Exploration of imagery in people with agoraphobia

Aim: Past research has shown that imagery can be important in the development (Wells & Hackmann, 1993) and maintenance of anxiety disorders (Hackmann, Surawy & Clark, 1998). Images have also shown to be useful in uncovering core beliefs and memories that occurred around the onset of the disorder (Wells & Hackmann, 1993; Hackmann, Clark & McManus, 2000). Although previous studies have studied imagery in obsessive- compulsive disorder (de Silva, 1986), social anxiety (Wells, Clark & Ahmad, 1998), health anxiety (Wells & Hackmann, 1993) and depression (Beck & Ward, 1961), there has been no published study exploring the imagery specific to those with agoraphobia. This thesis aims to be the first rigorous investigation exploring the imagery in people with agoraphobia, and the content of memories associated with these images. This seems a promising direction given the usefulness of imagery in other anxiety disorders for understanding development, maintenance and onset. Method: Twenty people with agoraphobia and a matched control group were interviewed using a modified imagery questionnaire. The interview enabled the participants to talk about their recurrent images in agoraphobic situations and memories that are associated with these images. Questionnaires measuring anxiety, depression, and agoraphobic symptomology were administered before the interview, and one week after the interview. Results: All the participants with agoraphobia were able to recall and describe recurrent images that occur in agoraphobic situations. All the participants were also able to recall and describe memories associated with these images. Characteristics of the images and the associated memories were analysed using quantitative statistics. The themes in the images and the associated memories were analysed using a content analysis approach (Smith, 2000). Conclusions: People with agoraphobia have recurrent images in agoraphobic situations that are linked to past negative memories. The themes that emerged in the imagery and the associated memories are significantly different to those found in the matched control group. The findings of this study contribute to a fuller understanding of the agoraphobic experience, and the relevance of exploring imagery in those with agoraphobia, and other psychological disorders. Clinical and theoretical implications of the findings in the study are discussed