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The role of imagination in the disease process: pre-Cartesian histroy (the role of imagination in the disease process).

Ancient and Renaissance physicians implicated the soul's imaginative faculty in the genesis and remission of disease. The theory stated that images of objects of desire or aversion aroused emotions, which in turn set up humoral imbalances, disturbing digestion and other vital functions, culminating in various forms of pathology. This concept explained the therapeutic efficacy of 'placebos' in forms such as spells, charms and talismans. The theory merits close attention by contemporary physicians and researchers.

History of Medicine

Fact and fantasy: the roles of accuracy and variability in confusing imaginations with perceptual experiences.

In Experiment 1, pictures were presented to subjects two, five, or eight times, and subjects were asked to imagine each pciture two, five, or eight times. Subsequently, subjects estimated the number of times each picture had been presented. Their estimates of the frequency of these external events were influenced by imagination trials; this effect was greater for good imagers than for poor imagers. Experiment 2 involved a similar design in which subjects were asked either to imagine the same referent for a word or to imagine a different referent for a word on successive imagination trials. Consistency (same referent) did not increase the influence of imaginations on immediate judgments of external frequency. Thus, the results of Experiment 1 were attributed to the greater accuracy (as opposed to greater consistency) of good imagers' internal generations of the stimuli. Furthermore, variation (imagining different referents), like greater accuracy, increased the effects of imagination trials on immediate but not on delayed judgments of frequency. Possible mechanisms underlying these effects are discussed. In general, the two studies show that qualitative characteristics of completely covert generations influence their impact on estimates of the frequency of external events.

Form Perception

[The objectivation of auditory and optical imaginations in the electroencephalogramm (author's transl)].

This study describes two new DC-potentials, which are related to auditory or optical imagination. The "auditory imagination potential" (AIP) is a negative DC-shift on the vertex lasting during the whole period of an auditory imagination. During an optical imagination there is a similar negative DC-shift in the ocipital region only. These "imagination potentials" can be already recognized in the "raw-EEG" by means of a special experimental technique. The magnitude of amplitudes correlates with the degree of concentration of the subject. In the case of intense imaginations potentials with amplitudes up to 20 muV and a duration of some seconds are recorded. The comparison between the vertex and the occipital lead permits the examination of the alternate occurence of auditory and optical conscious processes. The "imagination potentials" (AIP and OIP) are not related to any external stimulation or motor reaction and represent modality-specific EEG-correlates of cognitive, conscious processes (memory and imagination). Their significance for the "objective audiometry" is discussed.

Acoustics

[The effect of alpha- and beta-ecdysone on differentiation of imaginal disks of Drosophila melanogaster cultivated in vitro].

The effect of alpha- and beta-ecdysone was studied upon differentiation of eye and leg imaginal discs of Drosophila cultivated together with neural ganglia in the medium C-39. In the medium without hormone, eye and leg imaginal discs from larvae of the early 3rd instar are not capable of differentiation. In these conditions, eye imaginal discs from larvae of the late 3rd instar become pigmented in 5 weeks and leg imaginal discs form sometimes segmented limbs on the 4th week of cultivation. In the medium with alpha- and beta-ecdysone, eye and leg imaginal discs from larvae of the early 3rd instar reveal only initial stages of differentiation. The effect of beta-ecdysone concentration was studied upon differentiation of leg and eye imaginal discs from larvae of the late 3rd instar. On decrease of beta-ecdysone concentration from 0.05 down to 0.005 mug/ml, initial stages of differentiation of leg imaginal discs proceed at a slower rate but, then, more complete differentiation with the formation of chitin and neuromuscular tissue is observed. In eye imaginal discs alpha-ecdysone at a concentration of 0.5 mug/ml and beta-ecdysone at a concentration of 0.005-0.5 mug/ml induce the pigment accumulation already at the 1st week of cultivation and beta-ecdysone at a concentration of 5 mug/ml fully inhibits the formation and accumulation of pigment.

Drosophila melanogaster

Imaginal response events in systematic desensitization: a pilot study.

