Positive visual reframing: A randomised controlled trial using drawn visual imagery to defuse the intensity of negative experiences and regulate emotions in healthy adults

Keywords: drawn images, reframing, negative open memories, emotional regulation


This research explores the outcome of positive visual reframing (PVR), a single session intervention where drawn images of negative experiences and open memories were redrawn and visually reframed to form new positive narratives. The study hypothesised that PVR would lead to improvements to positive and negative affect, self-efficacy and the perceived intensity and perceived resolution of a selected negative experience. Healthy adults (N=62) were randomly assigned to the PVR or control condition. For the experimental group, statistical significance was identified for positive affect and the perceived intensity and resolution of the negative experience immediately following the PVR activity. Self-efficacy was marginally significant. The findings highlight the potential of positive visual reframing to enhance emotional regulation when negative emotions are triggered. At two weeks’ post-intervention, improvements were identified in both conditions. This suggests that over time, the visual and sensory exposure created by drawing a negative memory may also lead to positive gains. The study emphasises the potential of PVR to regulate emotions and defuse the intensity of negative or open memories by visually transforming a moment of peak perceptual intensity. Future studies exploring the effectiveness of positive visual reframing to shift negative emotions in clinical and non-clinical populations are recommended.


Download data is not yet available.

Author Biographies

Julia C. Ruppert, Collective Arts
Collective Arts, Transformation and wellbeing
Francisco Jose Eiroa-Orosa, University of Barcelona

Marie Skłodowska-Curie Researcher

Section of Personality, Evaluation and Psychological Treatment

Department of Clinical Psychology and Psychobiology

Faculty of Psychology

University of Barcelona



Abele, A. (1985). Thinking about thinking: Causal, evaluative, and finalistic cognitions about social situations. European Journal of Social Psychology, 15, 315-332. http://doi.org/10.1002/ejsp.2420150306

Allport, G.W., & Postman, L. (1946). An analysis of rumor. Public Opinion Quarterly, 10, 501–517. https://doi.org/10.1093/poq/10.4.501

Antonovsky, A. (1993). The structure and properties of the Sense of Coherence scale. Social Science & Medicine, 36, 725–733. https://doi.org/10.1016/0277-9536(93)90033-Z

Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman.

Bar-Anan, Y., Wilson, T., & Gilbert, D. (2009). The feeling of uncertainty intensifies affective reactions. Emotion, 9, 123-127. http://dx.doi.org/10.1037/a0014607

Beike, D. R., & Wirth-Beaumont, E.T. (2005). Psychological closure as a memory phenomenon. Memory, 13, 574-593. http://doi.org/10.1080/09658210444000241

Bell, C. E., & Robbins, S. J. (2007). Effect of art production on negative mood: A randomized control trial. Art Therapy: Journal of the American Art Therapy Association, 24, 71-75. http://doi.org/10.1080/07421656.2007.10129589

Bocanegra, B. R., & Zeelenberg, R. (2009). Emotion improves and impairs early vision. Psychological Science, 20, 707-713. http://doi.org/10.1111/j.1467-9280.2009.02354.x

Bohanek, J., Fivush, R., & Walker, E. (2005). Memories of positive and negative events. Applied Cognitive Psychology, 19, 51-66. http://doi.org/10.1002/acp.1064

Chan. K., & Horneffer, K. (2006). Emotional expression and psychological symptoms: A comparison of writing and drawing. The Arts in Psychotherapy, 33, 26-36. http://doi.org/10.1016/j.aip.2005.06.001

Cohn, N., Paczynski, M., Jackendoff, R., Holcomb, P. J., & Kuperberg, G. R. (2012). (Pea) nuts and bolts of visual narrative: Structure and meaning in sequential image comprehension. Cognitive psychology, 65(1), 1-38. https://doi.org/10.1016/j.cogpsych.2012.01.003

Conway, M. A. (2009). Episodic memories. Neuropsychologia, 47, 2305-2313. http://doi.org/10.1016/j.neuropsychologia.2009.02.003

Conway, M., Anderson S., Larsen S., Donnelly C., McDaniel M., McClelland A., Rawles R., & Logie R. (1994). The formation of flashbulb memories. Memory & Cognition 22, 326-343. Cohn, N., Paczynski, M., Jackendoff, R., http://doi.org/10.3758/BF03200860

Conway, M. A., & Pleydell-Pearce, C. W. (2000). The construction of autobiographical memories in the self-memory system. Psychological Review, 107, 261-288. http://dx.doi.org/10.1037/0033-295X.107.2.261

