Imagination-Based Mental Imagery Linked to PTSD 'Hotspots'

Strategic Insights -

A recent study published in the Behavioural and Cognitive Psychotherapy journal has shed light on the role of imagination-based mental imagery in post-traumatic stress disorder (PTSD). Researchers from the Grenfell Health and Wellbeing Service undertook a data-only study of cognitive therapy for PTSD 'hotspot' charts used by clinicians after the Grenfell fire disaster. The study found that 81% of individuals reported an imagination-based 'hotspot', with 38% of all hotspots containing an imagination-based component. The most common imagination-based mental image was one where the person watching the fire imagined themselves in the 'shoes' of a tower resident.

Key Takeaways:

  • 81% of individuals reported an imagination-based 'hotspot', indicating a strong link between imagination-based mental imagery and PTSD.
  • 38% of all hotspots contained an imagination-based component, suggesting that imagination-based mental imagery plays a significant role in PTSD 'hotspots'.
  • The most common imagination-based mental image was one where the person watching the fire imagined themselves in the 'shoes' of a tower resident.
  • Imagination-based mental imagery appears to be linked to the 'hotspots' of a high proportion of people experiencing PTSD, emphasizing the importance of enquiring about mental imagery during PTSD treatment.
  • The study highlights the importance of considering imagination-based mental imagery in the treatment of PTSD, particularly in relation to the updating of 'hotspots'.

Statistics:

  • 81% of individuals reported an imagination-based 'hotspot' (=21 of 26 charts).
  • 38% of all hotspots (=159) contained an imagination-based component.
  • 21 individuals reported an imagination-based 'hotspot'.

Sources:

  • The power of imagery: examining the prevalence of imagination-based hotspots after a traumatic event in the Grenfell Health and Wellbeing Service. Behavioural and Cognitive Psychotherapy, 2025:1-12.
  • Cambridge University Press. Behavioural and Cognitive Psychotherapy. journals.cambridge.org/action/displayJournal?jid=BCP
  • Grenfell Health and Wellbeing Service. Central and North West London NHS Trust, London, UK.
  • NewsRx. Data on Post-Traumatic Stress Disorders Described by Claire Gibson et al (The power of imagery: examining the prevalence of imagination-based hotspots after a traumatic event in the Grenfell Health and Wellbeing Service). Mental Health Weekly Digest. November 3, 2025; p 108.