People who can’t imagine

When I remember primary school, I remember one of my teachers cutting snot out of his nose with a pair of scissors when he thought no-one was looking. When I remember high school, I remember teachers saying two things, mainly.  “Lorimer, LORIMER, are you with us?” and “Well you certainly have a good imagination…”  In fact, imagining things is something I have always enjoyed and I guess I have taken for granted.  Until recently.  I have now seen a few patients, and heard from a few others, who claim to not be able to imagine moving, or, in a couple of cases, not able to imagine anything.

Current theories on perception and on consciousness and on motor control and in social psychology all suggest that the brain is constantly running scenarios and only picking one of them to implement, so I would expect that ‘imagining’ is somewhat fundamental to the living human. If one can’t imagine, I guess it does not preclude all that stuff, but it certainly raises the interesting question (and the bleedingly obvious one) of why not? Does anyone know the answer to this question? I guess if one cannot imagine but does have dreams, that would implicate the volitional aspect of it. Also, if one can make left/right judgments of body parts but can not imagine movements, that too would implicate the volitional aspect.

I have seen a couple of patients who report that they USED to be able to imagine moving and doing things, but since their CRPS they can not. One of those patients could not even recognise a left hand, let alone imagine it.  I would hold my left hand in front of her face (standing behind her so it was from her perspective) and ask her “What hand is that?” to which she would respond without any delay “Right”.  I would leave my left hand there and put my right hand there as well and she would jump and say “WOW! You have two right hands!”  Now there is some dodgy cortical processing.   I would be interested in how often other people have come across this inability to imagine, either within the context of graded motor imagery, which involves imagining movements and activities, or otherwise. If you have got some tricks, share them?  Either here, or on an excellent blog site called How To Cope With Pain, which has a discussion going on it at the moment. I found the discussion really interesting and helpful – it made me write this.

Comments

  1. The issue with the CRPS patient whom you describe sounds to me more like neglect, similar to what can occur after strokes. It makes sense that if you can’t even identify a side when it’s right in front of you and obvious, it would be impossible to imagine moving that side.

    I do believe neglect in pts with CRPS is bound up in, as Lorimer says, “dodgy cortical processing.” (Psychological issues also contribute, but I believe it’s primarily neurologically-based.) Perhaps neglect is on the severe end of a continuum, while R/L discrimination problems are a lesser variant.

    I would wonder if, in the pt Lorimer describes, there was any improvement in the neglect after doing graded motor imagery?

  2. Thanks Sarah –
    I too reckon there is a fair bit about CRPS that looks like neglect. We have published one paper testing this hypothesis that seems pretty clear in suggesting a tactile neglect-type phenomenon. I am reluctant to call it neglect because it is different. Frettloh has shown the differences quite well and, of course, there is no frank brain damage. Still – I agree that the left/right judgment deficits in response time are likely to reflect information processing of body-related stimuli rather than disrupted schema, but i don’t really know. Re the patient – she found left/right judgments too difficult and frustrating, so we actually started tactile training on the edge of her ‘neglect-like phenomena’, which we established with l/r judgments of shoulders – long RT and 60% accuracy (which sort of goes against what i just said about information processing), and l/r neck rotation judgments (pretty much fine). So we did tactile training from shoulder down and l/r judgments neck then shoulder. We did stuff with her affected hand on the right side of her body (there is a theory here that we hope to publish on very soon – under review). One thing i am still unsure about and that i think it would be good to determine – are these neglect-like changes a brain-attempt to minimise pain provocation, are they are disruption that contributes to pain disruption, or are they neither, or both?

  3. This is a topic which has interested me for a while. It came up when I was collecting narratives from knitters who were commenting on being able to imagine and ‘look forward’ again since they’d taken up the craft. I’ve discussed it at length with psychologists who tell me that depressed people often lose the ability to look forward to ‘picture’ images in their Mind’s Eye. It prompted me to ask questions like, Can you plan or goal set when you can’t imagine? Can you look forward to tomorrow? Can you move normally? Do you lose your motivation, because you can’t imagine anything beyond the present moment?

    Our recent online survey of knitters (3,500+ responses in 2 weeks) showed that knitters picture the finished article in their Mind’s Eye as they knit. They also picture the reaction of others to the finished product so it prompted us to ask, ‘Can knitting reawaken the Mind’s Eye?’ It certainly seems to be doing something to reverse those backward, spiraling thought cycles. They start looking forward to the next project and then to the next day – is this connected to re-awakening the ability to imagine, perhaps?

    I also recently had a patient with CRPS of his left arm. He ‘neglected’ this arm and it hung by his side with his head turned away. He stressed he was unable to use the arm at all, yet when we asked him to knit, he picked up the needles and had learnt a basic stitch within an hour. I think there is something important in automatic, bilateral, rhythmic movement and although this appears to be wondering away from the inability to imagine, in my mind it is all closely linked.

    Is imagination linked to creativity? I certainly think there is something important in being actively creative as opposed to being a passive recipient of something which is perceived as destructive such as pain or depression. Can you perhaps re-awaken the ability to imagine by developing a person’s creativity??

