








































21 

Ann. psychophysiol. 
ISSN 2412-3188 (Online)|2410-1354 (Print) 

APP| Published By AEIRC| https://doi.org/10.29052/2412-3188.v10.i1.2023.XX-XX 

Original Article 

Effectiveness of Eidetic Psychotherapy on 
Psychosomatic Symptoms in Adults with 
Anxious Attachment Style 
Janeeta Sohail, Zaofishan Qureshi, Afia Misri & Shahzadi Siddiqa Kayani 
Department of  Psychology, Air University, Islamabad-Pakistan 

Abstract 
Background: Individuals exhibiting an Anxious Attachment Style often 
experience more severe Psychosomatic Symptoms compared to those with other 
insecure attachment styles. These symptoms can lead to a diminished quality of 
life and impaired functioning. This study aimed to investigate the efficacy of 
Eidetic Psychotherapy as a psychological intervention for managing 
Psychosomatic Symptoms in Adults with Anxious Attachment Style. We 
hypothesized that there would be a significant reduction in Psychosomatic 
Symptoms following therapeutic intervention sessions.  
Methodology: The sample consisted of 15 adults, including 7 males and 8 females 
(Mean Age = 20.27, SD = 1.36), recruited from academic institutes in Islamabad, 
Pakistan, using purposive sampling. A pre-and post-experimental design was 
employed, with the Revised Adult Attachment Scale - Close Relationship Version 
(RAAS; Collins, 1996) used for initial screening. The Psychosomatic Symptoms 
Scale (PSS-35; Vulić-Prtorić, 2021) was administered at the baseline. Eight to twelve 
individual therapy sessions were conducted with the participants, and levels of 
Psychosomatic Symptoms were reassessed post-intervention using PSS-35. Paired-
sample t-tests were employed to compare mean differences.  
Results: The analysis of pre-test and post-test scores revealed a significant 
decrease in both the frequency (t = 3.20, p = .006) and severity (t = 3.09, p = .008) of 
Psychosomatic Symptoms among the study participants. 
Conclusion: Consequently, Eidetic Psychotherapy emerges as a promising 
therapeutic approach for enhancing the well-being of individuals suffering from 
Psychosomatic Symptoms associated with anxious attachment. 

Keywords 
Anxious Attachment Style, Psychosomatic Symptoms, Eidetic Psychotherapy, 

Adults, Academic Institutes. 

Citation: Ali S, Ali SM, Zia A. The 
Relationship of Emotional Intelligence and 
Life Satisfaction with Resilience in 
Students. APP. 2023; 10(1): 21-34 

Corresponding Author Email: 
janeetakhokhar@gmail.com 

DOI: 10.29052/2412-3188.v10.i1.2022.21-
33 

Received 16/03/2023 

Accepted 26/05/2023 

Published 01/06/2023 

Copyright © The Author(s). 2023. This is 
an open-access article distributed under 
the terms of the Creative Commons 
Attribution 4.0 International License, 
which permits unrestricted use, 
distribution, and reproduction in any 
medium, provided the original author and 
source are credited.  

Funding: The author(s) received no 
specific funding for this work. 

Conflicts of Interests: The authors have 
declared that no competing interests 
exist. 

https://doi.org/10.29052/2412-3188.v10.i1.2023.
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22 

ISSN 2412-3188 (Online)| 2410-1354 (Print) 

APP| Published By AEIRC| Volume 10 Issue 1 

Introduction 
Attachment style refers to how an individual 
forms relationships with others, involving 
their confidence in the availability of a 
caregiver to serve as a secure base1. These 
attachment styles are shaped by a person's 
early experiences, particularly the type of 
care they received during infancy2. Early 
attachments established during childhood 
play a crucial role in an individual's ability to 
form emotional bonds, contributing 
significantly to their survival3. When 
children experience inconsistent emotional 
communication during infancy, and their 
needs are not met consistently, they are more 
likely to develop unsuccessful or insecure 
attachment styles, adversely affecting their 
capacity to maintain stable relationships. 
Conversely, secure bonds between 
caregivers and children can positively 
impact mental health and resilience4. 

John Bowlby, the founder of attachment 
theory, emphasized the critical nature of 
attachment formation during the first 2.5-5 
years of life. He suggested that if attachment 
does not develop during this early period, it 
may not develop at all, potentially leading to 
social, emotional, and cognitive challenges 
later in life. These early attachments form an 
internal working model that shapes an 
individual's understanding of themselves, 
the world, and others. This internal model, 
known as the continuity hypothesis, 
continues to influence a person's behavior 
and relationships throughout their life1. 

Anxious Attachment Style is characterized 
by a pattern of attachment marked by a 
strong fear of being left alone, diminished 
self-confidence, and extreme dependence on 
loved ones. Individuals with this insecure 
attachment pattern tend to be highly 
emotional, reliant on others for emotional 
needs, and seek closeness and intimacy to 

remedy their emotional distress5. Research 
has shown that traumatic incidents in early 
life can be correlated with attachment 
anxiety and somatic symptoms6. Attachment 
patterns have also been linked to various 
aspects of life, including physical and mental 
health, social relationships, and work7. 

