ArticleHealth psychology and behavioral medicine2026
Embodied meaning in therapeutic discourse during cognitive-behavioral therapy for generalized anxiety disorder: an image schema analysis.
Article in Health psychology and behavioral medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Image schemas are simple mental structures that are formed from the body's interaction with the physical environment. One of the leading theories in this area is the one proposed by Mark Johnson. The aim of this study was to identify, classify, and quantify image schemas employed by psychotherapists during cognitive-behavioral therapy sessions with patients diagnosed with Generalized Anxiety Disorder and to explore the conceptual organization of therapeutic discourse through Johnson's image schema framework. Methods: This study employed a qualitative cognitive discourse analysis approach, supplemented by descriptive statistical methods. Data collection was done through audio recording of psychotherapy sessions of 16 patients with generalized anxiety disorder based on cognitive-behavioral therapy approach. The sampling method was purposive. Then, the conversations of the treatment process have been investigated based on the frequency and types of image schemas used in the discourse. Results: A total of 2,057 cognitive schemas were identified throughout the therapeutic conversations. Among these, 1017 schemas with an average of 49.44% related to types of force schemas, 557 schemas with an average of 27.08% related to types of path schemas, and 483 schemas with an average of 23.48% related to types of containment schemas. A chi-square goodness of fit test and pairwise Z-tests for proportions were conducted to assess whether these differences were statistically significant. The results showed that force schemas were used significantly more than other types. Conclusions: The results of this study suggest that integrating Johnson's theory of image schemas with cognitive-behavioral therapy may offer a complementary conceptual framework for understanding how anxious patients might reframe their negative thoughts and underlying mental models.
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