Unseen Minds: A Therapist's Guide to Multisensory Aphantasia and Invisible Cognitive Differences

Therapy with aphantasia and SDAM can be problematic. As you noted, you have PTSD flashbacks, but they aren't visual, and many therapists don't understand that. Many techniques require visualization and/or reliving past events, and we can't do that. Some diagnostic criteria assume visualization and can point to the wrong diagnosis if you don't have it. As for what SDAM is, the simple explanation is the inability to relive past events from a first-person point of view. That is the lack of episodic memory. Semantic memory (facts) can be good or bad. Check out the FAQ of this sub. It is quite good. Back to therapy, one suggestion is to find a therapist that works with neurodivergences. They tend to have more tools available to them and are more open to different internal experiences. To explain aphantasia, I would start with this guide from the Aphantasia Network for just basic information. https://aphantasia.com/guide/ Unseen Minds: A Therapist's Guide to Multisensory Aphantasia and Invisible Cognitive Differences– by Sassy Smith is an excellent guide for therapists. She does address SDAM as well. I actually wish all therapists would read it. It is on Amazon: https://a.co/d/0472wf0F Since you have SDAM as well (maybe a quarter to half of us do), then that is problematic with many therapies as well, as documented in Unseen Minds. Body based therapy can work when your mind doesn’t remember: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, although some of the techniques may still need to be modified to work with other cognitive differences. https://a.co/d/0a3skjyh In 2024 Dr. Zeman did a review of the first decade of research. It has lots of citations if your therapist wants to dig in. https://www.cell.com/trends/cognitive-sciences/fulltext/S1364-6613(24)00034-2 Here is an update of that review: A decade of aphantasia research – and still going! - ScienceDirect This paper specifically on therapy and aphantasia was published after Dr. Zeman's review article. It has specific information about some of what works and what doesn't. https://online.ucpress.edu/collabra/article/10/1/127416/204719 If you are more for video than scientific papers, here is an interview with 2 of the researchers on that paper. It is very informative: mental-health-day And here are a couple articles they wrote for the Aphantasia Network: https://aphantasia.com/article/mental-imagery-ptsd-neurodiversity-treatment/ https://aphantasia.com/article/science/imagery-in-mental-healthcare/ In other research, Dr. Merlin Monzel looked at aphantasia and anxiety treatment via imaginal exposure. Here is an interview with him on it. https://aphantasia.com/video/aphantasia-and-anxiety-treatment-rethinking-therapeutic-approaches/ And the paper: https://onlinelibrary.wiley.com/doi/full/10.1111/psyp.14756

Just 2 days ago someone posted here about successfully using EDMR as an aphant. I'm guessing that your therapist knows about your aphantasia and is attempting to adjust. I do have some suggestions to help you and your therapist work together. If they don't really get aphantasia, I would start with this guide from the Aphantasia Network for just basic information. https://aphantasia.com/guide/ Unseen Minds: A Therapist's Guide to Multisensory Aphantasia and Invisible Cognitive Differences– by Sassy Smith is an excellent guide for therapists. I actually wish all therapists would read it. It is on Amazon: https://a.co/d/0472wf0F If you happen to have SDAM as well (maybe a quarter to half of us do), then that is problematic with many therapies as well, as documented in Unseen Minds. Body based therapy can work when your mind doesn’t remember: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, although some of the techniques may still need to be modified to work with other cognitive differences. https://a.co/d/0a3skjyh In 2024 Dr. Zeman did a review of the first decade of research. It has lots of citations if your therapist wants to dig in. https://www.cell.com/trends/cognitive-sciences/fulltext/S1364-6613(24)00034-2 Here is an update of that review: A decade of aphantasia research – and still going! - ScienceDirect This paper specifically on therapy and aphantasia was published after Dr. Zeman's review article. It has specific information about some of what works and what doesn't. https://online.ucpress.edu/collabra/article/10/1/127416/204719 If you are more for video than scientific papers, here is an interview with 2 of the researchers on that paper. It is very informative: mental-health-day And here are a couple articles they wrote for the Aphantasia Network: https://aphantasia.com/article/mental-imagery-ptsd-neurodiversity-treatment/ https://aphantasia.com/article/science/imagery-in-mental-healthcare/ In other research, Dr. Merlin Monzel looked at aphantasia and anxiety treatment via imaginal exposure. Here is an interview with him on it. https://aphantasia.com/video/aphantasia-and-anxiety-treatment-rethinking-therapeutic-approaches/ And the paper: https://onlinelibrary.wiley.com/doi/full/10.1111/psyp.14756

Welcome. The Aphantasia Network has this newbie guide: https://aphantasia.com/guide/ It is normal to have vividness of visualization decrease as one ages. It is not normal for one to lose the ability to visualize. It is rare, but it does happen. In one study, only 3% of their aphants acquired aphantasia. It is not believed that acquired aphantasia just happens. Something must happen to cause it. In the only study I know of the causes of aphantasia, they were split into 2 groups: neurological and psychological. Neurological is brain damage, like stroke and TBI. It can also include drugs and disease. COVID-19 is a known cause of acquired aphantasia, although not often. Other inflammatory diseases are also known causes. Once again, not often. Surgery has caused it. However, based on your description, it is quite likely yours is psychologically acquired. Trauma, depersonalization and even depression can cause acquired aphantasia. There are a few cases of acquired aphantasia which have resolved (that is visualization has returned) once the underlying cause was dealt with. I strongly recommend seeing someone. A doctor or neurologist may be able to rule out neurological causes. Strokes, especially small ones, often go unrecognized. Here is the paper on causes of acquired aphantasia in case your doctor needs convincing that aphantasia is a reason to check: https://jnnp.bmj.com/content/92/8/A6.3.abstract Unfortunately, most medical health providers - including mental health professionals - have never heard of aphantasia and many may not believe it exists. The guide above can be a good introduction. Based on the other problems you describe, I hope you see a mental health professional. There is a book I highly recommend you have your therapist read: Unseen Minds: A Therapist's Guide to Multisensory Aphantasia and Invisible Cognitive Differences– by Sassy Smith. I actually wish all therapists would read it. It is on Amazon: https://a.co/d/0472wf0F Finally, one thing all the causes listed for acquired aphantasia have in common is neuroinflammation. Often, they can both cause and be caused by it. Improving your brain health can (but is not guaranteed to) improve some of your symptoms. Here is Xenia Kachur talking about some recent research to cool that inflammation but which is not yet standard of care because it is too new. https://youtu.be/p2c_Mgn5SA4?si=LNsFJ4enOjumV7V6 Here is the book she wrote about that research and what works: Mindfire Book