Psychosomatic Symptoms, also known as 
medically unexplained somatic symptoms 
(MUSS), refer to physical symptoms for 
which no physical cause can be found, and 
they are often attributed to stress or anxiety. 
These symptoms are concerning and are 
frequently associated with concurrent 
mental health problems8. Childhood trauma 
and adversity have been identified as risk 
factors for compromised physical well-being 
and the development of Psychosomatic 
Symptoms. Insecure attachment styles have 
also been found to be associated with 
childhood adversity. Prolonged stress and 
hyperarousal can disrupt typical 
development, affecting bodily responses to 
stress and disrupting emotional and 
cognitive responses to somatic stimuli9. 

One explanation for the development of 
Psychosomatic Symptoms is the concept of 
mentalization, a mechanism that evolves 
through the relationship between a child and 
their caregiver. The ability to mentalize is 
learned and is more developed in 
individuals with secure attachments. 
Insecurely attached individuals tend to have 
poor mentalization skills and are highly 
sensitive to the mental states of others. 
Anxious attachment individuals often 
struggle to identify their emotions, resulting 
in somatic experiences of emotional 
distress10. Additionally, exposure to stress 
and trauma, which often involves the 
development of unhealthy or insecure 
attachments, can hinder the development of 
the frontal cortical executive function 



23 APP| Published By AEIRC| Volume 10 Issue 1 

responsible for managing involuntary 
signals from the parasympathetic nervous 
system, affecting various bodily systems 
such as the gastrointestinal, endocrine, and 
cardiovascular systems. The frontal cortex 
plays a critical role in organizing and 
managing bodily symptoms, and this 
function is disrupted in individuals with 
insecure attachment styles11. 

Furthermore, the literature suggests a 
connection between anxiety and somatic 
symptoms, indicating that negative affect 
can suppress the immune system and 
increase disease susceptibility, leading to 
somatic complaints12. Numerous studies 
have reported that somatic complaints are 
common in individuals with psychiatric 
distress. Prolonged exposure to stress has 
also been linked to somatic symptoms such 
as palpitations, gastrointestinal complaints, 
and headaches. This situation poses a 
significant risk to young people's mental and 
physical health and future generations13. 
Mental stress has been associated with 
various Psychosomatic Symptoms, 
including sleep problems, gastrointestinal 
issues, and muscular pain. Stress is also a 
primary contributor to headaches and can 
lead to the development of disorders such as 
irritable bowel syndrome, fibromyalgia, and 
chronic fatigue9. Somatic symptoms often 
indicate emotional distress in an individual's 
life and can progress to somatic symptom 
disorder and other severe illnesses. 
Additionally, health anxiety, characterized 
by heightened anxiety about one's bodily 
symptoms, can develop due to these 
symptoms, further exacerbating the 
situation14. 

A descriptive-correlational study 
investigated the relationship between 
attachment styles and somatic symptoms, 
with the mediating role of emotional 
processing. The study included 220 
participants aged 18-59, and data were 

collected using the Adult Attachment Scale 
(AAS), Baker's Emotional Processing Scale, 
and the Patient Health Questionnaire (PHQ-
15). Correlation and t-test analyses revealed 
that the predominant attachment style 
among participants was anxiety-based, 
leading to deficits in emotional processing 
and severe somatic symptoms. Conversely, 
secure attachment was a protective factor 
against emotional deficits and the 
somatization of negative emotions15. 

Treating Psychosomatic Symptoms typically 
involves raising awareness of underlying 
core issues and addressing negative events 
and emotions that impact an individual's 
emotional well-being16. Evidence-based 
therapies such as Cognitive Behavior 
Therapy (CBT), Mindfulness, and 
Hypnotherapy have effectively treated these 
symptoms. Another therapeutic approach, 
Eidetic Psychotherapy, has demonstrated 
promise in addressing various psychological 
conditions. Eidetic Psychotherapy involves 
eliciting and manipulating mental images 
known as 'Eidetic' images, and Akhter 
Ahsen introduced it in Pakistan during the 
1960s17. According to Eidetic Psychotherapy, 
images play a central role in psychological 
resolution, personal growth, learning, and 
enlightenment. These images are multi-
leveled, multisensory, and experiential, 
comprising three main components: 'I' 
(visual), 'S' (somatic, including physical and 
emotional states associated with the image), 
and 'M' (meaning or significance of the 
experience), collectively known as ISM. The 
somatic component, situated between the 
image and its meaning, is of particular 
importance, as it provides the physical 
triggers in the brain that lend relevance to 
the Eidetic image18. 

