Aphantasia – Causes, Symptoms & Treatment


The Aphantasia is a special form of visual agnosia and corresponds to the complete inability to voluntarily retrieve visual images. The clinical picture probably goes back to brain defects. Therapies do not exist so far.

Table of Contents

What is Aphantasia?

The subconscious and the consciousness of man work on mental pictures. Visualization is a basic process of cognition. Cognitive visualization processes arise through a network of different brain regions, mainly through the areas of the parietal, frontal, temporal and occipital lobes. For cognitive visualization stored memories are crucial, the corresponding images call to consciousness.

For example, those who read a novel generally see the described situations in their mind’s eye. The ability to cognitive visualization is individual to a degree. The absolute inability for such a visualization and thus the total absence of an imagination is called Aphantasia. Professor Adam Zeman of the University of Exeter Medical School introduced the term 2015 as part of a study on soul blindness.

The term was used by him to describe a hypothetical state. He referred to a 65-year-old man who allegedly lost his imagination after undergoing cardiac surgery. After the publication of Zeman’s remarks, more than 20 people described themselves as Aphantasia patients.


Adam Zeman and his colleagues have associated the Aphantasia with the blindness or visual agnosia. It is a disorder in the processing of visual stimuli caused by damage to the visual center. This visual center sits in the occipital lobe and does not allow visual agnostics to recognize objects and faces even though they can clearly see the objects.

Most patients of visual agnosia can at least approximately describe objects based on their visual memory. Patients of the hypothetical Aphantasia would not be able to do this. Thus the Aphantasia would be a special form of visual agnosia and could at the same time be described as the most extreme type of blindness. As a cause for the absolute inability to visual representation, the first authors of a serious defect in the involved brain regions.

Whether genetic factors such as hereditary mutations or external factors such as toxin exposure favor the absolute Aphantasia is not yet clear. Some of the apparent Aphantasia patients have reported symptoms since birth. Others attributed the onset of the disease to a major traumatic event in their lives, such as the death of a loved one. It is also probable that the innate form of the Aphantasia differs so far from the acquired one, that it must be assumed that there are various diseases.

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Symptoms, complaints & sign

Although patients of the Aphantasia can see, despite the ability to process visual stimuli, they have no ability to arbitrarily retrieve images from their visual memory or their cognitive imaginations. This connection leads to the fact that those concerned can not visualize situations, objects or living beings on the basis of a pure description.

Some patients feel excluded from professions such as architecture because they can not imagine the end product of the work. Many state that descriptive texts are fundamentally meaningless to them. Still others can not remember the looks of their partners or deceased family members and are very much affected by this. Most of the patients are completely unable to relive moments already lived in their imagination.

Patients often describe a feeling of isolation and loneliness accompanied by symptomatic symptoms. The nocturnal dreams do not seem to be affected by Aphantasia. Most of the patients say they can not imagine what they are thinking. The visualization of thoughts corresponds to a conscious visualization. The visualization in the dream is a visualization of the subconscious. The apparent decoupling of unconscious and conscious visualization suggests, as the cause of the Aphantasia, a defect in a region of the brain that is particularly active when awake.


So far, the history is the only means of diagnosing an Aphantasia. So far, the diagnosis can only be suspected. Diagnostic means do not exist. Since the history takes place on the basis of subjective descriptions by the patient, an objective diagnosis is currently impossible.


In Aphantasia, there are usually no special medical complications. Through the Aphantasia, the patient can not visualize things or processes or only very limited. The Aphantasia can occur completely differently in many people, with this symptom there is no measure, at which the expression can be defined.

As a rule, the patient can not visualize mental images or imagine events. This usually leads to a limited ability to think. However, people with Aphantasia can lead a completely ordinary life without any further restrictions. You may not be able to perform certain artist professions or remember events well.

Often those affected also descriptions of events from the past are relatively difficult. The Aphantasia is largely unexplored, so there is no way to treat this symptom. It may be innate or occur after an accident. With strong characteristics, a spatial thinking and imagination is not readily possible.

In everyday life, this leads to no special complications. Also, the life expectancy in people with Aphantasia is no less than in healthy people. In most cases, those affected are unaware that they are suffering from Aphantasia.

When should you go to the doctor?

An Aphantasia does not necessarily have to be clarified by a doctor. Anyone who has the suspicion that they have no visual imagination should seek medical advice. Although there is still no effective treatment method, by therapeutic measures, the lack of imagination can be compensated. Whether this is necessary depends on whether it is an innate or a developed Aphantasia and how strong the phenomenon is pronounced.