The primary focus of systematic desensitization (SD) is physiological responsivity in the presence of a conditioned aversive stimulus. However, SD also effects changes in motorapproach behavior and self-report. This study explores the possibility that SD directly affects the motor response system by way of conditioning covert approach responses in the presence of the imaginal aversive stimulus. Two independent variables were investigated: the content of instructions and actual covert motor responses during SD. Twenty-four subjects were classified as high- or low-responders on the basis of electromyographic responsiveness to instructions to imagine movement. Half the high- and half the low-responders were given a series of instructions to imagine-motor-approach behavior toward snakes. The remaining subjects received instructions to imagine only the snakes themselves with no reference to motor response. Imaginal scenes of 30-sec duration were alternated with relaxation periods of the same length. A significant difference was found between the posttreatment scores of high- and low-responders on performance measures, the high-responders performing better. The difference between the two instruction groups was not statistically significant. Self-report data suggested some subjects given instructions to imagine only snakes actually imagined themselves approaching snakes. Therefore, data were re-analyzed after instruction groups were reconstructed accordingly. A statistically significant difference was found on both factors. Continued investigation may further support imagery as covert behavior, open to empirical study.

Behavior Therapy

On the medical history of the doctrine of imagination.

In the early modern era the notion of imagination was made responsible for phenomena which were later explained in terms of embryology, genetics, psychology, bacteriology or other scientific disciplines. Images, often seated in the upper abdomen (hypochondriac region) or the womb (hysteria), were regarded as powerful influences on material reality. In the course of the seventeenth and eighteenth centuries the hypochondriac forms of imagination became mere whims and spleens, but they kept much of their original potency in respect of the uterus, accounting for monstrosities and the shaping of human offspring. The hysterical conversion of imagination into somatic phenomena has never been questioned. Since the two World Wars the realm of imagination has again expanded beyond the uterus and the older disease-concepts. In the last 10-20 years images seem to have regained some of their original creative force.

Congenital Abnormalities

Explaining imaginal inference by operations in a propositional format.

Solving problems by imaginal inference often seems inefficient for an organism that is manipulating propositions. One explanation for the apparent inefficiency is that the problems are being solved not in propositional format by operations in an analogue format. Imaginal inference might then be the most efficient method compatible with the limitations inherent in the analogue format. In the present paper an alternative rationale is given for the use of imaginal inference by explaining how the processes involved in mental problem solving are related to those in perception: it is suggested that the mechanisms used in problem solving have evolved from a perceptual system in which hypotheses about events in the sensory field are generated from an internal representation of the world. This thesis denies that perception is passive and suggests that originally for perception. Acceptance of the thesis implies that the capabilities of a propositional format in problem solving would be limited. This limitation could account for the apparently inefficient use of that format in imaginal inference.

Biological Evolution

Patterns of protein synthesis in imaginal discs of Drosophila melanogaster.

Patterns of polypeptide synthesis in wing, leg and eye-antenna imaginal discs and in whole larvae of wild-type and and mutant Drosophila melanogaster have been examined using two-dimensional polyacrylamide gel electrophoresis and autoradiography. After 2 hr of labeling with 35S during the third larval instar, the synthesis of more than 318 polypeptides has been detected in imaginal discs. Of these, 268 are present in similar amounts in all three disc types. The remaining polypeptides detected in the three imaginal disc types fall into two categories: those unique to a particular disc type, and those specific for a particular pair of disc types. These results are discussed in relation to the spectrum of gene expression in imaginal discs.

Animals

Functional representations common to visual perception and imagination.

Subjects determined whether probe dots appearing in component squares of a 5 X 5 grid fell on a figure that, depending on the condition, was (a) visually presented as a pattern of darkened squares, (b) only remembered from a preceding presentation of such a pattern, or (c) imaginally generated from a verbal code. The speed and accuracy of the responses to the probes as well as the functional dependencies of the reaction times on structural variables were essentially the same whether the figural pattern was imagined, remembered, or actually seen. Reaction times averaged between 400 and 500 msec and were consistently faster (a) for on-figure than for off-figure responses, (b) for simpler figures that had fewer squares, (c) for off-figure probes that were more distant from the figure, and (d) for on-figure probes that consisted either of more dots on the figure or of a dot at the intersection of a horizontal and a vertical bar. The reults were consistent with a model in which a subject's perceptual or imaginal representations of these forms contain barlike units that respond independently to the probes.