ISM serves as the fundamental storage unit, 
with experiences naturally stored in an 
individual's consciousness as they occur. 
The development of a psychological 



24 APP| Published By AEIRC| Volume 10 Issue 1 

disorder occurs when there is a fixation on 
the negative aspects of an experience or 
when there is a pseudo-separation of the 
visual core of the image from its meaning. 
Eidetic Psychotherapy addresses this by 
repetitively visualizing the image, leading to 
a resolution of its associated effect. 
Substantial evidence of the effectiveness of 
eidetic imagery in neuropsychology 
suggests that different brain regions, 
including the middle temporal (MT) and 
middle superior temporal (MST) areas, 
respond to the visualization of these images. 
These regions subsequently impact the 
emotional system of the subject, connecting 
with perception, sensory signals, and 
memory19. Eidetic images are akin to mental 
pictures and movies used by the brain to 
remember and record life events. When 
remembered, these images recreate vivid 
experiences with details and clarity. This 
type of imagery allows individuals to revisit 
and recall life events, including all the 
physical and emotional aspects associated 
with them and their significance in the 
subject's life20. 

Eidetic images are distinct from ordinary 
mental imagery, occupying a space between 
imagination and physiological after-images. 
These images can overcome intellectual 
resistance, separating them from talk 
therapy and verbal therapeutic approaches. 
Additionally, eidetic images have the 
potential to alter aspects of personality 
through a repetitive process that 
intentionally projects critical eidetic until the 
associated effect is exhausted. As a result, 
problematic fantasies and experiences 
related to these images can be effectively 
addressed. Eidetic Psychotherapy has been 
effective in treating conditions such as 
psychosomatic complaints, acute neurosis, 
hysteria, and schizophrenia21. 

The process of eidetic therapy involves three 
levels, with the first level addressing 

Psychosomatic Symptoms, the second level 
focusing on developmental themes related to 
parents, and the third level delving into the 
subject's integration and deeper 
psychological meanings. Two valuable 
assessment instruments, the Age Projection 
Test (APT) and the Eidetic Parents Test 
(EPT), were developed for this purpose. The 
APT is designed to extract information about 
a series of events related to the subject's 
current symptoms, exposing them to 
experiences responsible for forming their 
disorder. Test items trigger different images 
associated with various life events, revealing 
experiences related to the symptoms and 
helping to uncover quasi-somatic symptoms 
and their meanings. During the APT, clients 
are asked to visualize an image of 
themselves and identify the clearest image, 
after which they provide details such as 
location and Age-related to that image. This 
technique contributes to the construction of 
therapeutic images. On the other hand, the 
EPT places significant emphasis on the 
parent-child relationship and explores 
various dimensions of pathological 
development in the subject. Comprising 30 
items, the EPT also aims to construct 
therapeutic images, similar to the APT19. 

Imagery is a multisensory technique, often 
described as "seeing with the mind's eye" or 
"hearing with the mind's ear." Eidetic 
imagery combines sensory, affective, and 
cognitive aspects of an individual's 
consciousness22. It is a powerful and rapidly 
effective therapeutic intervention that can be 
applied in clinical settings. The therapy 
encourages individuals to rely on 
themselves, enabling them to identify and 
recognize sensory and affective components 
and consciousness gaps. Eidetic 
Psychotherapy can treat various disorders 
and conditions, including pain, anxiety, 
phobias, eating disorders, sexual concerns, 
and substance abuse23. 



25 APP| Published By AEIRC| Volume 10 Issue 1 

The effectiveness of Eidetic Psychotherapy 
has been demonstrated in the treatment of 
depression. A study in Islamabad, Pakistan, 
involved ten men and women with high 
scores on the Beck Depression Inventory 
(BDI-II), referred from local hospitals. The 
study consisted of three phases: pre-
intervention, intervention, and post-
intervention. Therapy was administered for 
5-7 weeks, resulting in significantly lower
depressive symptoms post-intervention.
Demographics, such as Age, marital status,
and income, were associated with
improvements in depressive symptoms24.
Another pre-post study explored the impact
of Eidetic Psychotherapy on women
suffering from PTSD due to spousal
domestic violence in Pakistan. The sample
included forty women referred from
outpatient clinics who met specific criteria.
Clients received Eidetic Therapy sessions for
10-12 weeks, resulting in reduced PTSD
symptoms, as measured using the General
Health Questionnaire (GHQ) and the PTSD-
Checklist Civilian Version (PCL-C)23.

Individuals with Anxious Attachment Style 
often experience distressing Psychosomatic 
Symptoms that significantly diminish their 
quality of life and overall functioning. These 
symptoms can affect various bodily systems, 
from gastrointestinal to cardiovascular, 
causing considerable discomfort. Moreover, 
individuals with an Anxious Attachment 
Style frequently endure distress and 
interpersonal conflicts, further exacerbating 
their Psychosomatic Symptoms. 
Importantly, a notable research gap exists, as 
few attachment-focused therapies have 
specifically addressed the psychosomatic 
aspects of insecure attachment patterns. 
Consequently, this study prioritizes 
managing and treating these symptoms, 
serving as a preventive measure to help 
individuals improve their Psychosomatic 
Symptoms during the pre-marital stage of 
life. 