Curci, A., Lanciano, T., Soleti, E., & Rimé, B. (2013). Negative emotional experiences arouse rumination and affect working memory capacity. Emotion 13, 867-880. http://doi.org/10.1037/a0032492

Dalebroux, A., Goldstein, T., & Winner, E. (2008). Short-term mood repair through art making: Positive emotion is better than venting. Motivation and Emotion, 32, 288-295. http://doi.org/10.1007/s11031-008-9105-1

De Petrillo, L., & Winner, E. (2005). Does art improve Mood? A test of a key assumption underlying art therapy. Art Therapy: Journal of the American Art Therapy Association, 22, 205-212. http://doi.org/10.1080/07421656.2005.10129521

Dodge, R., Daly, A. P., Huyton, J., & Sanders, L. D. (2012). The challenge of defining wellbeing. International journal of wellbeing, 2(3). http://doi:10.5502/ijw.v2i3.4.Drake, J. E., & Winner, E. (2012). Confronting sadness through art-making: Distraction is more beneficial than venting. Psychology of Aesthetics, Creativity, and the Arts, 6, 255-261. http://doi.org/10.1037/a0026909

Ehring, T., Tuschen-Caffier, B., Schnulle, J., Fischer, S., & Gross, J. J. (2010). Emotion regulation and vulnerability to depression: Spontaneous versus instructed use of emotion suppression and reappraisal. Emotion, 10, 563-572. http://dx.doi.org/10.1037/a0019010

Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R. J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 992-1003.


Forgas, J. (1998). Happy and mistaken? Mood effects on the fundamental attribution error. Journal of Personality and Social Psychology, 75, 318-331. http://dx.doi.org/10.1037/0022-3514.75.2.318

Frederick, S., & Loewenstein, G. (1999). Hedonic adaptation. In E. Diener, N. Schwartz, & D. Kahneman (Ed.), Hedonic psychology: Scientific approaches to enjoyment, suffering, and well-being (pp. 302–329). New York: Russell Sage Foundation Press.

Fredrickson, B. L. (1998). What good are positive emotions? Review of general psychology, 2(3), 300-319. http://dx.doi.org/10.1037/1089-2680.2.3.300

Fredrickson, B. L. (2000). Extracting meaning from past affective experiences: The importance of peaks, ends and specific emotions. Cognition & Emotion, 14(4), 577-606. http://doi.org/10.1080/026999300402808

Frijda, N. (1988). The laws of emotion. American Psychologist, 43, 349-358. http://dx.doi.org/10.1037/0003-066X.43.5.349

Garnefski, N., Teerds, J., Kraaij, V., Legerstee, J., & van den Kommer, T. (2004). Cognitive emotion regulation strategies and depressive symptoms: Differences between males and females. Personality and Individual Differences, 36, 267-276. http://dx.doi:.org/10.1016/S0191-8869(03)00083-7

Hayes, S. C., & Wilson, K. G. (1994). Acceptance and commitment therapy: Altering the verbal support for experiential avoidance. The Behavior Analyst, 17, 289-303. http://dx.doi:.org/10.1007/BF03392677

Holmes, E. A., Arntz, A., & Smucker, M. R. (2007). Imagery rescripting in cognitive behaviour therapy: Images, treatment techniques and outcomes. Journal of Behavior Therapy and Experimental Psychiatry, 38, 297-305. http://doi.org/10.1016/j.jbtep.2007.10.007

Holmes, E. A., & Mathews, A. (2010). Mental imagery in emotion and emotional disorders. Clinical Psychology Review, 30(3), 349-362. http://doi.org/10.1016/j.cpr.2010.01.001

Huss, E., & Sarid, O. (2014). Visually transforming artwork and guided imagery as a way to reduce work related stress a quantitative pilot study. The Arts in Psychotherapy, 41(4), 409-412. http://doi.org/10.1016/j.aip.2014.07.004

Isen, A. M. (2002). Missing in action in the AIM: Positive affect’s facilitation of cognitive flexibility, innovation, and problem solving. Psychological Inquiry, 13(1), 57-65.

John, O. P., & Gross, J. J. (2004). Healthy and unhealthy emotion regulation: Personality processes, individual differences, and life span development. Journal of Personality, 72, 1301-1334. http://doi.org/10.1111/j.1467-6494.2004.00298.x

Klein, K., & Boals, A. (2001). The relationship of life event stress and working memory capacity. Applied Cognitive Psychology, 15, 565-579. http://doi.org/10.1002/acp.727

Kuvaasa, B., & Selart, M. (2004). Effects of attribute framing on cognitive processing and evaluation. Organizational Behavior and Human Decision Processes 95, 198-207. http://doi.org/10.1016/j.obhdp.2004.08.001

Lakoff, G. (2004). Don't think of an elephant: Know your values and frame the debate. Vermont, USA: Chelsea Green Publishing.

