For clinicians and therapists
Aphantasia in clinical practice
Many therapeutic techniques ask clients to picture something. For people on the aphantasia spectrum, that step may not be possible, and that's worth knowing before you start.
Why it matters in practice
Aphantasia describes a spectrum, from a reduced ability to picture things in the mind's eye through to none at all. It isn't a disorder or an illness, and it doesn't mean someone lacks memory, emotion or imagination. Those are simply held in a different way.
Guided imagery, imagery rescripting, visualisation-based relaxation and some exposure and trauma-focused techniques can all lean on the ability to form mental pictures. A client who can't do that may struggle with the exercise, or feel they're failing at therapy, when the technique simply doesn't fit them.
This page is general information to help you adapt your practice. It isn't clinical guidance, and it doesn't replace your own professional judgement.
Practical adjustments
A few questions and adaptations can make imagery-based work accessible.
Ask about imagery early
A short question at assessment, such as "When you imagine something, do you see a picture?", helps you choose techniques that will work for this client.
Adapt imagery-based techniques
Verbal, narrative, written, conceptual or body-based versions of an exercise can often reach the same goal without relying on a mental picture.
Don't read it as resistance
Difficulty with a visualisation exercise isn't necessarily avoidance or low engagement. It may simply be how this person's mind works.
Take non-visual memories seriously
People with aphantasia remember events, people and feelings, just not as pictures. This matters especially in grief work and trauma-focused therapy.
Downloadable guidance
We're developing guidance for clinicians and therapists. If you'd like a copy when it's ready, or have clinical experience you could share, get in touch.
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