Methodology 
The study was conducted in Islamabad, 
Pakistan, and received approval from the Air 
University Human Research Ethics 
Committee, which also adheres to the rules 
of the World Medical Association 
Declaration of Helsinki and meets its 
requirements. 

Sample Size 
A sample of 50 individuals was conveniently 
selected. These individuals were aged 
between 19 and 30 years and were recruited 
from academic institutes in Islamabad, 
Pakistan. These individuals were 
administered the Revised Adult Attachment 
Scale - Close Relationships Version (Collins, 
1996) and the Psychosomatic Symptoms 
Scale (Vulić-Prtorić, 2021). Among them, 15 
individuals who exhibited an Anxious 
Attachment Style and Psychosomatic 
Symptoms were purposively selected. 

Inclusion / Exclusion Criteria 
Individuals with an Anxious Attachment 
Style and Psychosomatic Symptoms aged 
between 19 and 30 years were included in 
the study. 

Married individuals were excluded from the 
study. Individuals outside the age range of 
19-30 years were also excluded. 
Additionally, adults suffering from parental 
bereavement and diagnosed with any 
psychological condition were not part of this 
study. 

Research Instruments 
Informed Consent 
Written consent was obtained from all 
participants willing to participate in the 
study using an informed consent sheet.  

Demographic Sheet 
The demographic sheet was used to collect 
basic socio-demographic information, such 



26 APP| Published By AEIRC| Volume 10 Issue 1 

as Age, gender, qualification, occupation, 
marital status, socioeconomic status, family 
system, number of siblings, birth order, 
earning members, presence of any 
psychological condition, and the head of the 
family.  

Revised Adult Attachment Scale - Close 
Relationships Version (Collins, 1996) 
To assess the levels of Anxious Attachment 
Style in adults, the Revised Adult 
Attachment Scale-Close Relationships 
Version was used. This 18-item scale 
comprises three subscales: "Close" (6 items), 
"Depend" (6 items), and "Anxiety" (6 items). 
It uses a 5-point Likert scale ranging from 1 
("Not at all characteristic of me") to 5 ("Very 
characteristic of me"). The Revised Adult 
Attachment Scale measures attachment in 
three dimensions: closeness, dependence, 
and anxiety. Individuals scoring high on the 
anxiety subscale and moderately on the 
others were considered to exhibit an 
Anxious Attachment Style. The Revised 
Adult Attachment Scale demonstrates 
acceptable internal consistency (Cronbach's 
coefficient alpha of .87 in anxiety, .73 in close, 
and .80 in depend subscales). 

Psychosomatic Symptoms Scale (Vulić-
Prtorić, 2021) 
To assess the level of Psychosomatic 
Symptoms in participants, the 
Psychosomatic Symptoms Scale was used. 
This 42-item scale comprises seven 
subscales: "Pseudoneurological" (9 items), 
"Cardiovascular" (3 items), 
"Musculoskeletal" (2 items), "Respiratory" (3 
items), "Gastrointestinal" (9 items), 
"Dermatological" (3 items), and 
"Pain/Weakness" (6 items). Items are scored 
on two scales: a frequency scale (ranging 
from 1, "Never," to 4, "Almost Every day") 
and a severity scale (ranging from 1, "Not at 
all," to 3, "A lot"). Scores on both scales are 
converted to deciles to identify individuals 
with Psychosomatic Symptoms. The scale is 

a reliable instrument for assessing somatic 
symptoms in individuals, demonstrating 
high internal consistency (Cronbach's alpha 
coefficient of .89 for frequency and .91 for 
severity scale). It is recommended for use. 

Procedure 
The research study began by selecting 50 
individuals (adults) aged 19-30 years using a 
convenient sampling method from academic 
institutes in Islamabad, Pakistan. The 
Revised Adult Attachment Scale-Close 
Relationships Version (Collins, 1996) and the 
Psychosomatic Symptoms Scale (Vulić-
Prtorić, 2021) were administered. After 
scoring and interpreting the scales, 15 
participants exhibiting an Anxious 
Attachment Style and Psychosomatic 
Symptoms were selected through purposive 
sampling. Selected participants were 
informed about the study's purpose, and 
written informed consent was obtained. 
Dates were scheduled for the pretest, 
intervention, and posttest in agreement with 
the participants. 

Pre-test 
The pretest included scores from the 
Psychosomatic Symptoms Scale (Vulić-
Prtorić, 2021), as well as the House Tree 
Person test (Buck, 1948) and the Thematic 
Apperception Test (Murray & Morgan, 
1935). Empirical testing was conducted on a 
sample of 2 participants. Eidetic 
Psychotherapy (8-12 sessions) was 
individually conducted with each 
participant. Following the intervention, a 
posttest was conducted using the 
Psychosomatic Symptoms Scale (Vulić-
Prtorić, 2021), the House Tree Person test 
(Buck, 1948), and the Thematic 
Apperception Test (Murray & Morgan, 
1935). 

