Survivors of childhood sexual abuse commonly report lingering feelings of being contaminated. This effect can lead to problems with self-esteem and body image, relationship trouble, and behavioral issues such as obsessive washing. Now a study in the January issue of Behavior Modification finds that a treatment that appeals to both logic and emotion, via mental imagery, can help relieve these intrusive feelings.

Psychologists at Goethe University Frankfurt in Germany tested a brief treatment consisting of one session and a follow-up “booster” meeting. First, therapists and participants discussed the details of their contamination thoughts—what it feels like, when and where it occurs, and how it affects daily life. Then participants were instructed to research on the Internet how often human skin cells are rebuilt. They also calculated how many times the cells in their trauma-related body regions have been replaced since their last contact with their abusers. (Skin cells rebuild every four to six weeks; mucous membranes more often.) The subjects discussed with the therapists what these facts mean—for instance, “not one of the dermal cells that cover my body now has been in contact with my abuser.” Finally, they performed an exercise in which they imagined shedding their contaminated skin.

The results found this treatment to sig­nificantly decrease feelings of being con­taminated and also—to the researchers’ surprise—overall post-traumatic distress scores. Study author Kerstin Jung says the combination of factual information with mental imagery is key because the information alone can leave a patient knowing the facts but not feeling they are true on an emotional level. At that point, “we introduce the imagery technique as a vehicle to transport the rational information from the head to the heart,” she says. “Images are much more powerful to change emotions than verbal information.”

This article was published in print as "Mental Cleansing."