Lambert, N. M., Graham, S. M., Fincham, F. D., & Stillman, T. F. (2009). A changed perspective: How gratitude can affect sense of coherence through positive reframing. The Journal of Positive Psychology, 4, 461-470. http://doi.org/10.1080/17439760903157182

Lang, P. J., & Bradley, M. M. (2010). Emotion and the motivational brain. Biological Psychology, 84, 437-450. http://doi.org/10.1016/j.biopsycho.2009.10.007

Latu, I. M., Mast, M. S., Lammers, J., & Bombardi, D. (2013). Successful female leaders empower women's behavior in leadership tasks. Journal of Experimental Social Psychology, 49, 444-448. http://doi.org/10.1016/j.jesp.2013.01.003

Lazarus, R. S. (1991). Progress on a cognitive-motivational-relational theory of emotion. American Psychologist, 46, 819-834. http://dx.doi.org/10.1037/0003-066X.46.8.819

Lazarus, R. S., & Alfert, E. (1964). Short-circuiting of threat by experimentally altering cognitive appraisal. Journal of Abnormal and Social Psychology, 69, 195-205. http://dx.doi.org/10.1037/h0044635

Libby, L. K., & Eibach, R. P. (2002). Looking back in time: Self-concept change affects visual perspective in autobiographical memory. Journal of Personality and Social Psychology, 82, 167-179. http://dx.doi.org/10.1037/0022-3514.82.2.167

Lyubomirsky, S. (2006). Happiness: Lessons from a new science. British Journal of Sociology, 57, 535-536. http://doi.org/10.1111/j.1468-4446.2006.00123_12.x

Lyubomirsky, S., Sheldon, K.M., & Schkade, D. (2005). Pursuing happiness: The architecture of sustainable change. Review of General Psychology, 9, 111-131. http://dx.doi.org/10.1037/1089-2680.9.2.111

Lyubomirsky, S., Sousa, L., & Dickerhoof, R. (2006). The costs and benefits of writing, talking, and thinking about life’s triumphs and defeats. Journal of Personality and Social Psychology, 90, 692-708. http://dx.doi.org/10.1037/0022-3514.90.4.692

Malle, B.F., & Knobe, J. (1997). Which behaviors do people explain? A basic actor-observer asymmetry. Journal of Personality and Social Psychology, 72, 288-304. http://dx.doi.org/10.1037/0022-3514.72.2.288

Mathews, A., Ridgeway, V., & Holmes, E. A. (2013). Feels like the real thing: Imagery is both more realistic and emotional than verbal thought. Cognition and Emotion, 27, 217-229. http://doi.org/10.1080/02699931.2012.698252

McIsaac, H. K., & Eich, E. (2002). Vantage point in episodic memory. Psychonomic Bulletin & Review, 9, 146-150. http://doi.org/10.3758/BF03196271.

Mercer, A., Warson, E., & Zhao, J. (2010). Visual journaling: An intervention to influence stress, anxiety and affect levels in medical students. The Arts in Psychotherapy, 37, 143-138. http://doi.org/ 10.1016/j.aip.2009.12.003

Metcalfe, J., & Mischel, W. (1999). A hot/cool-system analysis of delay of gratification: Dynamics of willpower. Psychological Review, 106, 3-19. http://dx.doi.org/10.1037/0033-295X.106.1.3

Nigro, G., & Neisser, U. (1983). Point of view in personal memories. Cognitive Psychology, 15, 467-482. http://doi.org/ 10.1016/0010-0285(83)90016-6

Ochsner, K.N., & Gross, J.J. (2005). The cognitive control of emotion. Trends in Cognitive Sciences, 9, 242-249. http://dx.doi.org/10.1016/j.tics.2005.03.010

Öhman, A., & Mineka, S. (2001). Fears, phobias, and preparedness: Toward an evolved module of fear and fear learning. Psychological Review, 108, 483-522. http://dx.doi.org/10.1037/0033-295X.108.3.483

Pakenham, K.I., & Cox, S. (2008). Development of the benefit finding in multiple sclerosis (MS) caregiving scale: A longitudinal study of relations between benefit finding and adjustment. British Journal of Health Psychology, 13, 583-602. http://doi.org/10.1348/135910707X250848

Peeters, G., & Czapinski, J. (1990). Positive-negative asymmetry in evaluations: The distinction between affective and informational negativity effects. European Review of Social Psychology, 1, 33-60. http://doi.org/10.1080/14792779108401856

