Last week I posted a piece in which I wrote about having wondered for years (off and on) whether I might have ASD, eventually getting myself referred to a psychologist and learning as a result that my real problem was that I’d been attempting for years to deal with anxiety without recognizing the fact. Almost as an amusing postscript, I added the fact that I’d just discovered that I’ve got aphantasia, which is a newly coined (2015) term for the absence of a visual imagination, or the inability to “see” mental pictures.
Even as I was writing that piece, my perspective on it was changing. I concluded it by wondering whether there might be a connection between the anxiety and the aphantasia. Was it possible that the condition could make it harder to overcome anxiety, in that the aphantasiac is unable to visualize favourable (or any) outcomes to possible actions, or alternative future scenarios? I’ll admit that I thought this suggestion a bit fanciful. Though people may speak of “visualizing”, for example, the future effects of their actions, that didn’t necessarily justify the assumption that they did so using actual mental images. In spite of my doubts, I thought the possibility was worth looking into further.
I found a short article by Rebecca Keogh, a postdoctoral fellow in cognitive neuroscience, which includes this passage:
Another form of treatment in clinical psychology involving visual imagery is imaginal rescripting, which is used to treat many different disorders such as depression, generalised anxiety, obsessive-compulsive disorder, and eating disorders. Imaginal rescripting involves participants imagining, or simulating, scenarios from the past or future that are fear- or anxiety-producing. They imagine these scenarios in as much detail as possible, and then are asked to imagine an alternative scenario or outcome that is more positive — they ‘rescript’ the memory or thought. They are also taught how to change their thinking towards these scenarios during the process.
A few paragraphs later, she adds: “… In addition to therapy, we use visual imagery when we remember the past and plan for the future” (emphasis added).
Dr Keogh doesn’t mention aphantasia but the main thrust of her article is that limitations or restrictions on visual imagination may make therapies like imaginal rescripting less effective. Since aphantasiacs have by definition an extremely restricted and limited visual imagination, it surely follows that imaginal rescripting would be unlikely to succeed with us.
Also, if imaginal rescripting is effective for the management of anxiety in the context of cognitive behavioural therapy, presumably an informal version of the same approach is used by people who are able to control their anxiety without being in therapy. Again, this is an approach which is not available to the aphantasiac. In other words, it seems as if my fanciful speculation might be right after all: it is possible that having aphantasia may make it harder to manage anxiety.
But I wasn’t ready to stop there. Might it not be the case that aphantasia, as well as hampering the management of anxiety, actually makes anxiety more likely in the first place? We all know that the future is unpredictable and beyond our control. And it seems obvious that uncertainty and a sense of not being in control is liable to cause anxiety. So it doesn’t seem that much of a stretch to suppose that a capacity to picture possible futures might help to make the future seem more predictable and therefore less threatening. And, as a consequence, less likely to induce anxiety.
This hypothesis seems to fit with Dr Keogh’s statement that “we use visual imagery when we … plan for the future”, though of course I’ve no way to test it. Since I can’t construct a visual representation of a possible future event or set of circumstances, I’ve no way of telling whether doing so would make me less anxious.
Whether or not a capacity to visualize things that haven’t happened yet is helpful in coping with anxiety, it seems clear that the absence of mental pictures can be relevant in another way. One of the anonymous contributors to a recent book on the subject reported:
I have depression and anxiety and was having a rough few years … my mom has —from as early as I can remember— told me to close my eyes and imagine … as a kid I would try but didn’t understand the concept or what I was supposed to “see”.
So, fast-forward to 33-years-old and I’m visiting with my mom and I’m stressed out and she again tells me to close my eyes and visualize myself somewhere peaceful like the “ocean”. I agree, close my eyes and listen to her words. She’s saying things like, “Now picture the sand, the colour of the water.”
I remember feeling frustrated with her words “picture” and “visualize”; after a while I open my eyes and I’m agitated so I ask, “What do you mean ‘picture’? I don’t see anything.”
I remember the look on her face. It was a mixture of confusion and shock.
(I read Aphantasia: Experiences, Perceptions and Insights on my Scribd subscription, so I can’t give page references for the quoted passages.)
So, it appears that it can sometimes be helpful for a person suffering from anxiety to imagine a calm and soothing present, quite apart from the future.
The curious thing is that, in the week since I first started to think about the possibility that aphantasia might be depriving me of one of the techniques for managing anxiety … I’ve actually been feeling much less anxious! I’ve had three great nights’ sleep in that week, and none where I lay awake for any length of time. As a result, I began to wonder if anxiety isn’t my core problem after all, but just a consequence of my general inability to picture possible futures.
Three years ago, I was sittin’ in a park (in Bordeaux, France, with apologies to Joni Mitchell) and it struck me that I’ve always been somewhat disengaged from my life. I’ve rarely had a regular, full-time job. Though I’ve been married, most of the time I haven’t been in a relationship. I’ve no children, of course. I owned a flat (apartment) for a few years in London but for most of my life my accommodation has been precarious, temporary at best. I never learned to drive. It’s almost as if I’ve been trying to say to the universe, “ignore me, I’m not really here.”
I originally qualified as a solicitor in Ireland but I wasn’t very good at practising law and gave it up after about 10 years. I then went back to university in my 30s to do English literature. And that went brilliantly. I loved it, was very enthusiastic, read nearly all the books (Middlemarch was the only exception, and I got halfway through even that), and handed in all the required essays. But after that it took me 15 years (part time) to finish my doctorate. So there’s clearly a pattern in my life of not persisting with things and leaving things uncompleted.
In any case, it was this sense of disengagement that eventually led me to ask to be referred to a psychologist, to see if I could finally resolve the question whether I have ASD. As I said last week, it doesn’t look as if I have.
Since I’ve started looking at and thinking about the implications of aphantasia (that’s to say, in the last 10 days), I’ve come to think that ASD was a red herring. I’m now considering the possibility that my aimlessness or lack of direction has nothing at all to do with ASD and a great deal more to do with aphantasia than it does with anxiety. Here’s another passage from the book I quoted above, this time from a different anonymous contributor:
It’s handicapped me for long-term prospects. Ambition is not present because of the inability to visualize plans and ideas and put them into action. Even small tasks require some type of visual acting out beforehand, and I suffer here as well.
Not everybody is affected in the same way of course, and I wouldn’t myself insist that it’s necessary to (literally) visualize plans in order to be able to put them into action. I don’t believe that the absence of “the vision thing” is necessarily fatal to my (or to anybody’s) ability to follow long-term plans sucessfully. I don’t have any doubt that it’s possible to compensate for the absence of a visual imagination. Aphantasia can be worked around—but only once you know you’ve got it. Until the week before last, I didn’t know that.
Since my teen years, I’ve been equally fascinated and puzzled by people who pursue a goal with determination and achieve it (or don’t, if they’re unlucky). How do they attain that focus, that single-mindedness, that persistence? It may be hard to believe, but it really is only very recently that I’ve realized that people like that have a carrot as well as a stick. The stick is typically a sense of duty or obligation, such as the need to provide for a family or other dependents. The carrot, of course, is their vision, their ability to imagine their own achievement and the consequences that can be expected to flow from it. Not having that, I need to find something to substitute for it. That’s a very belated realization on my part. But, as always, it’s better late than never.
So far, I’ve concentrated on the way I perceive or imagine the future, and the effects that has on my way of living. My perception of the past (memory) and of the present also has implications for my life, ones that I’ve only just started to examine and understand. I’ll be writing about that subject next week.