Imagery-Based Cognitive Therapy for Bipolar Disorder and Mood Instability

Emily A. Holmes, Susie A. Hales, Kerry Young, and Martina Di Simplicio
Foreword by Gillian Butler
Afterword by Guy Goodwin

A Paperback Originale-bookprint + e-book
A Paperback Original
May 28, 2019
ISBN 9781462539055
Price: $30.00
184 Pages
Size: 8" x 10½"
April 22, 2019
ePub and PDF ?
Price: $30.00
184 Pages
print + e-book
A Paperback Original + e-Book (ePub and PDF) ?
Price: $60.00 $33.00
184 Pages
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People with bipolar disorder are particularly vulnerable to anxiety and intrusive mental imagery, which can contribute to mood swings and a heightened risk for relapse. This book presents a novel brief treatment that focuses on working with mental images to reduce distress and enhance mood stability. Grounded in cognitive-behavioral therapy (CBT), the book provides therapists with tested techniques for formulating individualized treatment targets, using metacognitive strategies to reduce the power of images, rescripting problematic images, and building adaptive positive images. User-friendly instructions for assessment and intervention include case examples, sample scripts, and troubleshooting tips. In a large-size format for easy photocopying, the book includes 19 reproducible handouts and session agendas. Purchasers get access to a Web page where they can download and print the reproducible materials.

“Bipolar disorder has long been thought to be impervious to psychosocial interventions, and imagery has received scant attention as a focal point for treatment. This is about to change with the publication of this manual. The authors have built on absolutely superb basic psychopathology research to show how imagery serves as an 'emotional amplifier' to produce crippling affective states and out-of-control behavior—and how step-by-step remapping of imaginal processes can reverse the process. Presenting a whole new approach to treatment of bipolar disorder, this book is destined to become a classic. It is an invaluable addition to the clinical armamentaria of students entering the field and experienced practitioners alike.”

—Steven D. Hollon, PhD, Gertrude Conaway Vanderbilt Professor of Psychology, Vanderbilt University

“An extraordinarily helpful and well-researched guide. The authors' imagery-based CBT approach promises to revolutionize our toolbox of intervention techniques for bipolar disorder. The book describes how to set up treatment step by step and provides many useful tips and ideas for identifying and rescripting imagery. It will be useful to therapists in training as well as experienced mental health professionals who seek out novel interventions and ideas. Importantly, this book is based on many years of rigorous basic research on the role of imagery in psychopathology, an area in which Holmes is a leader worldwide.”

—Jutta Joormann, PhD, Department of Psychology, Yale University

“This practical, reader-friendly book offers an imagery-focused CBT framework for stabilizing mood in bipolar disorder. Numerous strategies are outlined in detail, including imagery rescripting, imagery-competing tasks, positive imagery, and metacognitive techniques. Illustrative case examples are used throughout. Given that imagery is a transdiagnostic process, the strategies outlined in this book will be useful for clinicians and trainees working with a variety of mental health problems.”

—David J. A. Dozois, PhD, Professor and Director, Clinical Psychology Graduate Program, Department of Psychology, University of Western Ontario, Canada

“Informed by neuropsychological research, this outstanding book provides a unique adaptation of CBT for bipolar disorder. Providing a focused set of innovative techniques and clinical vignettes, the authors clearly demonstrate strategies for reducing the emotionally amplifying and mood destabilizing effects of intrusive imagery. This is a welcome addition to the psychosocial treatment of bipolar disorder, as it targets the anxiety and trauma often associated with this challenging illness.”

—Noreen A. Reilly-Harrington, PhD, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School

Table of Contents

I. Introduction

1. Introduction to Bipolar Disorder sample

2. Introduction to Mental Imagery and the Development of MAPP

II. Overarching Principles and Basic Techniques

3. The MAPP Therapeutic Ethos

4. Mood Monitoring, “Blip” Management, and Being Kind to Oneself

5. Overcoming Barriers to Therapy: Chair Work

III. Assessment and Treatment

6. MAPP Assessment: “Mapping”

7. Microformulation of a Particular Mental Image, and Psychoeducation for Clients

8. Metacognitive Techniques to Reduce the Power of the Image

9. Imagery Rescripting Techniques

10. Promoting Positive Imagery

11. Introducing Imagery-Competing Tasks

12. Consolidation Sessions: Making Video Blueprints

13. Final Comments

Afterword, Guy Goodwin




About the Authors

Emily A. Holmes, DClinPsy, PhD, is Professor of Psychology in the Department of Psychology at Uppsala University in Uppsala, Sweden, and in the Department of Clinical Neuroscience at the Karolinska Institutet, Stockholm, Sweden. She is Visiting Professor of Clinical Psychology at the University of Oxford, United Kingdom. Her research and publications focus on mental imagery and emotion across psychological disorders. She is a clinical psychologist with a PhD in cognitive neuroscience. Dr. Holmes is an associate editor of Behaviour Research and Therapy and serves on the Board of Trustees of the international mental health research charity MQ: Transforming Mental Health. She is a recipient of the May Davidson Award from the British Psychological Society, the Comenius Early Career Award from the European Federation of Psychologists' Associations, and the Award for Distinguished Early Career Scientific Contribution to Psychology from the American Psychological Association, among other honors. She is a member of the Royal Swedish Academy of Sciences.

Susie A. Hales, DClinPsy, is Research Tutor and Clinical Psychologist at the Oxford Institute of Clinical Psychology Training, University of Oxford, and Oxford Health NHS Foundation Trust, United Kingdom. Her research focuses on mental imagery processes and treatment innovation for mood disorders. Dr. Hales has published papers on psychological aspects of bipolar disorder and suicidality, and on novel ways of delivering cognitive therapy. She is active in the supervision and training of mental health professionals in a range of research and clinical competencies, with a particular emphasis on the provision of imagery-focused cognitive therapy training workshops.

Kerry Young, DipClinPsy, is Consultant Clinical Psychologist and Clinical Lead of the Woodfield Trauma Service in London, United Kingdom. She is also Honorary Lecturer in Clinical Psychology at University College London and a clinician at the Oxford Rose Clinic. Dr. Young is an expert in mental imagery techniques, particularly imagery rescripting and its use with clients who have experienced complex trauma. She has published in the area of trauma and mental imagery.

Martina Di Simplicio, MD, PhD, is Clinical Senior Lecturer in Psychiatry at the Centre for Psychiatry, Imperial College London, United Kingdom, and Honorary Consultant Psychiatrist in the West London NHS Trust. Her research focuses on understanding the cognitive mechanisms that underlie psychopathology and that drive successful treatment of mental disorders. Dr. Di Simplicio investigates the role of mental imagery in regulating emotions, with the aim of developing innovative digital interventions for young people who experience mood instability and self-harm. She has published on emotion processing, neuroimaging, psychopharmacology, and mental imagery.


Clinical psychologists, psychiatrists, clinical social workers, counselors, and psychiatric nurses.