A qualitative exploration of change processes relevant to compassion-focused therapy that occurs when people view both soothing and non-soothing images

Objective: Using soothing imagery within psychotherapy may support people to undertake positive visualisation exercises. However, little is known about what processes happen when people view images they find to be soothing or non-soothing. Design: Exploratory qualitative methods were used. Method: Responses from 644 participants who had written about images they found to be soothing or non-soothing were analysed using thematic analysis. Results: Two key themes were developed that related to the importance of the image content (such as it being a natural scene or artificial) and the internal cognitive and psychological processes that it triggered within participants as being key drivers for an image being perceived as soothing or non-soothing. This included recall of positive autobiographical memories and liking the image content. Conversely, negative autobiographical memories and disliking image content were associated when people viewed images they considered to be non-soothing. Conclusions: Experiences of feeling soothed when viewing an image appear to be maintained by imagining positive sensory experiences that were associated with the image or linking the image to positive experiences from the participant's autobiographical memory. This has implications for the delivery of therapy using pre-existing image sets and suggests there is a need to find out what images are most suited for people accessing services.