Brenda Chiang: Intrusive Images in OCD—Is a picture worse than a thousand words?

In brief

Imagery can be a powerful healing agent. Meditation can guide people to think about images that evoke positive feelings, achieve mental stillness, and release tension in the body.

Research supports the therapeutic use of guided imagery, which is available outside of clinical environments, through fitness, yoga and relaxation programs. However, when horrific shameful images show up unannounced, unwanted, and repeatedly over the course of a day they are anything but healing. Such intrusive images are an important and under researched characteristic of Obsessive Compulsive Disorder (OCD).

Brenda Chiang

Brenda Chiang (pictured right) is a student in the University of Waterloo’s leading scientist practitioner Ph.D. program in Clinical Psychology. Her research is focusing on an under‐researched topic: the role that image‐based obsessions have on OCD.

In our latest Student Spotlight, EENet’s Pam Gillett profiles Brenda’s research.

Read it below or download the PDF.

Student Spotlights are brief profiles of up-and-coming student researchers.

What you need to know

Brenda Chiang is a student in the University of Waterloo’s leading scientist practitioner Ph.D. program in Clinical Psychology. Her research is focusing on an under-researched topic: the role that image-based obsessions have on Obsessive Compulsive Disorder (OCD). She hopes her work will lead to a more thorough assessment of intrusive images in OCD and a better menu of image-based treatment options to help reduce their frequency and impact.   

About Brenda

Brenda completed her Honours Bachelor of Health Sciences degree at McMaster University, graduating with distinction on the Dean’s honour list. She completed an M.A. in Psychology supported by a Canadian Institutes for Health Research (CIHR) Canada Graduate Scholarship and an Ontario Graduate Scholarship Master’s Award.

She is currently pursuing a Ph.D. in Clinical Psychology under the supervision of Dr. Christine Purdon at the University of Waterloo, supported by a Social Sciences and Humanities Research Council (SSHRC) Canada Graduate Scholarship.  Inspired to fill a knowledge gap, Brenda is focusing on the role that image-based obsessions have on Obsessive Compulsive Disorder (OCD).

What is Brenda’s Research About?

Picture yourself on your favourite beach with the sun shining brightly in a vivid blue sky, warming your skin. Waves are lapping at your feet…

Imagery can be a powerful healing agent. Meditation can guide people to think about images that evoke positive feelings, achieve mental stillness, and release tension in the body. Research supports the therapeutic use of guided imagery, which is available outside of clinical environments, through fitness, yoga and relaxation programs. However, when horrific shameful images show up unannounced, unwanted, and repeatedly over the course of a day they are anything but healing. Such intrusive images are an important and under researched characteristic of Obsessive Compulsive Disorder (OCD).

OCD is a psychological disorder characterized by obsessions – persistent and anxiety-provoking intrusive ideas, thoughts, impulses or images. The individual tries to get rid of these obsessions by repeatedly performing compulsive rituals that provide a temporary relief. Obsessions can appear in three forms: word-based suggestions, behavioural impulses or urges, and images or mental pictures. However, while the diagnostic criteria for OCD in the Diagnostic and Statistical Manual of Mental Disorders (DSM) have long differentiated between these three forms, existing research has not distinguished between the different forms of obsessions. 

“Recent research suggests that images and verbal suggestions differ in important ways,” says Chiang. “First, visual images create a more powerful impact on emotions; they are emotional amplifiers affecting both positive and negative responses. Second, images are uniquely linked to behaviour patterns; if you visualize an action, the corresponding motor areas of your brain are activated, just as if the body is actually performing the action.  Visualizations prepare our bodies to act. Imagining an event also leads us to believe that the imagined event is more likely to occur. Lastly, research has shown that intrusive verbal thoughts and intrusive images can be manipulated independently of each other. A person exposed to something that provokes a strong emotional reaction may experience an increase in intrusive images without an increase in verbal thoughts.”  

Brenda is fascinated with this area of research. For her, it represents a huge knowledge gap.

“I want to know more about the relationship between these powerful intrusive images and compulsions. What are the characteristics of these images and how do they differ from word-based thoughts? Once we know more about the impact of intrusive images on people with OCD, we can improve clinical care and outcomes for patients. Right now, we know that therapy results in a 50 to 60% success rate for OCD patients. I find myself asking, what are we missing here? How can we do better?” 

What is next for Brenda?

Brenda plans to continue her research on intrusive images in OCD, noting there is still much to learn. Beyond her published articles and work in review, she is busy sharing her findings at international conferences. She hopes her research inspires others to contribute new knowledge in the area. Looking to the future, Brenda believes her research will make her a better clinician. And, once she is working as a clinician, she will share her experiences in the field to inspire new research she hopes will lead to better clinical interventions and improved outcomes for her clients. Her passion is palpable.

For more information about Brenda’s study, please contact her at b2chiang [at] uwaterloo [dot] ca

Author: Pam Gillett
Date: May 28, 2014