Using Imagery of a Client’s Future Self in CBT for Behavior Change

Morgan Hagner, PsyD, Post-Doctoral Fellow

Dr. Hagner is completing her postdoctoral fellowship at Beck Institute under the supervision of Dr. Judith Beck.

As therapists, we want to help our clients understand their patterns of cognitions, develop insight, and evaluate their responses. At times, clients may question the need to look at things differently or have difficulty looking at their thoughts, emotions, and behaviors from different perspectives. Guided discovery is an important component of CBT that can help clients and therapists collaboratively explore clients’ thoughts, emotions, and behaviors and develop more adaptive coping strategies.

A client that I’m working with, we’ll call her Paige,* is a 26-year-old, single woman who recently completed a graduate degree and is newly working in the marketing field. Paige recently shared that she was considering reducing her drinking but felt it wasn’t the right time. On one hand, Paige recognized the need to make a behavior change; on the other hand, she was reluctant to commit. During a supervision session, Dr. Beck and I discussed Paige’s dilemma.

Dr. Beck often recommends using imagery to elicit clients’ aspirations for their future.  She suggested that asking Paige to imagine her future self might help motivate her to make the desired change. She offered to engage in a roleplay to explore how this might work in practice. Playing the therapist, Dr. Beck asked questions about where Paige saw herself in one, five, and ten years. She asked specific questions about what Paige was doing, who she was with, and how she would feel about herself as she lived the life she described.

During our next session, Paige broached the topic of reducing her drinking and again shared that she wasn’t sure she needed to make the change now. I asked Paige if we could talk about where she wants to be five years in the future. Using Dr. Beck’s recommendations from supervision, I asked Paige to create a detailed visual image or “movie” of what her life would look like when she was 31: who she’s spending time with, where she’s living, what she’s doing for work and fun, etc. Paige very quickly described a future where she has her own apartment, is spending time with friends, has a stable partner, is excelling in her marketing career, exercising regularly, going to workout classes, and so on. Paige was beaming and said how excited she was about the idea of having this life.  

I then asked Paige how alcohol would fit into this future self’s life and Paige reported that she’d go out a few times a month with friends for dinner and maybe have one or two drinks on each occasion—less than her current drinking behavior.

We then discussed what life would look like if she continued her current drinking pattern. As a result of our discussion, Paige recognized that she might be okay for a few years, but ultimately her drinking would likely increase and become a barrier to her personal and professional goals. She was able to see that her excessive alcohol intake would lead to interpersonal issues, limit her career progression, and create difficulties with finances.

I asked Paige to go back to the first future version of herself, the one where she is living a life according to her values and aspirations. Together we imagined that 31-year-old Paige was in the room with 26-year-old Paige who was considering reducing her drinking. I asked her:

“What would 31-year-old Paige say?”

Invigorated by the vision of the life she wanted, Paige decided that it would be more helpful to work on reducing her drinking now. We collaborated on a hierarchy to reduce her drinking, starting with limiting alcohol to the weekends when with friends. Paige wrote in her therapy notes, “If I am tempted to drink more than my goal, I’ll remind myself that 31-year-old Paige would tell me that even though it’s difficult, it’s so important to reduce my drinking now so I can have the future life I dream of.”

Paige’s Action Plan for the coming week also included reading her therapy notes each afternoon when she’d typically start drinking. Helping Paige envision her future self and creating a dialogue between her current and future self, was a powerful tool, enabling effective guided discovery and providing motivation for behavioral change.

*The client’s name and identifying details have been changed to protect confidentiality.