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Guided Imagery and Recovered Memory Therapy:

Considerations and Cautions
a b c
Amanda Thayer BA & Dr. Steven Jay Lynn PhD
a
StateUniversity of NewYork , Binghamton
b
American Psychological Association's Division of Psychological Hypnosis
c
National Institute of Mental Health
Published online: 11 Oct 2008.

To cite this article: Amanda Thayer BA & Dr. Steven Jay Lynn PhD (2006) Guided Imagery and Recovered Memory Therapy:
Considerations and Cautions, Journal of Forensic Psychology Practice, 6:3, 63-73, DOI: 10.1300/J158v06n03_04

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 COMMENTARY SECTION
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Guided Imagery
and Recovered Memory Therapy:
Considerations and Cautions
Amanda Thayer, BA
Steven Jay Lynn, PhD

Amanda Thayer received her BA in Psychology at the University of North Carolina

Wilmington. She was the recipient of the 2005 Cape Fear Psychological Association Stu-
dent Excellence in Applied Research Award. She has published in the Journal of Forensic
Psychology Practice and presented her findings at the 2004 Sandhills Regional Psychol-
ogy Conference. Her research interests are in the area of forensic psychology, with an em-
phasis on both false memories and eyewitness memory errors.
Steven Jay Lynn is Professor of Psychology, State University of New York, Binghamton.
He is a licensed psychologist in independent practice and a Diplomate in both Clinical
and Forensic Psychology. Dr. Lynn has been the recipient of numerous professional
awards including the Chancellor’s Award of the State University of New York for
Scholarship and Creative Activities, the American Psychological Association’s Award
for Distinguished Contributions to Scientific Hypnosis, and the President’s Award for
outstanding contributions to scientific and clinical hypnosis from the Society of Clini-
cal and Experimental Hypnosis. Dr. Lynn is past President, American Psychological
Association’s Division of Psychological Hypnosis, and serves on eleven editorial
boards, including the Journal of Abnormal Psychology. Dr. Lynn has published more than
225 articles and book chapters, and he has written or edited 13 books, many of which have
received awards from professional organizations. His research program is currently funded
by the National Institute of Mental Health.
Address correspondence to: Steven Jay Lynn, Department of Psychology, Bing-
hamton University, State University of New York, P.O. Box 6000, Binghamton, NY
13902-6000 (E-mail: slynn@binghamton.edu).
Journal of Forensic Psychology Practice, Vol. 6(3) 2006
Available online at http://jfpp.haworthpress.com
© 2006 by The Haworth Press, Inc. All rights reserved.
doi:10.1300/J158v06n03_04 63
 64 JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE

ABSTRACT. In this commentary we argue that therapists commonly

employ memory recovery methods such as guided imagery for sexual
abuse victims, despite the fact that little empirical evidence exists to sup-
port their therapeutic benefits. Moreover, research on source monitoring
and imagination inflation indicates that guided imagery may carry too
many risks to be used for memory recovery in a therapeutic context.
Because false memories can have devastating consequences for indi-
viduals and families, therapists should make every effort to evaluate
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the role of suggestion, suggestibility, and imagination inflation in their

treatment. doi:10.1300/J158v06n03_04 [Article copies available for a fee from
The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address:
<docdelivery@haworthpress.com> Website: <http://www.HaworthPress.com>
© 2006 by The Haworth Press, Inc. All rights reserved.]

KEYWORDS. Guided imagery, memory recovery therapy, false mem-

ories, imagination inflation

In the last half century, one of the most contentious issues that has
emerged in the field of psychology is whether psychotherapists create
rather then simply “recover” ostensibly repressed or dissociated memo-
ries of traumatic experiences, including early childhood sexual abuse.
Numerous researchers and practitioners (e.g., Lindsay & Read, 1994;
Loftus & Ketcham, 1994; Ofshe & Watters, 1994; Lynn, Lock, Loftus,
Krackow, & Lilienfeld, 2003) have articulated manifold risks inherent
in the proliferation of memory recovery techniques. However, propo-
nents of the use of such techniques have marshalled a vigorous defense
based on three contentions. First, the mere fact that a patient fails to re-
call sexual abuse should not deter a therapist from implementing mem-
ory recovery techniques insofar as traumatic memories are commonly
represssed (e.g., see Williams, 1994). Second, memory research does
not, in the main, apply to traumatic memories because there are salient
differences in the recall of traumatic and mundane events (Alpert,
Brown, & Courtois, 1998a,b; van der Kolk, 1994). Finally, therapists
are duty-bound to help their clients, which necessitates taking a non-
judgmental stance toward remembrances that arise in treatment (Fred-
rickson, 1992; Herman, 1992).
Given that the general topic of memory recovery techniques has been
debated in multiple forums, we will limit our discussion to four points:
(1) memory work in general, and guided imagery in particular, is by no
 Commentary Section 65