Treatment Plan 



27 APP| Published By AEIRC| Volume 10 Issue 1 

The study was conducted in four phases: 
pre-assessment, pre-intervention, 
intervention, and post-assessment. 

Phase I - Pre-assessment 
During this phase, participants were 
screened for Anxious Attachment Style. 
Demographic information was recorded 
using a Demographic Sheet, and two 
instruments, the Revised Adult Attachment 
Scale-Close Relationships Version (Collins, 
1996) and the Psychosomatic Symptoms 
Scale (Vulić-Prtorić, 2021), were used. 
Participants were briefed about the study's 
objectives, informed of their right to 
withdraw, and assured of confidentiality. 
Participants exhibiting Anxious Attachment 
Style along with Psychosomatic Symptoms 
were included. 

Phase II - Pre-Intervention 
In this phase, Eidetic Psychotherapy was 
applied to participants based on the nature 
and intensity of their symptoms. 

Step 1 
During the initial phase, participants' intake 
was conducted individually. Rapport 
building, trust establishment, active 
listening, and a non-judgmental and 
supportive attitude were emphasized. Open-
ended questions were used to encourage 
participants to express their concerns. 
Therapeutic sessions were paced to align 
with the study's time frame. 

After the initial phase, protocols of Eidetic 
Psychotherapy were implemented. This 
included recording participants' presenting 
complaints, worries related to their 
symptoms, bodily feelings related to each 
symptom, and other names of the 
participants. 

Step 2 
In the next step, the Eidetic Parents Test 
(EPT) was administered. Participants were 
introduced to Eidetics and asked to recall the 
first session as an image. Items from the EPT 
were administered to explore and identify 
problematic areas in participants' lives. 
Responses, including somatic symptoms, 
were recorded. Resistances and participants' 
reactions were observed to ensure an 
accurate experience. 

Key images related to Anxious Attachment 
Style and associated Psychosomatic 
Symptoms were selected for intervention in 
the next phase. 

Phase III - Intervention 
During this phase, relevant images were 
maneuvered to reduce the intensity and 
improve the Psychosomatic Symptoms 
associated with each participant. 

Phase IV - Post-assessment 
The post-assessment phase involved using 
the Psychosomatic Symptoms Scale (Vulić-
Prtorić, 2021) again to assess participants' 
levels of Psychosomatic Symptoms. Posttest 
scores were compared with pretest scores to 
evaluate the efficacy of Eidetic 
Psychotherapy. 

Fidelity of the Intervention 
Treatment Fidelity Checklist was assessed at 
the end of the intervention. Fidelity was 
ensured by following specific modules in the 
treatment manual, sufficient briefing, and 
training on the intervention by a clinical 
supervisor. This included the completion of 
practice cases and intervention-specific case 
consultation, along with expert review of 
intervention notes. 



28 APP| Published By AEIRC| Volume 10 Issue 1 

Table 1: Steps of Therapeutic Sessions of Eidetic Psychotherapy 
Phases Therapy Plan Details Description 

Phase 1 Pre-assessment RAAS-CRV, PSS-35, 
Briefing, Informed 
Consent, 
Confidentiality and 
Demographics  

Screening was done through RAAS-CRV and PSS-35. Scores 
of RAAS-CRV and PSS-35 were recorded. Participants were 
briefed about the purpose of the study, informed consent was 
taken, confidentiality was assured, and demographics were 
recorded.   

Phase 2 Pre-Intervention 
(Step 1)  

Intake sessions, 
Rapport Building, 
Eidetic Preliminaries, 
and Psychoeducation  

A detailed history was taken, a therapeutic relationship was 
established by the providence of a safe environment, and 
rapport was built.  
The four preliminaries of Eidetic were fulfilled, and 
psychoeducation was done to increase and improve 
awareness and insight into the issues and associated 
symptoms.   

(Step 2) Introduction to 
Eidetics, 
Administration of EPT, 
Relevant Setting, 
Resistances, and Overt 
Behavior  

The participants were introduced to Eidetics practically in a 
comfortable setting. The Eidetic instructions were given as per 
the items, and images were repeatedly projected to maximize 
the authenticity of the experience. The associated ISM was 
noted down.  
Moreover, the resistances were catered with the required 
guidance, and overt behavior like body language, facial 
expressions, and mood were taken into observation. The key 
(triggering images) related to Anxious Attachment Style and 
associated Psychosomatic Symptoms were selected for 
maneuvering (Intervention). 

Phase 3 Intervention Maneuvering of the 
images was done.  

The identified images associated with Anxious Attachment 
Style and related Psychosomatic Symptoms were maneuvered 
for about 8-12 sessions depending upon the requirement of 
each participant. 

