본 연구는 외상으로 인한 침투적 심상의 처리에 효과적으로 활용될 수 있는 심상 재각본(imagery rescripting; IR) 기법의 치료적 메커니즘과 적용 및 연구에 대해 구체적으로 살펴보았다. 심상 재각본은 외상적인 심상에 노출한 상태에서 심상의 내용을 수정하는 과정을 통해 정서적인 조절과 부적응적인 신념을 변화시킬 수 있게 한다. 이는 심상의 활용을 통한 정서적 정보 처리, 교정적 심상의 구성을 통한 무조건 자극(외상 경험) 평가 및 인지 도식의 수정이라는 기제를 통해 설명할 수 있다. IR은 PTSD의 치료에 주로 적용해 왔으나, 사회불안, 악몽, 우울장애, 성격장애 등 여러 장애에서 침투적 심상을 처리하기 위해 적용해 왔으며, 그 효과를 밝히는 연구가 다수 이루어져 왔다. IR은 심상을 활용하기 때문에 창의적인 적용이 가능하고, 재각본 단계를 통해 개입의 고통을 감소시킬 수 있다는 장점이 있다. IR을 장애 특성에 따라 개발하고 적용하는 것은, 심리치료에서 핵심적인 외상 심상을 다루는데 있어 유용한 도구가 될 것이다. 또한, 향후 IR 연구에 있어 IR을 활용한 치료적 개입의 근거 기반을 마련할 수 있는 치료 효과 및 메커니즘에 관한 연구를 제안하였다.
This study reviews the therapeutic mechanisms, applications and studies of imagery rescripting (IR) therapy. IR is a treatment that can be used effectively to deal with traumatic and intrusive images. IR treatment promotes the modification of the imagery while exposed to the traumatic imagery, which can control emotions and change maladaptive beliefs. This has been found to be possible through the mechanisms of emotional information processing through the use of images, evaluation of unconditioned stimulus (trauma experience), and modification of cognitive schema. IR has been mainly applied to the treatment of PTSD, but has been applied to deal with intrusive images in various disorders. Using images can be creatively applied and can reduce the pain of interventions through rescripting phases. Therefore, developing and applying IR according to the disability characteristics may be a useful tool for dealing with traumatic imagery. And this article also suggests future researches on IR intervention.
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