Discrimination, Psychological

Accuracy of extrapolating a pointer into perceived and imagined space.

The authors investigated the ability of people to extrapolate lines in tridimensional space: an experimenter pointed at variously located targets, and the subjects tried to identify them. In an experimental condition, the subjects sat with their backs turned to the target objects, which they had previously inspected during a brief learning period; in two control conditions the targets were in front of the subjects and clearly visible. Overall error (difference in degrees of pointer angle between correct and judged targets) was no worse for objects imagined behind the head than for visible targets, about 2.7 degrees (root-mean-square) in both cases. Variable error was 29% greater for the imagined objects, but constant error was greater on the matched control targets. Some qualitative differences, in constant error patterns, were also found. With due allowance for these differences, the results strongly indicate that imagined space is functionally continuous with perceived space in the representational system.

Cognition

[Effect of actinomycin D on development of the ocular imaginal disks of drosophila].

The actinomycin D treated discs were transplanted into imago or larvae ready for pupation to determine the period of synthesis of mRNA's engaged in eye development during the development of eye imaginal discs. When transplanting 24, 48 and 72 hrs eye imaginal discs into larvae ready for pupation, no inhibition of either eye pigment synthesis, or cuticular structure development by actinomycin D was found. When transplanting actinomycin D treated 72 hrs and prepupal eye imaginal discs into imago, the inhibition of eye pigment synthesis was found only in 72 hrs discs.

Animals

The desensitization derby: in vivo down the backstretch, imaginal at the wire?

Recontacted 17 Ss who had undergone successful imaginal or in vivo desensitization for snake phobia and had been evaluated pre- and posttreatment for a 9-month follow-up. Main findings were that: (a) overall treatment gains were maintained through the follow-up period; (b) differential gains in favor of the in vivo technique on one behavioral and two self-report snake-specific criteria were dissipated; and (c) imaginal Ss registered a reduction in self-rated fear during an approach task from posttesting to follow-up. Results are discussed in relation to the notion of cognitive rehearsal as a means of self-reinforcing treatment gains.

Adult

Imaginative play training and perceptual-motor interventions with emotionally-disturbed hospitalized children.

This study evaluates fantasy play training and perceptual-motor intervention methods which temporarily increased the imaginative behavior of severely emotionally-disturbed, hospitalized children. Increases in imaginative behavior were accompanied by positive changes in body image and by affective and social gains. Implications for further development and implementation of these methods are discussed.

Adolescent

Differential effects of television programming on preschoolers' cognition, imagination, and social play.

Three groups of preschoolers were exposed over two weeks to daily programs of Misterogers Neighborhood, Sesame Street, or a control series of nature and animal films. Specific hypotheses about the effects of program format upon recall of content and upon subsequent behavior were tested. The apparently more slow-paced format and other characteristics of Misterogers were found to yield positive changes, especially for less imaginative children, in imaginative play, affect, concentration, and social interaction.

Attention

Imaginal flooding and exposure to real phobic situations: treatment outcome with agoraphobic patients.

Each of thirty-six female agoraphobic out-patients were treated by one of three methods: 8 sessions of imaginal flooding followed by 8 sessions of practice in the real situation; 16 sessions of combined flooding and practice; or 16 sessions of practice alone. Three therapists treated equal numbers of patients in each group, and there was some evidence that patients' response varied according to the therapist seen, irrespective of treatment group. There were no significant differences between treatment groups after 8 sessions, 16 sessions or on six-month follow-up. It is concluded that there are no long-term differences between the effects of treatments involving exposure to either imaginal or real phobic situations or to a combination of both, provided that patients are encouraged to practise between sessions.

Agoraphobia

Imaginal flooding and exposure to real phobic situations: changes during treatment.