Ultimately, the person affected must decide for himself whether and to what extent the Aphantasia restricts the quality of life. An initial consultation, however, can take uncertainties in dealing with the rare phenomenon and show treatment options. Aphantasia after a stroke or other illness should be discussed with the appropriate physician.

It may just be the side effect of a certain drug, or the Aphantasia has mental causes. A doctor should be consulted at the latest when the phenomenon affects the quality of life. For example, if the person concerned is no longer able to learn properly or perform the activities in the workplace, medical advice is required.

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treatment & therapy

Since Aphantasia has so far been a hypothetical concept rather than an objectively real disease, there are no options for therapy so far. Only with the clarification of the causes, for example, can causal therapies develop. Symptomatic therapies would probably include cognitive training in the Aphantasia that activates and promotes visual imagination. If a defect in the brain actually causes the condition, such training may still alleviate the symptoms.

Stroke patients, despite irreversible brain damage, are able to rehabilitate by bringing healthy brain regions to take over tasks from the damaged regions by repeating certain procedures frequently. According to this principle, patients of the Aphantasia could under professional guidance, for example, daily train the visual memory of certain objects or faces.

Under certain circumstances, an electrical stimulation of the defective brain region would be considered as a treatment option. Since Aphantasia after a psychic trauma can not be the same disease as the congenital or the physical Aphantasia, these patients are probably treated in a completely different way. Thus, a review of the triggering psychological trauma in psychotherapy presumably repeal the conceptual blockage for these patients.

view & forecast

The Aphantasia has an unfavorable prognosis. The disease is not treatable or curable according to current scientific findings.

There is a defect in the brain tissue that is not repairable with current medical research. In addition, within some therapeutic approaches there is the increased risk of damaging further brain tissue. This would lead to an immediate deterioration of the common good and cause new disturbances or impairments. This threatens the patient a life-threatening condition. Without treatment or therapy, the physical state of health usually does not change. An increase in symptoms is therefore not expected in the course of further life.

Since this condition can not be cured, the treatment plan focuses on improving the after-effects of Aphantasia. These usually relate to the psyche of the patient. In order to maintain the zest for life and to optimize the well-being, psychotherapeutic approaches are available to the patient.

In a therapy, the self-confidence of the patient is strengthened, cognitive patterns are questioned and the handling of the disease is discussed and trained. This helps the sufferer to improve the quality of life in everyday life and to be more optimistic about the daily challenges. With a mental strength, it is often possible to have a fulfilled life despite impairments.

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The Aphantasia can not be prevented so far, because the research has not progressed far enough.


One goal of the aftercare is to prevent the recurrence of the disease. According to the current state of science this can not be done with an Aphantasia. It is considered incurable. The reason is a defect in the brain tissue. This may be innate or caused by an accident.

Nonetheless, follow-up may be useful to prevent complications and provide day-to-day support to the patient. In practice, the wish of the person affected is decisive. The Aphantasia is not a life-threatening disease. Only if the quality of life suffers, the way to the doctor is advisable.

The attending physician can arrange for a psychotherapy. As a result, cognitive supports are to be set in everyday life. The self-confidence can be strengthened as well. A drug treatment is not effective according to previous scientific standards. The Aphantasia is diagnosed by means of presentation tests.

Patients score comparatively poorly compared to other subjects. An essential diagnostic tool is also the subjective description. Clear and objective methodologies for detection do not yet exist. Some scientists believe that electrostimulation can treat brain areas positively. However, this is an experimental field so far.

You can do that yourself

If Aphantasia is suspected, various online tests and diagnostic methods can be consulted. If this results in the fact that the imagination is actually severely limited, a doctor must be consulted. This can determine whether it is a congenital or a mental or disease-related Aphantasia and suggest a suitable therapy.

In a disease-related Aphantasia, as occurs for example in stroke patients, the imagination can be strengthened by regularly repeating certain processes and so in the long term raised to its original level. Under professional guidance or at home, further exercises to strengthen the visual memory and more generally the imagination can be performed. In a psychic Aphantasia must be treated within psychotherapy, the triggering psychological trauma.

Possible self-measures include changing the environment or changing the lifestyle. An innate phantasia must be accepted by those affected. Treatments such as cognitive training or electrical stimulation may be able to alleviate the symptoms but not completely restore the imagination. Dealing with the disease can be learned, for example, by appropriate specialist reading and discussions with medical specialists.

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Christina Cherry
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