平松 洋一

<p>Background: Imagery rescripting (IR) is a technique used in cognitive-behavioral therapy and schema therapy, the treatment process of which has not been empirically verified despite being implemented for various mental disorders. This study aims to examine the experiential process of patients who undergo IR.Methods: Schema therapy sessions were video-recorded with the consent of five patients with chronic depression. Two raters adopted the task analysis protocol to analyze the videos of seven IR sessions.Results: The following experiential process common among successful sessions with the patients was revealed: (1) recalling the episode of an adverse childhood experience, (2) expressing anger and dissatisfaction with the behavior of others during the adverse experience, (3) expressing needs that were not met during the adverse experience, (4) expressing hurt feelings due to needs that were not met during the adverse experience, (5) expressing complex emotions due to fulfillment of needs, and (6) having a sense of relief, attachment, or self-compassion. The behavioral markers of each step were identified as well.</p>

OBJECTIVE: Shame contains external and internal aspects. However, a Japanese language scale for simultaneously assessing both aspects of shame has not been developed to date. This study aimed to standardize the Japanese version of the External and Internal Shame Scale (EISS-J). An online survey was conducted among university students (N = 203) at six universities in Japan (Study 1). A retest questionnaire was sent to the participants by email three weeks after the first survey (Study 2). Study 1 examined the internal consistency, factor structure, and criterion-related validity of the EISS-J, while Study 2 examined its test-retest reliability. Moreover, an additional study was conducted to examine the criterion-related validity of the scale. RESULTS: Study 1 demonstrated the high internal consistency of the EISS-J. Moreover, confirmatory factor analysis indicated a two-factor model: external and internal shame. However, exploratory factor analysis indicated a three-factor structure. Study 2 confirmed the test-retest reliability of the scale. Furthermore, both studies indicated correlations between the EISS-J and fear of compassion, anger, humiliation, depression, anxiety, and stress. In addition, the study established the criterion-related validity of the scale. These results confirmed adequate reliability and validity of the EISS-J.

We applied two sessions of memory rescripting in routine cognitive behavioural therapy (CBT) practice for MDD and measured its effectiveness. We also examined the content of intrusive memories and rescripted memories. Sixteen patients with MDD were asked to identify intrusive memories and rate their vividness, distress, interference with daily life, and uncontrollability before and after memory rescripting. As a result, memory rescripting significantly reduced the intrusive memory index. With one exception, memory rescripting created an image containing compassionate imagery, mastery imagery, or both elements. These results suggest that two sessions of memory rescripting could be incorporated into traditional CBT to improve distress caused by intrusive memories experienced by patients with MDD.