Martijn van Teffelen

Imagery-enhanced cognitive restructuring: Protocol 107 5 JOHN: “Alright, I am in the situation, I am in the living room with my daughter. My wife is sitting nearby, and my daughter tells me that in fact she already had sex with the boy. It is like a black haze comes over me, like my brain is going in overdrive. All reason is drained away from my body, I feel anger, I am so heavily disappointed, and I start splurging curse words. THERAPIST: “If what you see is a picture, describe what you see.” JOHN: “My wife is behind me hoping I do not do something crazy; we are in the living room; my daughter’s face is as white as it can be. If my gaze would have been deadly, then I surely would have killed someone that moment. I am standing there, and I am very tense. THERAPIST: “Do you hear or smell something?” JOHN: “No, it’s dead silent. I smell nothing.” THERAPIST: “What do you feel (in your body)?” JOHN: “I feel as if my heart is going to jump out of my body, like I’m under 480 volts. My chest muscles are super tense. As if I am very unstable nitroglycerin in which someone just light a spark. I am furious.” THERAPIST: “Can you feel it right now?” JOHN: “Yea, but much less as back then.” THERAPIST: “Alright try to make the feeling as strong as possible. Focus on the tension in your chest and on your pounding heart. What now goes through your mind is “She’s doing this on purpose to hurt me”. Hostile image transformation Arriving at the ‘hotspot’ of the anger-provoking event, we continued with the transformation of the hostile belief into a hostile image. To transform the hostile belief into an image, we aimed to let participants generate a mental image that is as lively as possible and adequately captures all sensory and affective information. Importantly, we told participants that this image does not have to be realistic, as long as it adequately captures a participant’s feelings. Below we continue with a written transcription of John. Other examples of hostile image transformations are provided in Table 1.