Phase 4 Post-assessment PSS-35 PSS-35 was administered, and pretest scores on 
Psychosomatic Symptoms were compared to the posttest 
scores after therapeutic sessions.  

*4 steps of preliminaries:
1) First report of symptoms. 2) Worry and concern about the symptoms. 3) Review of systems.
4) Patient's various names.  **Step 2 and onwards were used interchangeably, depending upon the situation.

Ethical Consideration 
Ethical considerations included obtaining 
informed consent from all participants, 
ensuring confidentiality, and informing 
participants about the potential 
repercussions of therapy. Participants not 
selected for the intervention were referred to 
a psychotherapist if interested in exploring 

their Anxious Attachment Style and 
associated Psychosomatic Symptoms. 

Statistical Analysis 
Data analysis was conducted using SPSS 22. 
Paired sample t-tests were used to analyze 
data collected through instruments. 



29 APP| Published By AEIRC| Volume 10 Issue 1 

Result 
We compared the scores on the pretest with 

the posttest scores using the PSS-35 scale. 

Table 2 presents the mean comparison of 

adults with Anxious Attachment Style 

before and after Eidetic Psychotherapy on 

Psychosomatic Symptoms. The findings 

indicate significant mean differences in 

Psychosomatic Symptoms frequency. The 

results show that mean scores on 

Psychosomatic Symptoms frequency 

decreased after Eidetic Psychotherapy. The 

Cohen’s d value indicates a small effect size. 

Moreover, the results also indicate 

significant mean differences in 

Psychosomatic Symptoms severity. The 

mean scores on Psychosomatic Symptoms 

severity also decreased after Eidetic 

Psychotherapy, with a Cohen’s d value 

indicating a medium effect size.

Table 2: Mean Comparison of Individuals Before and After Eidetic Psychotherapy on 

Psychosomatic Symptoms. 

Variables 

Before Eidetic 
Psychotherapy 

After Eidetic 
Psychotherapy t (14) p Cohen’s d 

Mean ± SD Mean ± SD 

Psychosomatic 
Symptoms 
(Frequency) 

75.20 ± 13.68 72.33 ± 14.80 3.20 .006** 0.20 

Psychosomatic 
Symptoms 
(Severity) 

73.00 ± 6.64 68.86 ± 9.32 3.09 .008** 0.51 

**p<.01 

Figure 1: Common Psychosomatic Symptoms Found in Participants. 

**The figure is based on the non-clinical sample. 

0

2

4

6

8

10

12

14

N
o

. 
o

f 
P

a
rt

ic
ip

a
n

ts

Psychosomatic Symptoms

Psychosomatic
Symptoms



30 APP| Published By AEIRC| Volume 10 Issue 1 

Figure 2: Psychosomatic Symptoms Before and After Eidetic Psychotherapy. 

**The figure is based on the non-clinical sample. 

These figures provide visual representations of the common psychosomatic symptoms found in 

the participants and the changes in psychosomatic symptoms before and after Eidetic 

Psychotherapy.

Discussion 
The results of this study indicate a significant 
reduction in both the frequency and severity 
of Psychosomatic Symptoms following 
Eidetic Psychotherapy sessions, with small 
and medium effect sizes. These findings 
align with previous research, demonstrating 
the effectiveness of eidetic imagery as a self-
regulatory process for dealing with specific 
patients' situations within their conscious 
state of mind, ultimately addressing 
traumatic mental images through repetitive 
visualization trials19. 

Eidetic Psychotherapy has been successfully 
employed to treat various conditions, 
including pain, phobias, eating disorders, 
and depression. Notably, it has shown 
promise in treating Posttraumatic Stress 
Disorder (PTSD), as evidenced by the 30 case 
histories reported by Ahsen. Trauma-based 
disorders or symptoms often trigger 
imagery-based recall of events. The 
resolution of clients' problems and 
symptoms encourages the exploration of 
images associated with traumatic events. 
Through therapy, clients learn to interact 
with these images, gaining insight and 
recognizing somatic and emotional 
reactions23. 

0

10

20

30

40

50

60

70

80

90

100

P
sy

ch
o

so
m

at
ic

 S
y

m
p

to
m

s

No. of Participants

Frequency Before Therapy

Frequency After Therapy

Severity Before Therapy

Severity After Therapy



31 APP| Published By AEIRC| Volume 10 Issue 1 

A related study applied Eidetic 
Psychotherapy to individuals with 
Generalized Anxiety Disorder (GAD) and 
observed improvements in physiological 
and psychological symptoms. This further 
supports the effectiveness of this therapy in 
treating various conditions25. 

In our study, several therapeutic techniques 
were employed, likely contributing to the 
variance in the Psychosomatic Symptoms of 
adults with Anxious Attachment Style. The 
process began with building rapport, 
gradually allowing participants to relax and 
trust the researcher. Personality measures 
like HTP and TAT provided valuable 
insights into participants' personality traits, 
attachment, family dynamics, self-esteem, 
resilience, and coping strategies. 