means a rare event; (2) extant research has failed to document any thera-
peutic benefit for revisiting early memories of traumatic events; (3) at-
tempts to help clients recall early abuse, including the use of guided
imagery, can engender false memories; and (4) studies of source moni-
toring and imagination inflation provide compelling reasons to be wary
of the use of guided imagery techniques. We will address each of these
issues in turn.
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GUIDED IMAGERY AS “MEMORY WORK”

IN THE TREATMENT OF CHILDHOOD ABUSE SURVIVORS

Memory work refers to a constellation of techniques that are de-

signed to help clients recover memories in psychotherapy (Shobe &
Kihlstrom, 2002). These techniques include hypnosis and hypnotic age
regression, bibliotherapy, dream interpretation, and guided imagery
(e.g., Lindsay & Read, 1994). The risks associated with hypnosis in cre-
ating false memories are legion and have been well documented (e.g.,
Laurence & Perry, 1983; Lynn, Weekes, & Milano, 1989; Spanos &
McLean, 1986), although controversy persists regarding the use of hyp-
nosis for memory recovery (e.g., Brown, Scheflin, & Hammond, 1998).
Furthermore, problems of false memories in conjunction with biblio-
therapy and dream interpretation have been discussed elsewhere (e.g.,
Lynn, Lock, Loftus, Krackow, & Lilienfeld, 2003; Mazzoni, Loftus, &
Kirsch, 2001; Mazzoni, Loftus, Seitz, & Lynn, 1999; Mazzoni, Lom-
bardo, Malvagia, & Loftus, 1997). Accordingly, we will focus our com-
mentary on the problems associated with the use of guided imagery for
enhancing memory retrieval.
In guided imagery, a person imagines scenarios that are suggested or
described by another person (Lindsay & Read, 1994). In psychother-
apy, the individual is often relaxed and invited to close his or eyes in or-
der to facilitate imagination. When memory accuracy is not a concern,
guided imagery techniques are arguably useful (e.g., treatment of pho-
bias, see Kazdin, 1994). However, we will contend that there is no em-
pirical warrant for the use of guided imagery for memory recovery.
Our concerns about the use of guided imagery emanates, in part, from
the visibility and popularity of these techniques. Not only is an exten-
sive literature regarding childhood sexual abuse and memory recovery
available to mental health consumers (e.g., Bass & Davis, 1988, 1993;
Frederickson, 1992), but therapists frequently employ memory recov-
ery techniques. For example, Poole and her colleagues’ (1995) national
 66 JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE

survey of doctoral-level psychotherapists reported that 71% of the re-

spondents used one of a number of different memory recovery techniques,
and 32% of respondents used guided imagery specifically. Similarly,
Polusny and Follete’s (1996) national survey of psychologists found
that more than a quarter of the sample used guided imagery, dream in-
terpretation, and referral to a sexual abuse survivor’s group with clients
failing to report childhood sexual abuse. Finally, Maki and Syman’s
(1997) survey of clinical and counseling psychology programs revealed
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that many of these methods were routinely taught to graudate students.

In short, there is ample reason for concern about guided imagery and
memory recovery techniques, in general, given their ubiquity and
widespread acceptance in the professional community.