Pennebaker, J.W., Kiecolt-Glaser, J., & Glaser, R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239-245. http://dx.doi.org/10.1037/0022-006X.56.2.239

Pennebaker, J. W. (1993). Putting stress into words: Health, linguistic, and therapeutic Implications. Behaviour Research and Therapy, 31, 539-548. http://doi.org/10.1016/0005-7967(93)90105-4

Pizarro, J. (2004). The efficacy of art and writing therapy: Increasing positive mental health outcomes and participant retention after exposure to traumatic experience. Art Therapy: Journal of the American Art Therapy Association, 21, 5-12. http://doi.org/10.1080/07421656.2004.10129327

Schwarzer, R., & Jerusalem, M. (1995). Generalized Self-Efficacy Scale. In J. Weinman, S. Wright and M. Johnston’s, Measures in Health Psychology: A User’s Portfolio. Causal and control beliefs (pp. 35-37). Windsor, UK: Nfer-Nelson.

Semmer, N. (2008) Stress Management and Well-being Interventions in the Workplace. State-of-Science Review: SR-C6. Report by the Foresight Project, London: Government Office for Science. Retrieved from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/292453/mental-capital-wellbeing-summary.pdf.

Taylor, S. E. (1991). Asymmetrical effects of positive and negative events. Psychological Bulletin, 110, 67-85. http://dx.doi.org/10.1037/0033-2909.110.1.67

Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health and Quality of Life Outcomes, 5(63). http://doi.org/10.1186/1477-7525-5-63

Thayer, J. F., Rossy, L. A., Ruiz-Padial, E., & Johnsen, B. H. (2003). Gender differences in the relationship between emotional regulation and depressive symptoms. Cognitive Therapy and Research, 27, 349-364. https://doi.org/10.1023/A:1023922618

Torralba, A., & Oliva, A. (2003). Statistics of natural image categories. Network: Computation in Neural Systems, 14, 391-412. http://doi.org/10.1088/0954-898X_14_3_302

Van der Kolk, B. A., & Van der Hart, O. (1991). The intrusive past: The flexibility of memory and the engraving of trauma. American Imago, 48(4), 425-454.

Walker, W. R., Vogl, R. J., & Thompson, C. P. (1997). Autobiographical memory: Unpleasantness fades faster than pleasantness over time. Applied Cognitive Psychology, 11, 399-413. http://doi.org/10.1002/(SICI)1099-0720(199710)11:5<399::AID-ACP462>3.0.CO;2-E

Watkins, E. R. (2008). Constructive and unconstructive repetitive thoughts. Psychological Bulletin, 134, 163-206. http://dx.doi.org/10.1037/0033-2909.134.2.163

Watkins, P. C., Cruz, L., Holben, H., & Kolts, R. L. (2008). Taking care of business? Grateful processing of unpleasant memories. The Journal of Positive Psychology, 3, 87-99. http://doi.org/10.1080/17439760701760567

Watson, D., & Clark L. A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS Scale. Journal of Personality and Social Psychology, 54(6), 1063-1070. http://dx.doi.org/10.1037/0022-3514.54.6.1063

Wegner, D. M., Schneider, D. J., Carter, S., & White, T. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53, 5-13.

Whalen, P. (1998). Fear, vigilance, and ambiguity: Initial neuroimaging studies of the human amygdala. Current Directions in Psychological Science, 7(6), 177-188. http://dx.doi.org/10.1111/j.1745-6924.2008.00085.x

Wilson, T.D., Centerbar, D. B., Kermer, D.A., & Gilbert, D.T. (2005). The pleasures of uncertainty: Prolonging positive moods in ways people do not anticipate. Journal of Personality and Social Psychology, 88, 5-21. http://dx.doi.org/10.1037/0022-3514.88.1.5

Wilson, T. D., & Gilbert, D. T. (2008). Explaining away: A model of affective adaptation. Perspectives on Psychological Science, 3, 370-386. http://dx.doi.org/10.1111/j.1745-6924.2008.00085.x

Winkielman, P., Berridge, K. C., & Wilbarger, J. L. (2005). Unconscious affective reactions to masked happy versus angry faces influence consumption behavior and judgments of value. Personality and Social Psychology Bulletin, 31(1), 121-135. http://doi.org/10.1177/0146167204271309

How to Cite
Ruppert, J. C., & Eiroa-Orosa, F. J. (2018). Positive visual reframing: A randomised controlled trial using drawn visual imagery to defuse the intensity of negative experiences and regulate emotions in healthy adults. Anales De Psicología / Annals of Psychology, 34(2), 368-377. https://doi.org/10.6018/analesps.34.2.286191
Basic Psychology