“Imagine you are walking toward an ocean – feel the sun on your skin, the ocean spray on your face – listen to the rolling waves….”
This kind of visualization is a popular wellness technique. Can you feel yourself becoming relaxed? Can you transport yourself to that place in your mind?
The Missing Mind’s Eye: Understanding Aphantasia
About 4% of the population can’t – they have aphantasia, or the inability to visualize things in their ‘mind’s eye’ (i.e. mental imagery).
In 2015, aphantasia exploded into popular discourse and sparked a decade of psychological research that continues to this day. Early research sought to measure how aphantasia affects a variety of cognitive processes thought to involve mental imagery, such as working memory and spatial navigation. Interestingly, these initial studies found that aphantasia does not impair performance on any cognitive task. Now, aphantasia is recognized as a type of neurodiversity, part of the natural spectrum of how people experience their inner worlds.
Beyond Visualization: How Aphantasics Experience the World
The starkest contrast between people with aphantasia (called aphantasics) and those with imagery (called imagers), is in the subjective experience of thoughts and memories. For example, aphantasics often report severely deficient autobiographical memory (SDAM), or an inability to re-experience significant memories from their life.
This has led to the proposition that aphantasics may be protected from developing mental health conditions that are characterized by intrusive imagery of adverse experiences, particularly post-traumatic stress disorder (PTSD). This claim has even been proliferated by aphantasia researchers. However, the latest study of aphantasia and mental health reveals a more complicated reality.
Emotions Without Images: The Surprising Reality of PTSD in Aphantasics
In collaboration with the Aphantasia Network, the biggest organization for aphantasia in the world, we surveyed 2,815 individuals across the mental imagery spectrum about their mental health. We asked about specific mental health condition/s, symptoms people experienced, whether they had sought clinical evaluation and diagnosis, and the perceived success of different types of mental healthcare sought.
The research revealed that aphantasia does not protect against mental health problems, including PTSD, for which intrusive imagery is currently considered a core diagnostic symptom. Although much less likely to experience intrusive visual imagery as part of a mental health condition, aphantasics report a similarly high proportion of intrusive emotions – e.g., the panicked feeling of reliving a traumatic event without the associated images.
Diagnostic Challenges: When Your Symptoms Don’t Match the Manual
This can have a significant impact on the process of getting a diagnosis. Importantly, we found that perceived success in therapy depended on whether the practitioner used visual imagery techniques in their protocol, with a 50% success rate for aphantasics if visual imagery was used. But there is a silver lining: this jumps to 72% if there are non-imagery techniques in the toolkit, which is comparable to the general therapy success rate reported by imagers.
Following the survey, we interviewed 22 aphantasics about their mental healthcare, to get a deeper understanding of the impact of aphantasia on these experiences. Aphantasics felt that discovering and learning about their aphantasia helped them understand themselves and empathize with others. Those who tried visual imagery techniques as part of their mental health treatment found that it blocked their path to recovery, especially if it was the only option offered. Those with complex mental health conditions, like PTSD, found getting a diagnosis most difficult because their flashbacks were predominantly emotional and non-visual.
Therapy Mismatch: Why Traditional Approaches May Fail 4% of Patients
Interestingly, the issues were reported by individuals from across Western Europe, North America, and Australia, suggesting there are widespread, systemic issues when it comes to the intersection of mental health and aphantasia.
Aphantasics from diverse backgrounds experienced three key problems when seeking mental healthcare:
- Being offered a “one-size-fits-all” approach to treatment, with some professionals offering few personalized alternatives
- Not quite fitting into a diagnostic category, meaning longer waits for diagnosis and treatment
- Feeling disbelieved and mistrusted by mental health professionals when they struggle to use guided imagery in treatment, mostly because there is a lot of evidence that says it works
Compounded with the fact that most practitioners and treatment-seekers are unaware that aphantasia exists, these pervasive issues are difficult to overcome – but solutions do exist.
Finding Alternative Paths to Healing: What Actually Works for Aphantasics
There has been a boom in personalized mental healthcare that brings individual differences to the forefront of treatment, and we have some tips for both practitioners and aphantasics. It is helpful to use techniques that focus on the here and now, rather than guided thinking to a different time or place. This includes physiological techniques like breathing exercises and progressive muscle relaxation, as well as externalizing thoughts by talking, drawing, or journaling.
The Power of Discovery: How Identifying Aphantasia Changes Lives
For many aphantasics, simply discovering that their experience has a name can be transformative. Understanding that they’re not “doing it wrong” when they can’t visualize during meditation or therapy exercises brings immense relief. This knowledge empowers them to advocate for alternative approaches and connect with others who share their experience.
Many report that learning about aphantasia helps them better understand their learning preferences, memory patterns, and emotional responses. This self-awareness can be crucial in developing personalized coping strategies that work with their natural cognitive style rather than against it.
Moving Forward: Creating Mental Healthcare That Works for Everyone
So, what does this mean for those with mental health challenges who experience the world a little differently? Well, perhaps it is no surprise that sometimes, help needs to be found and offered a little differently, too.
As awareness of aphantasia grows, mental health professionals have an opportunity to expand their toolkit to better serve this population. By recognizing that not all minds work the same way and being open to adapting evidence-based practices, therapists can provide more inclusive and effective care.
For those with aphantasia, knowing that alternative approaches exist and that their experience is valid can make all the difference in seeking and finding appropriate mental health support. By sharing these findings and continuing this conversation, we move toward a more nuanced understanding of the diverse ways humans experience their inner worlds—and how to support wellbeing across that spectrum.