QUESTIONABLE “BENEFITS” OF MEMORY RECOVERY

“Recovered memory therapy . . . is predicated on the trauma-memory

argument–that memories of traumatic events have special properties
that distinguish them from ordinary memories of the sort usually stud-
ied in the laboratory (p. 70) . . . Nothing about the clinical evidence sug-
gests that traumatic memories are special, or that special techniques are
required to recover them” (Shobe & Kihlstrom, 1997, p.74). Neverthe-
less, the claim persists that traumatic memories are not only different
than ordinary memories, but that research on false memories has done
little to advance our understanding of the application of clinical proce-
dures, which are far removed from emotionally sterile laboratory condi-
tions (e.g., Alpert et al., 1998a,b). It follows then, that retiring these
potentially beneficial techniques on the basis of infrequent instances of
false recollections, and research constrained by limited generalizability
to the real world is, in effect, throwing the baby out with the bathwater.
However, contrary to this viewpoint, the assumption that the recov-
ery of repressed material is an ingredient of effective psychotherapy is
dubious and has precious little empirical support. In fact, Littrell (1998)
has argued that re-experiencing painful memories and emotions can
have many negative consequences. When treatment gains are achieved
in psychotherapy, they are not the result of simple catharsis. Rather, op-
timal treatment effects are associated with new learning and enhanced
emotional self-regulation. Moreover, as Lindsay (1998) has explained,
there is little to be gained by searching for lost memories, as there is no
empirical evidence to suggest a causal relation between psychopathol-
ogy and forgotten abuse. Even if such a causal link were established,
 Commentary Section 67

Ornstein, Ceci, and Loftus (1998) point out that it is a logical fallacy to
assume that if a certain manifestation of psychopathology follows sex-
ual abuse, then a history of sexual abuse must exist when this particular
symptom is present. This error in logic is what is commonly referred to
as “affirming the consequent.” As Ornstein et al. (1998) have noted,
“we cannot argue from current symptoms back to a history of presumed
abuse”(p. 1008).
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GUIDED IMAGERY AND FALSE MEMORY CREATION

Guided imagery and related memory recovery methods are com-

monly used by professionals–but are they risky, and perhaps even “dan-
gerous” procedures? We canted that research implies that the answer is
“yes.” Hyman and Pentland (1996) examined the effects of guided im-
agery on college students’ false memory reports for early childhood
events. To verify that the suggested events did not in fact occur, they
contacted participants’ parents. Participants were then brought to the
laboratory and asked to recall an event that was ostensibly verified by
their parents to have occurred when they were very young (e.g., knock-
ing over a punchbowl at a wedding). Participants assigned to the control
group were encouraged to recall the event, whereas those assigned to a
guided imagery condition imagined the event taking place. After three
recall trials, 25% of participants in the guided imagery condition re-
called the false event, whereas only 9% of the control subjects did so. In
a similar study, Hyman and Billings (1998) found that false memory re-
ports correlate with imaginative ability as measured by the Creative
Imagination Scale (CIS: Wilson & Barber, 1978). Moreover, measures
of vividness of visualization have been found to be related to the produc-
tion of memory errors across a variety of other suggestibility paradigms
(Dobson & Markham, 1993; Tousignant, 1984; Winograd, Peluso, &
Glover, 1998). Although not all measures of imagination consistently re-
veal increased false memory risk across studies, we know of no study that
shows that imagination can reduce false memory risk.
It is also worth emphasizing that false memory reports in the labora-
tory are not limited to minor yet plausible early childhood experiences.
Porter, Yuille, and Lehman (1999) asked college students to recall highly
emotional (e.g., serious animal attack, serious medical procedure) early
childhood events over three sessions using guided imagery techniques.
Contrary to the notion that false memories rarely emerge for traumatic
experiences, Porter et al. found that over repeated interviews, more than
 68 JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE

25% of participants reported experiencing a stressful emotional event

that was false.

IMAGINATION INFLATION AND GUIDED IMAGERY

Why does guided imagery increase the likelihood of false memory

reports? Part of the answer undoubtedly lies in people’s difficulties in
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monitoring the source of information (e.g., memory vs. imagination),