This paper reports the results of measures taken during treatment in the study of imaginal flooding and exposure to real phobic situations previously described by Mathews, Johnston, Lancashire, Munby, Shaw and Gelder (1976). On weekly measures of change of similar reduction in phobic behaviour in all treatments was found, confirming the previous findings. Differences in therapist effectiveness were also confirmed. On measures of the immediate effects of treatment, exposure to the phobic situation had consistent positive effects, imaginal flooding had little or no detectable effect. It is proposed that the treatments studied differ in their immediate effects on phobic behaviour but also have the common effect of facilitating counterphobic behaviour outside the treatment situation, and that this is the main agent of therapeutic change.

Anxiety

The effects of mood upon imaginal thought.t.

The effects of mood upon imaginal thought were explored with a highly trained undergraduate female hypnotic subject. She was hypnotically programmed to experience free-floating anxiety or pleasure in varying degrees just before the exposure of combinations of three Blacky Pictures, and to produce dreamlike imagery in response to the Blacky stimuli while under sway of the mood. Data from 98 dream trials, separated by amnesia, indicated that the affective states clearly influenced imaginal processes. Blind ratings by a psychoanalyst showed anxiety moods to be more closely associated with primary-process features characteristic of nocturnal dreams, whereas pleasure had a relatively higher incidence of daydreamlike ratings. Empirical analysis of themes yielded significant relationships of anxiety to physical injury to the self and verbal aggression toward others; pleasure was associated with circular movements and overt sex themes.

Adult

(Re)imagining the Future of Genetic Counseling: A Reflexive Qualitative Analysis of Sociopolitical Power, Cultural Safety, Systemic Racism, and Comparative Practice in the United Kingdom, Aotearoa New Zealand and, Australia.

Genetic counseling is undergoing a rapid transformation as genomic medicine becomes embedded within mainstream healthcare systems. At the same time, the profession is being challenged to respond to systemic racism, colonial legacies, technological change, and evolving expectations regarding equity and justice. Historically, genetic counseling emerged within twentieth-century medical genetics and was influenced by political, social, scientific, and medical forces that included eugenic ideology, values, and practices. The profession has since evolved substantially toward psychosocial, patient-centered, and non-directive models of care. Contemporary debates regarding "newgenics" or "neugenics" further demonstrate how concerns regarding equity, reproductive ethics, disability, and genomic stratification continue to shape genomic healthcare discourse. This qualitative reflexive practice paper explores how systemic racism, colonial legacy, cultural safety and structural power shape genetic counseling practice in the United Kingdom (UK), Aotearoa New Zealand and Australia, and how these forces continue to reshape the profession's future identity. A reflexive, narrative, and comparative qualitative approach was employed, grounded in the authors' lived professional experiences across UK and Australasian contexts and informed by purposively selected policy, professional and scholarly literature relating to cultural safety, dignity, anti-racism, and Human Rights-Based Decision-Making. Through iterative reflexive dialogue, comparative analysis, and thematic synthesis, four interrelated themes were developed examining sociopolitical context, systemic racism, cultural safety and technologization within contemporary genetic counseling practice. Comparative analysis identified substantial differences in how culturally responsive practice is conceptualized and operationalized across settings. In Aotearoa, cultural safety is strongly shaped by Te Tiriti o Waitangi, bicultural accountability, and Māori sovereignty frameworks. In Australia, culturally safer genomic care has increasingly developed through Indigenous-led initiatives and workforce reform, including the Australian Alliance for Indigenous Genomics (ALIGN). In contrast, UK practice remains largely situated within equality, diversity, and inclusion (EDI) frameworks that may insufficiently address systemic racism and structural power within increasingly diverse populations. Reflexive clinical examples demonstrated how inequities may emerge through undocumented patient values, standardized pathways, assumptions regarding autonomy, and misinterpretation of culturally specific communication styles. Re-imagining the future of genetic counseling requires more than just technological advancement. It requires reflexive engagement with dignity, inequity, and the sociopolitical realities of the populations served. These insights re-imagine a culturally grounded, socially responsive future for genetic counseling in an era shaped by genomic mainstreaming, digital transformation, artificial intelligence and workforce reform and one in which the profession remains ethically anchored, relationally attuned, and committed to justice-oriented practice.

Humans