Eidetic Psychotherapy's preliminary phases 
helped participants become consciously 
aware of their issues and bodily symptoms, 
which they might not have fully recognized 
before. These phases unveiled their worries 
and concerns, raising awareness and 
acceptance of the need for therapy. 
Participants learned to locate painful 
emotions in their bodies understanding the 
impact of Psychosomatic Symptoms on their 
physical well-being. 

The Eidetic Parents Test (EPT) provided 
insights into participants' unconscious, 
revealing hurtful personal experiences and 
their connection to behaviors, cognitions, 
and Psychosomatic Symptoms. This phase 
identified problematic images, emotions, 
and somatic symptoms, helping to target 
specific areas for intervention. 

During the Eidetic Psychotherapy sessions, 
the focus was on manipulating and 
restructuring problematic images identified 
in the EPT. This process gradually led to 
cognitive restructuring, reducing 
Psychosomatic Symptoms and emotional 

distress associated with the targeted images. 
Additionally, participants gained insight 
into their irrational thought patterns and 
unhealthy coping strategies26. 

Mental imagery plays a pivotal role in the 
treatment of psychological and neurological 
disorders. For example, in PTSD, intrusive 
memories and nightmares involve vivid 
visual and auditory mental images of 
traumatic events. These intrusive images 
significantly impact behavior and 
physiology. Studies have shown that mental 
imagery elicits stronger emotions than 
verbal processing of the same content, 
intensifying anxiety with negative scenarios 
and amplifying positive emotions with 
positive scenarios. 

Conclusion 
In conclusion, the therapeutic intervention 
provided in this study facilitated 
participants' recognition of emotions and 
meanings associated with their mental 
images. By repeatedly projecting these 
images, the therapy also led to changes in 
bodily symptoms and their associated 
meanings. The findings of this study support 
the hypothesis that Eidetic Psychotherapy is 
a valuable intervention for addressing 
Psychosomatic Symptoms in Individuals 
with Anxious Attachment Style. 
Psychosomatic symptoms can significantly 
affect an individual's quality of life and may 
lead to other physical and psychological 
conditions. Therefore, this study 
underscores the importance of prioritizing 
the treatment of these symptoms, similar to 
any other medical condition. 

The use of Eidetic Psychotherapy as a 
therapeutic tool opens up possibilities for 
effectively addressing psychosomatic 
symptoms and improving the overall well-
being of individuals with Anxious 
Attachment Style. Further research and 



32 APP| Published By AEIRC| Volume 10 Issue 1 

clinical applications of this therapy may 
yield valuable insights into its broader utility 
and effectiveness.   

Acknowledgment 
I am greatly indebted to my supervisor, Dr. 
Asghar Ali Shah, and Co-supervisor, Dr. 
Saima Masoom Ali and Manzoor Ahmed, for 
their contributions and valuable 
suggestions, and without their support, this 
work would not have been possible.  

References 
1. Mcleod S. John Bowlby’s Attachment Theory

[Internet]. 2022 [cited 2023 Aug 21]. Available
from:
https://www.simplypsychology.org/bowlb
y.html

2. Huang S. Attachment Styles | Simply
Psychology [Internet]. 2022 [cited 2023 Feb
18]. Available from:
https://www.simplypsychology.org/attach
ment-styles.html

3. Gasiorowska A, Folwarczny M, Otterbring T.
Anxious and status signaling: Examining the
link between attachment style and status
consumption and the mediating role of
materialistic values. Personality and 
Individual Differences. 2022 May 
1;190:111503. 

4. Robinson L, Segal J, Jaffe J. How Attachment
Styles Affect Adult Relationships - 
HelpGuide.org [Internet]. 
https://www.helpguide.org. 2023 [cited 2022 
Dec 13]. Available from: 
https://www.helpguide.org/articles/relatio
nships-communication/attachment-and-
adult-relationships.htm 

5. Gordon J. Anxious Attachment Style Guide:
Causes & Symptoms [Internet]. Attachment
Project. 2020 [cited 2022 Dec 13]. Available
from:
https://www.attachmentproject.com/blog/
anxious-attachment/

6. Lin HC, Yang Y, Elliott L, Green E. Individual
differences in attachment anxiety shape the
association between adverse childhood
experiences and adult somatic symptoms.

Child Abuse & Neglect. 2020 Mar 
1;101:104325.  

7. Dent H. Why everyone should know their
attachment style [Internet]. The Conversation.
2018 [cited 2023 Feb 18]. Available from:
http://theconversation.com/why-everyone-
should-know-their-attachment-style-105321

8. Sumter SR, Baumgartner SE. Psychosomatic
complaints in adolescence: Untangling the
relationship between offline and online peer
victimization, psychosomatic complaints and
social support. European Journal of
Developmental Psychology. 2017 Jul
4;14(4):399–415.

