The key finding
A 2024 review of 15 experimental studies found that mental imagery-based interventions—specifically imaginal extinction and imagery rescripting—are effective at reducing conditioned fear responses in healthy individuals. The analysis, which examined 13 published articles following PRISMA guidelines, revealed that imagining feared situations appears to produce comparable effects to standard real-world exposure therapy in reducing learned fear. Researchers searched four major databases (PubMed, Scopus, Science Direct, and Web of Science) to identify all studies combining imagery techniques with fear conditioning paradigms, providing the first comprehensive look at this emerging intervention approach.
What the study looked like
This was a systematic review rather than a single experiment, meaning researchers compiled and analyzed findings from multiple independent studies. The review focused exclusively on studies involving healthy participants (not clinical populations) who underwent fear conditioning—a laboratory procedure where people learn to associate neutral stimuli with something unpleasant. All included studies had to use differential fear conditioning, meaning they compared responses to a stimulus paired with something aversive versus a neutral stimulus. The interventions examined fell into two categories: imaginal extinction (repeatedly imagining the feared stimulus without the negative outcome) and imagery rescripting (mentally rewriting the feared scenario to have a different, less threatening outcome). The 15 studies varied in their specific protocols, participant numbers, and measurement approaches, but all examined whether these mental imagery techniques could reduce the learned fear responses.
Why researchers think this happened
The paper suggests that mental imagery may engage similar neural pathways as real-world exposure, allowing the brain to update fear memories without requiring direct confrontation with feared situations. When people vividly imagine encountering a feared stimulus without experiencing negative consequences, their brain may process this similarly to actual safe encounters, gradually weakening the fear association. This builds on established theories of fear extinction, which propose that new safety learning competes with and eventually overshadows the original fear memory. The researchers note that imagery-based approaches might be particularly useful because they can be conducted anywhere, don’t require physical presence of feared objects, and may offer more control over the exposure experience. The review connects these findings to broader work on mental imagery’s role in emotional processing and memory reconsolidation.
How to read this carefully
Several important limitations deserve attention. First, these studies involved healthy volunteers learning artificial fears in laboratories, not people with actual phobias or anxiety disorders experiencing real-world fears. Whether these findings translate to clinical populations remains uncertain. Second, the review authors explicitly note that relatively few studies have been conducted overall, meaning we need more replication before drawing firm conclusions. Third, the lack of standardized intervention protocols across studies makes direct comparisons difficult—different researchers used varying imagery instructions, session lengths, and outcome measures. The review also points out that we don’t yet fully understand the underlying mechanisms, so we’re still learning why these techniques work when they do. Finally, “comparable effects” to standard extinction doesn’t necessarily mean imagery is superior; it may simply be an alternative route to similar outcomes.
What this means for everyday life
This research suggests that mental rehearsal might play a meaningful role in how we process and reduce fears, though it’s premature to replace established therapeutic approaches. For someone working through anxieties with a mental health professional, these findings support the potential value of guided imagery exercises as part of a comprehensive treatment plan. The portability of imagery-based techniques is noteworthy—if mental rehearsal can genuinely help update fear memories, it might complement traditional exposure therapy, especially for situations that are difficult to recreate safely in real life. However, given that this research involved laboratory-induced fears rather than real phobias, readers should view imagery techniques as potentially promising tools rather than standalone solutions. If you’re dealing with significant fears or anxiety, these findings underscore the importance of working with qualified professionals who can determine which evidence-based approaches, possibly including imagery work, might be appropriate for your specific situation.