  4. I have found the effects of differences in laterality, recognition, etc to be fascinating/confounding in their breadth, scope, and intensities. Those patients who fall outside ( I hate to use this term) normal or expected responses are particular intriguing to me. I have tried an interesting variant in two patients with whom I was getting nowhere. One could not recognize pictures of the amputated limb ( he had stump but not phantom pain) and one who was extremely accurate in recognizing the affected side but not the unaffected side (the remaining effects of shingles). Using the recognise, mirror, sensory discrimination did not produce much of a change. Not going anywhere, I then had them use the mirror and move in ways that produced a profound dissonance ( windshield wiper movements of the legs and arms). This activity did not change their pains but produced profound headaches. Amazingly afterward, however, their 2-point discriminations and recognise scores improved. The headaches lasted for about an hour afterward and went away. I have repeated it twice now in the clinic with the same results. I have been hesitant to send them home to try it on their own since I am not sure what I am doing. If no adverse effects are seen and the headaches rapidly resolve like they have been doing, I will have them try it on a home basis. No profound carry over effect was seen. On the last visit, however, I had them move in patterns that did not produce a dissonance ( simultaneous movements away and toward the mirror) after the dissonant movements, the scores on recognise and 2-point reverted to the poorer level after improving with the dissonant movements.
    I must be scrambling something. Does that scrambling disrupt the present neural tag so that another could be expressed? I have contemplated this over several sips of scotch. I have been trying to disrupt mine.

  5. John – this is cool: “This activity did not change their pains but produced profound headaches. Amazingly afterward, however, their 2-point discriminations and recognise scores improved.” I have no idea what happened. By how much did the scores change? fluke, variance, or stupendous discovery? Any chance you could give us the numbers – a few before and a few after? LOVE your contributions here.

    Johnbarb1 Reply:

    Two point discrimination increased from 60% to 90%. recognise increased by 20%. After the symmetrical motions, scores returned to previous levels. In trying it myself I found the experience profoundly disrupting. The headache could have easily been produced by the discrepancy produced by eye motion following the image and the perceived motions of the arms and the legs. When I did it to myself I felt quite disoriented after. I am waiting to see if there were any lingering problems with the headaches. So far neither have contacted me. I will keep you posted on the responses. The similarities of the responses took me by surprise. May be it was just one of those days. JOhnB

  6. I see this is an older post, but absolutely fascinating! I have had brief forays into laterality and mirror perception but mostly within a bimanual coordination context.

    When taking my license renewal a couple of weeks back, the guy opened up the vision testing cabinet which displayed the normal chart in a mirror up behind the tellers. For a reason I still do not understand, I read them from right to left and then quipped that reading mirrored letters wasn’t a fair test. He looked at me dumbfounded and opened up the cabinet again at my request and mentioned my vision was fine but there might be something else wrong up there!

    I have no idea what went on there except that I anticipated needing to make mirror corrections and did so, but there must be a bit of a tangle… It most certainly did get this budding little motor control researcher thinking!

    (I realize this has been a pretty pointless addition to the posts but i’m still startled by it all)

    Betsan Corkhill Reply:

    Many years ago when I was training as a physio our psychology lecturer asked us to draw between two guidelines in the shape of a star. We had to do this in a mirror image and every time we touched one of the guidelines we had to start again. Everyone else in the class managed it quite quickly – embarrassingly it took me nearly an hour. We were then asked to write up the ‘experiment’. I wrote perfectly backwards from right to left and was completely unable to write forwards for about half an hour. I can remember my brain feeling very ‘confused’ and it was frustrating not being able to make it do what I wanted it to. I’m still fascinated by it.

    Lorimer Reply:

    Mic –
    This is absolutely excellent. I don’t really know what it means, nor how to interpret it, but one possibility is that your brain put the switch in place, as you seem to suggest, and didn’t correct it. This might have happened to you to Betsan, I guess – a bit like those studies with prism glasses that turn the world upside down – in a very short amount of time, we adapt to an upside down world and function normally. In that scenario, the brain seems to quickly process everything through the ‘turn downside up’ link. Perhaps, if you were to put on a pair of prism glasses, you would adapt quicker than most, whereas Betsan might adapt slower than most and take longer to adapt back when you take them off.

  7. If a person has lost the ability to imagine movement because they haven’t performed a normal movement for some time would it be possible (and has anyone tried) to use digitally altered video images which would enable that patient to see themselves moving normally in 3D from all angles? An image of the patient’s head would be superimposed on a body which is performing the required movement. You could take this a step further by giving that patient some simple anatomy lessons which might enable them to reconnect with the affected part from within. I’ve noticed when I learn a new exercise at the gym, being a physio, I automatically visualise the anatomical structures I’m moving and it makes sense that people need to ‘know’ what they’re being asked to move.

    The narratives we’ve collected about the use of knitting with patients suggest that when the brain is engaged in an automatic pattern of movements it may be more open to suggestion / change – the ‘guard’ appears to be down.

