from a neurotic
conflict resolution.
The focusing approaches of Psycho-Imagination Therapy are designed to free the patient
from a deadlocked position in his psychological life. Suppression, avoidance, distortion
and withdrawal provide avenues to sustain conflict and escape from resolution. As their
cornerstone, Psycho-Imagination Therapy approaches depend upon the concept of self-
definition. It is essential that the patient be assisted in changing his self-image and in
combating the inclination to let others define him falsely. Psycho-Imagination Therapy
provides a mobilization of the patient's constructive forces to work for him to liberate
himself from an alien identity to be what we are all hopefully striving to be -- more
human -- namely, ourselves.