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(Reuters Health) – Therapists often use a technique that involves exposing patients to the source of their fears to conquer them, but a new study suggests that guided imagery of the source of fear can be just as effective .
The traditional method, called threat extinction, relies on triggering areas of the brain involved in perception, memory, learning, and imagination. The authors of the new study show that the same processes occur when the source of fear is "simulated" by imagining it.
"The most interesting aspect was that we could measure the neural responses and examine the state of the brain during the imagination and see that it looked like what is happening at a real show. ", said lead author Daniela Schiller, associate professor of psychiatry and neuroscience at Icahn. School of Medicine at Mount Sinai in New York. "By acting mentally, we can bring our brain to a state similar to that which occurs when there is a real exposure."
One of the disadvantages of traditional exposure therapy is that it may be difficult or impractical to attempt to address the source of a patient's fears, for example if they result from trauma in an area of war. And sometimes, the fear is so intense that the actual exposure therapy can be overwhelming.
To test the imaginary exposure principle, Schiller and his colleagues set up an experiment involving 68 volunteers who would be conditioned to bind some sound to a light electric shock. The researchers repeatedly played two tones to the volunteers and they were slightly shocked. Finally, the sound is enough to make them react.
Then Schiller and his colleagues divided the volunteers into three groups. One group was repeatedly exposed to the sound that had been linked to a shock, but now without shock. A second group was invited to imagine the sound without shock the attendant. The third group, who served as a witness, had to imagine two neutral sounds of nature, birdsong and rain.
The brains of the volunteers were scanned with functional MRI during this phase of the experiment. Sensors on volunteers' arms also measured cutaneous conductance, "a measure of excitement," Schiller explained.
When the researchers looked at brain scans, they found that "when you follow an exposure therapy, real or imaginary, a network in the ventromedial prefrontal cortex (switches to action)," said Schiller . "This network is important for the learning of extinction."
In people with anxiety disorders, this network can be altered. The results of the study, published in Neuron, show that it can be triggered by both actual exposure to frightening experiences and imaginary exposure, Schiller said.
Therapists already use fantasy therapy, even without the evidence that it causes real brain changes, said Dr. Robert Hudak, Associate Professor of Psychiatry at the University of Pittsburgh School of Medicine. , who did not participate in this study. "We do it all the time with OCD patients."
For example, a person who leaves home for a few hours can remove the plugs from each outlet of the house hoping that it will prevent it from igniting, Hudak said. Having the person who imagines leaving the house repeatedly without unplugging the candles can possibly lessen the anxiety felt about the fire of his house.
Ultimately, the person in the company of a therapist could actually do the therapy. "In this case, exposure to the imagination can be a first step," Hudak said.
Hudak does not recommend people to try themselves to expose their imagination. This is because it takes practice to sit still and allow anxiety to dissipate itself, he said.
SOURCE: bit.ly/2DD9NaW Neuron, online November 21, 2018.
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