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Front. Psychiatry | doi: 10.3389/fpsyt.2019.00779

Mental imagery and brain regulation – new links between psychotherapy and neuroscience

  • 1Maastricht University Medical Centre, Netherlands
  • 2School for Mental Health and Neuroscience, Maastricht University, Netherlands

Mental imagery is a promising tool and mechanism of psychological interventions, particularly for mood and anxiety disorders. In parallel developments, neuromodulation techniques have shown promise as add-on therapies in psychiatry, particularly non-invasive brain stimulation for depression. However, these techniques have not yet been combined in a systematic manner. One novel technology that may be able to achieve this is neurofeedback, which entails the self-regulation of activation in specific brain areas or networks (or the self-modulation of distributed activation patterns) by the patients themselves, through real-time feedback of brain activation (for example from functional magnetic resonance imaging). One of the key mechanisms by which patients learn such self-regulation is mental imagery. Here we will first review the main mental imagery approaches in psychotherapy and the implicated brain networks. We will then discuss how these networks can be targeted with neuromodulation (non-invasive or invasive brain stimulation or neurofeedback). We will review the clinical evidence for neurofeedback and discuss possible ways of enhancing it through systematic combination with psychological interventions, with a focus on depression, anxiety disorders and addiction. The overarching aim of this perspective paper will be to open a debate on new ways of developing neuro-psychotherapies.

Keywords: Mental Imagery, Emotion Regulation, Psychotherapy, Neuromodulation, Neurofeedback, real-time fMRI, Brain Stimulation

Received: 30 Jun 2019; Accepted: 30 Sep 2019.

Copyright: © 2019 Linden and Skottnik. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. David E. Linden, Maastricht University Medical Centre, Maastricht, Netherlands, lindend@cardiff.ac.uk