Does valence of autobiographical memories change during imagery rescripting for anxiety?

Imagery rescripting (IR) is a therapeutic technique aimed at changing the meaning and emotional impact of negative autobiographical memories, thereby reducing clinical symptoms. During IR, patients rescript a negative autobiographical memory through imagination, addressing unmet needs from the time of the event to create a more positive narrative. However, it is unknown if changing memory valence is essential for symptom improvement. A total of 277 individuals high in pathological anxiety participated in one session of IR. Detailed autobiographical memory narratives were collected pre- and postintervention. Memory valence was coded as positive, negative, or neutral. Consistent with our hypothesis, positive emotions increased, and negative emotions decreased during the IR session. In addition, the number of negative and neutral memory details decreased following IR. Contrary to our hypothesis, the number of positive memory details did not change, nor did the proportion of negative, positive, or neutral details. Changes in total and negative memory details were mildly associated with symptom changes. New beliefs about the memory were formed in 94.6% of the participants, and these new beliefs were rated as low in distress after IR session. Rather than changing memory valence, we propose that the potential mechanism of IR involves changing how these memories are related to patients’ self-schemas, suggesting that IR works by “unhooking” the memory from its negative personal meaning. Further studies should focus on updating self-relevant beliefs related to autobiographical memories as a potentially stronger mechanism than changes in the nature of memory valence per se.