I was in a consultation group recently and we were discussing the concept of Aphantasia. This wasn’t something I recalled discussing in any of my schooling to become a therapist, and it wasn’t something I have heard other therapists discuss. Aphantasia is “... when your brain doesn’t form or use mental images as part of your thinking or imagination” (Cleveland Clinic, n.d.).  This is not considered a medical concern, mental health diagnosis or a disability. A recent New Yorker magazine article explains, “There [is] evidently a spectrum of mental imagery, with aphantasia on one end and extraordinarily vivid imagery on the other and most people’s experience somewhere in between” (MacFarquhar,2025).  People who do not have the ability to create mental images might also struggle to imagine or notice other sensory information as a mental picture/experience in their bodies. Some people are born with this and it can sometimes happen because a person has dealt with a significant injury, illness, or mental health condition. We don’t know exactly how common Aphantasia is at this point, and the statistics on this vary widely (Feiyang et all, 2024). Some studies show possible links between Aphantasia with mental health concerns such as anxiety and depression, however, more research to define this. There is some data that supports connections to neurodivergence but, again, we need more research to understand how they may be related. (Cleveland Clinic, n.d)

Since Aphantasia exists on a spectrum, this means some people also exist on the opposite end which is called Hyperphantasia. People who have hyperphantasia are able to create very vivid images in their minds and research shows that they may see past images and memories as clearly as looking at something in a present moment.  Emotions and other sensory experiences (how someone felt, smelled, tasted, heard, things in that memory or past situation) are likely to be recalled very clearly.  It is also likely that people who experience hyperphantasia can recall memories as mini movies that play in their minds as they recall these past experiences. This can be helpful in a variety of ways. Some examples of helpful situations might include being able to remember things very clearly in one’s mind when taking a test in school, remembering details about events that help people make connections for learning as they grow older, bonding with loved ones in a unique way because the visuals or multiple senses are experienced in this deep way, or literally being able to picture a future where they/we can create change for themselves/ourselves when needed. It also has the possibility to impact people negatively, however.  People with hyperphantasia are likely to take in distressing, disturbing, or violent images (ex. Horror movies or even the news) in a way that they ‘can’t shake’ easily later.  The upsetting imagery (and associated sensations) can potentially ‘pop up’ or replay for them long into the future. (MacFarquhar, 2025)

Most people are believed to fall more into a ‘middle ground’ on this spectrum. It is more common for people to be able to create/recall some level of visual (or other sensations) imagery in their minds and bodies but don’t have a complete absence or all visual experiences like the versions described above.  Most of us may not even realize there is a different version of what simply happens in our own minds—-we just know what feels ‘normal’ to us.  

In the context of therapy, therapists often ask body-based questions such as, “What do you notice happening in your body?” or ask questions that require our clients to identify things they remember from the past.  Asking about these things gives therapists a lot of information about patterns, struggles, strengths, self-awareness, and sometimes it naturally taps into a client’s capacity to envision changes they may want to make in their lives.  If a client cannot bring up any visual or sensory related images in their own mind, this is important for us to figure out. This would likely require us therapists to get creative and try out some other ways to help clients explore their past, understand their emotions, or develop other strategies to explore trauma.  We may have to become ‘emotional detectives’ to help clients ‘picture’ their emotions, identify new possibilities, or find ways to shift treatment going forward when there is no ‘internal picture’ available.  Therapists need to be aware that clients may need this additional support and be ready to pivot if this comes up. 

 If you’re interested in finding out where you land with the ability to create or recall visual images, you can check out this link: Vividness of Visual Imagery Questionnaire

The VVIQ includes 16 scenarios with what is known as a Likert scale (1-5: 5 as the most vivid visual image someone can create mentally; 1 as no visual image). 

So if you’re ever in a session, and your therapist asks you to ‘picture’ something, you’ll have a stronger understanding of how this works for you.  If this is difficult for you to do, make sure to share this with your therapist.  If your therapist isn’t quite sure what you mean, feel free to direct them to the link above! It may make for an interesting conversation and greater understanding that will help both of you work even more effectively towards your therapy goals.

References:

Cleveland Clinic. (n.d.) https://my.clevelandclinic.org/health/symptoms/25222-aphantasia

Crowe, C.. (2024,May 7). Five things I’ve learned about aphantasia as a therapist. Dig a Little Deeper: Psychotherapy & Counselling. https://digalittledeeper.ca/five-things-ive-learned-about-aphantasia-as-a-therapist/

Feiyang, J., Shen-Mou, H., & Yu, L. (2024, Sept. 24).  “A Systematic Review of Aphantasia: Concept, Measurement, Neural Basis, and Theory Development”. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC11437436/

MacFarquhar, L. (2025, Oct. 27). “Some People Can’t See Mental Images. The Consequences Are Profound”.The New Yorker. https://www.newyorker.com/magazine/2025/11/03/some-people-cant-see-mental-images-the-consequences-are-profound *Published in the print edition of the November 3, 2025, issue, with the headline “Phantasia.”