I hope you’re working with a therapist. Unseen Minds by Sassy Smith can help your therapist work with you. https://a.co/d/0fhKfgX0

You can find "Unseen Minds" on Amazon: https://a.co/d/0472wf0F It is even on Kindle Unlimited!

Welcome. The Aphantasia Network has this newbie guide: https://aphantasia.com/guide/ It can be quite a shock to learn others actually see stuff when they visualize. Most people come to terms with it fairly quickly, but about a third take longer and may benefit from talking with someone. Your distress is real and it probably would help to talk with someone. A therapist will not be able to do anything about your aphantasia, but all therapists are trained to help people deal with broken world views and feelings of loss and FOMO. Unfortunately, most therapists have never heard of aphantasia. The guide above can be an introduction. But many therapeutic techniques use visualization, and some diagnostic criteria assume it. There is a book that can help a therapist work with you and your aphantasia: Unseen Minds: A Therapist's Guide to Multisensory Aphantasia and Invisible Cognitive Differences– by Sassy Smith is an excellent guide for therapists. I actually wish all therapists would read it. It is on Amazon: https://a.co/d/0472wf0F As for memory, there are lots of different memory problems. Many studies find aphants have (on average) reduced autobiographical memory. One has found reductions in some forms of audio and visual memory. But many aphants have excellent memories. About a quarter to half of us also something called SDAM. Even with SDAM, many people thought I have a photographic memory, so my memory deficit is specific, not everything. SDAM is Severely Deficient Autobiographical Memory. Most people can relive or re-experience past events from a first-person point of view. This is called episodic memory. It is also called "time travel" because it feels like being back in that moment. How much of their lives they can recall this way varies with people on the high end able to relive essentially every moment. These people have HSAM - Highly Superior Autobiographical Memory. People at the low end with no or almost no episodic memories have SDAM. Note, there are other types of memories. Semantic memories are facts, details, stories and such and tend to be third person, even if it is about you. I can remember that I typed the last sentence, a semantic memory, but I can't relive typing it, an episodic memory. And that memory is very similar to remembering that you asked your question. Your semantic memory can be good or bad independent of your episodic memory. Please note that SDAM is specifically lack of episodic memory and that it is generally lifelong. It is not progressive or degenerative and not caused by diseases or psychological problems like traumas. It applies to all episodic memories, not just those for specific times or events. If what you are describing is new, then please see a doctor/neurologist about it. If it is lifelong and you think it is SDAM, most doctors won't know what that is because it is not in any diagnostic manuals. It was only named a decade ago and standard of care is at least 20 years behind research. Wired has an article on the first person identified with SDAM: https://www.wired.com/2016/04/susie-mckinnon-autobiographical-memory-sdam/ Dr. Brian Levine talks about memory in this video https://www.youtube.com/live/Zvam_uoBSLc?si=ppnpqVDUu75Stv_U and his group has produced this website on SDAM: https://sdamstudy.weebly.com/what-is-sdam.html We have a Reddit sub r/SDAM with an excellent FAQ.

There are a couple different levels. In this article, Merlin Monzel (who has aphantasia) et. al. argue that there isn't a pathological significance: (PDF) No general pathological significance of aphantasia: An evaluation based on criteria for mental disorders He argues that aphantasia meets a couple conditions, such as rarity. But it doesn't negatively affect enough people to be included in the diagnostic manuals. In this speech by Christian Scholz, he argues “Dysfunction does not Imply Impairment: the Curious Case of Aphantasia”: https://www.youtube.com/watch?v=CELUAnJz1Xc So, he it accepts it is a dysfunction, but not that it is an impairment. In this book, Sassy Smith points out the many ways that the assumption of visualization impacts mental health care: Unseen Minds: A Therapist's Guide to Multisensory Aphantasia and Invisible Cognitive Differences It is on Amazon: https://a.co/d/0472wf0F There was a teacher here earlier this year getting input on an article to help teachers working with aphants. As far as I know, it has not been published. Once again, this is about removing visualizer bias in teaching, not accommodating a deficit. Here is a different take on aphantasia (and SDAM and ADHD): https://medium.com/@terry.grace/rethinking-reality-what-aphantasia-sdam-and-adhd-reveal-through-donald-hoffmans-interface-d73e4c359df3 If you want to look into Hoffman’s Interface Theory, here it is. It is a bit of a heavy lift: The Interface Theory of Perception | Psychonomic Bulletin & Review | Springer Nature Link As I noted at the start, there are a couple different levels of working with aphantasia. I agree with Monzel that except for acquired aphantasia, it isn't a pathology. But that isn't to say it should be ignored. There is a huge visualizer bias in much of society that needs to be addressed as Sassy Smith does in her book. And there are some people who experience significant psychological issues that they can't do what others can and they need to be helped, not ignored.