    Combining those two points, it would be interesting to put a patient who had an arm problem (for example) on a treadmill, so their brain is engaged in walking and then showing them a video of themselves walking strongly with full normal arm swing. You could distract the brain even further with some music which has a beat that matches the walking pace. I’d be interested to see what happens…..

  8. I’ve just read an edited extract from ‘imagine: The Science of Creativity’ in The Saturday’s Age (Melbourne) by Jonah Lehrer and I came across the line, ‘Sleeping is the height of genius’ by Kierkegaard. It made me wonder what would happen if someone could force my dreams so I’m doing the activities that seem to bring on pain: sitting straight on my coccyx, driving, lifting over a couple of kilos, sitting cross legged, lying on my back, (yes, the list goes on and its been about 5 years!!).Of course my wondering made me wonder straight to BIM and I found this great article but does anyone have any ideas, experience or experiments to share?

    I can imagine freely but no image is quite as real as a dream.

  9. Definitely agree with what you explained. Your explanation was definitely the easiest to understand. I tell you, I generally get irked when folks discuss issues which they plainly do not know about. You managed to hit the nail correct on the head and explained out every thing without complication. Perhaps, individuals can consider a signal. Will most likely be back to obtain more. Thanks

  10. Greetings! During this week-end I met a colleague, physical therapist, who told me that she is not able to imagine. It is not something new for her. She hasn’t been able to imagine ever! She tells me that she cannot recall her mother’s face or any other thing that I could ask for.

    She says usually doctors laugh about her when she tells them she cannot imagine a thing. She realized it, when studying Physical Therapy, that she was handicapped in this area, which sometimes makes her job very difficult.

    I promised her to look for information, and I am amazed of finding the first article here in bodyinmind, which I read often. I am looking forward finding information about recovering a function she thinks she has never been capable of. Thanks!!

  11. May be the cure is to have them listen to John Lennon and then watch “Sargent Pepper Lonely Heart’s club” for hours on end.

    From an imaginary Universe called Philadelphia. JohnB

  12. Fiona Methven says:

    I use to dream as a child, but have no ability to visualise or imagine . I have never been able to imagine.

    David Croxson Reply:

    I thought I was alone in not being able to imagine. In fact it was only a few years back (I am 64 years old) that it dawned on me that other people could day dream or imagine scenes, activities, people etc in their minds eye or imagination. It has never been something I have ever done. I never realised for example that when people talked of counting sheep to fall asleep they were actually creating sheep in their imagination which they could then make jump some wall or other and count them in the process. I just thought it was a quaint phrase – I never for a moment thought that things could be visualised in your head. I have never day dreamed and again thought it was a phrase people used rather than an activity they could voluntarily take part in at will. I ask people where they see their visualisation and if they themselves are in the “picture” and can they then see themselves and watch themselves move? I just don’t understand what they are seeing let alone how they do it. When I close my eyes all I get is blank – black if the lights are off , red or purple if there is light – but no picture action or movement. I don’t dream in pictures but I do recall the passage of events almost like reading a play script. Istrangely I do remember having visual nightmares as a boy and I used to have when a youth certain recurring dreams that were very very real to the point I was convinced I could do things when I slept that I could not do when awake – so it seems I did at one stage have a visualisation capability but only when asleep – never when awake. I rarely listen to music and never read fiction for pleasure – yet I learned to play piano and trumpet as a boy but regard these more as a mechanical process rather than an emotional experience. I wonder therefore if I have never “switched on” my imagination. I feel I am missing out on the imaginary world that everyone else apparently has access to – so it is good to learn there are a few others who like me have no access to their “minds eye” – I would never have imagined there was anyone else like me!!

    Josh Reply:

    I feel as if you worded things perfectly to how Im the same way. I want to learn how to use my imagination. I feel as if a whole new whole is on the other side. I feel as if it would be greener as long I had full control over my imagination. It does sound intense to be able to vividly picture, feel, and smell. I would be on the beach all day in my living room : )

    Cheers! and God Bless everyone!
    Josh

    David Croxson Reply:

    I would like to try to find a “cure” but not sure what that might be. I did think of hypnotherapy but that requires one tro relax by visualising something usually and thats where it stops for me. I wonder if everyone imagines the same way or if there is a single part of the brain that is used for day dreaming. Does anyone know if day dreaming has been rtesearched – there has obviously been much research into sleep dreaming but I have no ability to day dream or “imagine” whilst awake.

    David Croxson Reply:

    Josh

    People tell me they are able to create both vivid but mainly fuzzy pictures in their mind but they are very real experiences to them apparently – I have not heard about smells being imagined.

    I still dont underrstand where the picture appears for them and where they are or what the perspective is – are they looking down, is it a close up or longshot type picture – is it like a video or more involving, could they come into and out of the picture, is it always a real scene or could a complete fantasy scene be visualised, are they relying on memory pictures or could they create something new and necer actually before seen, is it always in colour, can they look at a scene and move around in different perspectives – Id love to know it sounds a great tool to have control over, but if everyone can imagine visually how come the movies ever got invented??

  13. Hey I also do not have an imagination and just found this out this year it was not normal to be able to see images inside your head. Good to know Im not the only one.. What do I do now?