Aphantasia

Aphantasia is when your brain doesn’t form or use mental images as part of your thinking or imagination.

It isn’t a medical condition, disorder or disability. Instead, it’s a characteristic, like being left- or right-handed. Aphantasia is simply a difference in how your mind works. Aphantasia that you’re born with may be a type of neurodivergence. In rare cases, it can develop after a brain injury.

Imagination is how your brain “simulates” something based on knowledge or experiences. For most people, it can take many forms, including things you can see, hear and taste. If you have aphantasia, mental pictures aren’t part of your imagination.

Aphantasia is uncommon overall. Experts estimate that between 2% and 4% of people have it. But research on it — including how many people have it — is limited. Many people don’t realize they think differently from most people.

Forms of aphantasia

There are two forms of aphantasia:

• Congenital: You’re born with aphantasia and have it your whole life. You may not know you have it because it’s all you’ve ever known.
• Acquired: You develop aphantasia later in life. It almost always happens because of an injury, illness or mental health condition.

Features of aphantasia

There are degrees of aphantasia. For example, you may:

• Never experience mental images
• Only be unable to form voluntary mental images and may have brief image “flashes” without trying (involuntary)
• May not “see” things in your dreams
• Only experience it with closed eyes

Because your “mind’s eye” doesn’t use images, your imagination works in other ways. You can still have a creative imagination with aphantasia. For example, people with it have designed video games and animated movies.

The brain is very complex. Researchers have found connections between aphantasia and other ways your brain works. Studies show that, compared to people without aphantasia, those with it tend to have:

• Poorer first-person (autobiographical) memory
• More difficulty with facial recognition
• More difficulty with visual search tasks (like scanning a room to find something)
• Higher scores on the Autism Quotient Questionnaire (AQ), which may point to a connection between visual imagery deficits and autism spectrum disorder
• A lower likelihood of developing PTSD

But each person — and brain — is different. You may find that some, all or none of these features are true for you. Researchers mainly study aphantasia to better understand how parts of the brain work overall. They don’t study it because they’re trying to find a fix for it.

What causes aphantasia?

Experts don’t know the exact cause of aphantasia. Congenital aphantasia may be genetic. People with aphantasia are much more likely to have a close biological family member who also has it.

Acquired aphantasia can develop due to damage to certain areas of your brain, like your occipital lobe and visual cortex. In rare cases, it may develop after:

• Head injuries
• Stroke
• Substance use

Is aphantasia linked to autism?

Data from one study in 2021 showed people with aphantasia are also more likely to have autism-like traits. However, the study only measured the traits, not whether the participants were actually autistic. It also didn’t measure whether autism causes or contributes to aphantasia or vice versa.

Testing for aphantasia

The most common test experts use to assess aphantasia is the Vividness of Visual Imagery Questionnaire (VVIQ) or a variation of it. The original VVIQ consists of 16 questions divided into four groups. Each question can have a score of 1 to 5.
The meaning of those scores is as follows:

• 5: You see the image so clearly and vividly, it’s like you’re looking at it in front of you.
• 4: You see the image very clearly and vividly.
• 3: You see the image moderately clearly and vividly.
• 2: You see the image, but it’s dim or vague.
• 1: You know you’re thinking about what you’re supposed to visualize. But you don’t see anything.

The VVIQ then adds up the score from each answer. The lowest possible score is 16. The highest is 80. Most experts define aphantasia as a score of 32 or less. If you have a score of 16, you have total aphantasia.

Most people with congenital aphantasia don’t realize they have it until they’re teenagers or adults. Many just assume everyone thinks the same way they do. If you have the congenital form, it’s not necessary to get a diagnosis because it doesn’t need treatment.

Acquired aphantasia is something that generally needs a diagnosis. It’s a sign that something has changed in your brain. Your provider may use a combination of imaging and diagnostic tests, along with the VVIQ, to diagnose it.

If you have acquired aphantasia, you may need treatment for the underlying cause.

When should I see a doctor or healthcare provider?

If you notice a sudden change in how your imagination or mind works, see your healthcare provider. Sudden changes can be a sign of an underlying brain issue.