Working with imagery to modify core beliefs in people with eating disorders: A clinical protocol

Imagery is a relatively novel area of interest in eating disorders (EDs). Clinical experience and some research work indicate that rescripting of early memories may be a useful way to modify core beliefs in EDs. Relevant constructs, as applied in the current paper, are defined and described, including core beliefs, imagery rescripting, and early memories. Existing empirical research on the outcome of imagery rescripting of early memories is outlined, including in EDs. Relevant ED research on images and early memories in EDs is presented. A case is made for applying imagery rescripting to early memories in EDs. The origins and development of a clinical protocol are described. The aim of the protocol is to identify and rescript or modify early memories associated with the core beliefs characteristic of EDs. This process has also been applied in other disorders. Clinical examples illustrate the application of the protocol in EDs, including extracts of dialogue from a clinical case. The paper covers indications for use of the protocol, practical and ethical considerations, its suitability in individual cases, and some final practical tips. These include examples of useful questions to ask patients that facilitate successful rescripting of memories, and thus core belief modification. The paper concludes with some thoughts on future work. © 2011.