Can positive mental imagery help high worriers stop worrying? An experimental test

Replacing worry with images of positive outcomes reduces negative intrusions, worry and trait anxiety in GAD. However, the possibility that replacing worry with positive imagery, unrelated to worry content, can terminate a stream of worry has not been tested. High worriers (N = 201) were randomly allocated to receive training to replace worry with an unrelated positive image (active condition) or a control condition. Participants completed the stop worry task (SWT) in which they were instructed to engage in worry, and then stop worrying. Participants in the active condition were asked to bring a positive image to mind if they began to worry during the stop worry phase. We conducted exploratory comparisons of two modes of delivery of each condition: (i) non-guided (no experimenter guidance), (ii) with experimenter guidance (via videocall). Participants in the active condition were better able to stop worrying overall during the SWT than those in the control condition, with stronger effects within experimenter-facilitated condition compared to the non-guided condition. Participants in the active condition were also better at initially shifting away from worry and sustaining this shift than the control condition - irrespective of whether they received experimenter guidance. Within the experimenter-guided condition, the active condition sustained longer streams of non-negative thoughts than the control condition. Perceived ability to stop worrying was better in the active versus control condition. Hence, replacing worry with an unrelated positive image helps high worriers to stop worrying. Our preliminary findings suggest that this approach holds promise as a tool to reduce worry.