Work

The power of imagery: examining the prevalence of imagination-based hotspots after a traumatic event in the Grenfell Health and Wellbeing Service

Year: 2025

Type: article

Abstract: BACKGROUND: Intrusive re-experiencing of traumatic events is a cornerstone of post-traumatic stress disorder (PTSD). Clinicians notice that clients also experience intrusive mental images of what they think might happen during a traumatic event. As mental imagery has a powerful impact on emotion, imagination-based imagery may be implicated in the peaks of distress ('hotspots') during a trauma. AIMS: A data-only study was undertaken of cognitive therapy for PTSD 'hotspot' charts used by Grenfell Health and Wellbeing Service clinicians after the Grenfell fire disaster. The aim was to establish the prevalence and nature of peri-traumatic 'imagination-based hotspots' in this sample. METHOD: =26) for the presence and content of 'imagination-based hotspots', defined as 'a peak of emotion during a traumatic event that is related to something imagined "in the mind's eye" as opposed to directly perceived with the senses'. RESULTS: =159) contained an imagination-based component. The most common was an image in which the person watching the fire imagined themselves in the 'shoes' of a tower resident. CONCLUSIONS: Imagination-based mental imagery appears to be linked to the 'hotspots' of a high proportion of people experiencing PTSD in this sample. Results underline the importance of enquiring about the presence of mental imagery during PTSD treatment. The presence of peri-traumatic mental images has implications for effective updating of 'hotspots' in PTSD treatment.

Source: Behavioural and Cognitive Psychotherapy

DOI: 10.1017/s1352465825101033