and in distinguishing imagination and reality. Adequate source moni-
toring requires that we are not only able to retrieve a particular memory,
but also to locate the source of the memory as well (Johnson, Hash-
troudi, & Lindsay, 1993). Since Johnson and Raye’s (1981) early research
in reality monitoring (i.e., deciding whether a memory originated from
our perceptions or only our imagination), substantial evidence has
emerged that breakdowns in source monitoring can account for deci-
sion-making errors across a variety of domains such as adult (e.g.,
Lindsay, 1993) and child (e.g., Ceci, Loftus, Leichtman, & Bruck, 1995)
eyewitness testimony. Indeed, the mere act of imagining events that
have never occurred can engender what is known as “imagination infla-
tion”–enhanced confidence that the imagined events occurred in reality
(Garry, Manning, Loftus, & Sherman, 1996).
Early studies demonstrated that some participants display consider-
able difficulties in distinguishing real versus imagined events. For ex-
ample, Anderson (1984) asked subjects to trace line drawings or only
imagine tracing line drawings. Later, these subjects were asked if they
traced the drawings or only imagined doing so. Of those who reported
tracing the drawings, 39% had, in fact, only imagined tracing. In their
initial investigation of imagination inflation, Garry et al. (1996) devel-
oped a three-step procedure, which has become the conventional para-
digm for investigating imagination inflation. Subjects were first asked
about childhood events, as measured by the Life Events Inventory
(LEI), which consists of 40 childhood events (e.g., “broke a window
with your hand”), and asked to rate the likelihood of the event on an
8-point scale. The researchers then selected 8 events that all participants
were least likely to have experienced. Two weeks later, participants re-
turned to the laboratory and were assigned 4 of the 8 items and were
given an imagination procedure for each of the 4 items. The imagination
task involved participants reading a brief description of the event and
then imagining the experience, with encouragement to include familiar
places, people, and things in the imagined event. After completing the
 Commentary Section 69

imagination task, participants were told that their original responses to

the LEI had been misplaced and they were asked to complete the scale a
second time. The researchers found that for the majority of items, there
was no change in confidence between time 1 and time 2. They also
found a small percentage of items decreased in confidence from time 1
to time 2. However, for those items where confidence increased from
time 1 to time 2, it was more likely that it was an imagined item (34%)
than a not-imagined item (25%). This imagination inflation effect has
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been demonstrated in numerous other instances (e.g., Horselenberg,

Merkelbach, Muris, Rassin, Sijsenaar, & Spaan, 2000; Paddock, Joseph,
Chan, Terranova, Manning, & Loftus, 1998; Paddock, Noel, Terranova,
Eber, Manning, & Loftus, 1999).
Relatedly, Goff and Roediger (1998) examined whether repeatedly
imagining an event increases the likelihood that it is judged to be a real
event. For the first session, participants enacted, imagined, or only
heard about action events. For the second session a day later, individu-
als were asked to imagine these events 0, 1, 3, or 5 times. For session
three, two weeks after session 1, participants were given a recognition
test and were asked to judge whether (for the first session) they had en-
acted the action, imagined the action, or only heard about the action
(i.e., made a source monitoring judgment). As the number of imagining
trials increased, so did the likelihood that a participant incorrectly re-
ported they enacted an event. Moreover, source monitoring judgments
fell to chance levels when subjects imagined events five times.
The findings reviewed raise the index of suspicion that source moni-
toring errors can play a role in false memories of childhood events. In
the course of therapy, clients may be repeatedly asked to imagine abuse
events, which, over time, prove increasingly difficult to disentangle
what is real from what is only imagined. As the perceptual clarity of the
imagined event increases, misattributing it to an actual experience be-
comes all the more likely (Johnson, Foley, Suengas, & Raye, 1989).

FINAL CONSIDERATIONS

In closing, we return to the claims of the defenders of the use of guided

imagery and other memory recovery techniques in psychotherapy that
we mentioned at the outset. If there were benefits associated with exca-
vating and working with “repressed memories” in psychotherapy, then
the use of techniques such as guided imagery might be justified for this
purpose. However, to date, no such benefits have been documented.
 70 JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE

It is true that generalizability of results from the laboratory to the

clinic is an important issue. However, it seems plausible, if not likely,
that expectancies, suggestive procedures, demand characteristics, and
imagination inflation play a far more significant role in the consulting
room than the laboratory. The therapists’s potential to exert influence
on a help-seeking, eager to please, vulnerable patient is likely much
greater than the experimenter’s influence on a subject participating in a
“one shot” experiment for money or course credit (Lynn et al., 2003).
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Even if some laboratory-based findings fail to generalize to clinical

practice, it does not provide an affirmative justification for the use of
guided imagery for memory recovery.
The argument that therapists are duty-bound to take a nonjudgmental
stance toward memories that surface in treatment is a completely sepa-
rate issue from the advisability of using such techniques in treatment.
Moreover, given that false memories can wreak havoc on individuals
and families, therapists should make every effort to evaluate the role of
suggestion, suggestibility, and imagination inflation in their treatment.
That said, the questionable status of guided imagery procedures as mem-
ory recovery techniques has no direct bearing on the therapeutic effi-
cacy of specific techniques such as hypnosis, which must ultimately be
investigated and judged on their own merit.

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