9. Hange D, Mehlig K, Lissner L, Guo X,
Bengtsson C, Skoog I, et al. Perceived mental
stress in women associated with
psychosomatic symptoms, but not mortality:
observations from the Population Study of
Women in Gothenburg, Sweden. Int J Gen
Med. 2013 Apr 24;6:307–15.

10. Riem MME, Doedée ENEM, Broekhuizen-
Dijksman SC, Beijer E. Attachment and
medically unexplained somatic symptoms:
The role of mentalization. Psychiatry
Research. 2018 Oct 1;268:108–13.

11. Adshead G, Guthrie E. The role of attachment
in medically unexplained symptoms and
long-term illness. BJPsych Advances. 2015
May;21(3):167–74.

12. Maulina VVR, Yogo M, Ohira H. Somatic
Symptoms: Association Among Affective
State, Subjective Body Perception, and
Spiritual Beliefs in Japan and Indonesia.
Frontiers in Psychology [Internet]. 2022 [cited
2023 Feb 18];13. Available from:
https://www.frontiersin.org/articles/10.338
9/fpsyg.2022.851888

13. Mostafaei S, Kabir K, Kazemnejad A, Feizi A,
Mansourian M, Hassanzadeh Keshteli A, et al.
Explanation of somatic symptoms by mental
health and personality traits: application of
Bayesian regularized quantile regression in a
large population study. BMC Psychiatry. 2019
Jul 3;19(1):207.

14. Kurlansik SL, Maffei MS. Somatic Symptom
Disorder. afp. 2016 Jan 1;93(1):49-54A.

15. Falahatdoost M, Dolatshahi B, Pourshahbaz
A, Dehghani M, Yalguzaghaji MN,
Mohammadi Z. Modeling the relationship
between attachment styles and somatic
symptoms with the mediating role of



33 APP| Published By AEIRC| Volume 10 Issue 1 

emotional processing. J Educ Health Promot. 
2020 Jun 30;9:157.  

16. Atratus P. How to Stop Psychosomatic Pain
and Live Your Life to the Fullest. [Internet].
2022 [cited 2023 Feb 20]. Available from:
https://domental.com/blog/how-to-stop-
psychosomatic-pain

17. Panagiotou N, Sheikh AA. Eidetic 
Psychotherapy: Introduction and Evaluation. 
Int J Soc Psychiatry. 2016;20(3–4):231–41.  

18. Dagnall L. Eidetic Image Psychology | What
is Eidetic Image Psychology? [Internet]. 2023
[cited 2023 Feb 20]. Available from:
https://eideticimagepsychology.com/what-
is-eidetic-image-psychology-2/

19. Syed Kumail Abdi, Akhtar Ali Syed, Ammara
Butt, Sumaya Batool. A Comparison of Eidetic
Image Therapy with Cognitive Behavior
Therapy for Treating Depressive and Anxiety
Disorders in Adults: A Randomized
Controlled Trial. J Allam Iqbal Med Coll
Lahore [Internet]. 2023 Feb 28 [cited 2023 Jul
8];20(3). Available from:
https://submitjaimc.website/index.php/JAI
MC/article/view/67

20. Sussman J. Jaqueline Sussman [Internet]. 2021
[cited 2023 Feb 21]. Available from:
http://www.jaquelinesussman.com/eidetic-
image-therapy/

21. Ahsen A. Basic concepts in eidetic
psychotherapy. Oxford, England: Brandon
House; 1973. xviii, 434 p. (Basic concepts in
eidetic psychotherapy).

22. Syed AA, Neelofur S, Moran A, O&#39 G,
Reilly. Investigating the potential clinical
utility of therapeutic techniques based on
eidetic imagery as adapted by the Eidetic
Model of Growth (EMG) for people with
intellectual disability (ID). Heliyon. 2020 Jan
1;6(10):e05115.

23. Kamran Ehsan M, Rowland DL. Possible Role
for Imagery-Based Therapy in Managing
PTSD in Pakistani Women Experiencing
Domestic Abuse: A Pilot Study Using Eidetic
Therapy. International Journal of
Environmental Research and Public Health.
2021 Jan;18(5):2478.

24. Kamran M, Rowland DL. Eidetic therapy in
the treatment of depression: An exploratory
application of an intervention in an emerging
nation population. Professional Psychology:
Research and Practice. 2020;51(5):527–35.

25. Ilyas S. Effectiveness of eidetic psychotherapy
for the treatment of generalized anxiety
disorder among adults. 2017 [cited 2022 Mar
15]; Available from:
http://localhost:8080/xmlui/handle/123456
789/6136

26. Pearson J, Naselaris T, Holmes EA, Kosslyn
SM. Mental Imagery: Functional Mechanisms
and Clinical Applications. Trends in
Cognitive Sciences. 2015 Oct;19(10):590.

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