Aphantasia

What is aphantasia?

Aphantasia is when your brain doesn’t form or use mental images as part of your thinking or imagination. Experts don’t define aphantasia as a medical condition, disorder or disability. Instead, it’s a characteristic, much like which hand you naturally use to write. Available research indicates it’s simply a difference in how your mind works.

Imagination is how your brain “simulates” something based on knowledge or past experience. For most people, imagination can take many forms (things you can see, hear, taste, etc.). And some people have stronger imagination abilities than others.

Think of visual imagination like a television. Some people have black-and-white TVs. Others have color TVs. An extremely vivid imagination is like having an ultra-high-definition digital television.

Having aphantasia is like your mind not having a TV because it wouldn’t use it. Because your “mind’s eye” doesn’t work like that, your imagination works in other ways.

Forms of aphantasia

There are two forms of aphantasia:

• Congenital. This is aphantasia you have your entire life. People who have this may not know they have it because they're unaware that not having mental imagery is uncommon.
• Acquired. This is aphantasia that you develop later in life. Acquired aphantasia almost always happens because of an injury, illness or mental health condition.

How common is aphantasia?

The available research indicates that aphantasia is uncommon overall. Experts estimate between 2% and 4% of people have it. However, research on this condition — including how many people have it — is limited.

It’s also difficult to determine who has it because many people with aphantasia don’t realize they think in a way that’s different from most people. People with aphantasia may not realize that most people can “see” images they generate in their minds. Some with aphantasia say they thought using the word “see” in that context was a metaphor. Because of this, aphantasia may be more common than research currently shows.

What do people with aphantasia experience?

Aphantasia doesn’t affect everyone with it in the same way:

• There are degrees of aphantasia. Some people have total aphantasia and never experience mental images. Others only have it when they try to form mental images. They still experience brief image “flashes” without trying or “see” things in their dreams.
• A small percentage of people with aphantasia only experience it with closed eyes. A little over 15% of people with aphantasia can “see” mental images if they open their eyes. Why this happens is unknown.
• Aphantasia may also affect the way you store or access memories. People with aphantasia are more likely to have difficulties with first-person (autobiographical) memory. That means while they can recall things they did or experienced, they can’t visualize them. Experts suspect that may limit memory in certain ways, but more research is necessary to confirm this.

What causes aphantasia?

Experts don’t know why exactly congenital aphantasia happens. There are some possible explanations, but for now, these are unconfirmed.

Congenital aphantasia

Congenital aphantasia may be genetic. People with aphantasia are much more likely to have a close biological family member who also has it, so it may run in families.

Congenital aphantasia may also be a form of neurodiversity. Being neurodivergent means your brain developed or works differently from the brains of people whose brains developed or work as expected (the term for that is “neurotypical”).

Conditions like autism spectrum disorder fall under the umbrella of neurodiversity, and autism has a genetic link. People with aphantasia are also more likely to have autism-like traits. However, more research is necessary before experts know what role genetics and neurodiversity play in developing congenital aphantasia.

Acquired aphantasia

Some — but not all — cases of acquired aphantasia have causes experts can find. In rare cases, it can be a symptom of injuries or illnesses that affect your brain. Aphantasia can happen due to damage to certain areas of your brain, especially your occipital lobe.

Some examples of conditions or circumstances that can cause acquired aphantasia include:

• Head injuries (such as concussion or traumatic brain injury).
• Stroke.
• Nonmedical drug use.

Even rarer, aphantasia can happen with (or maybe because of) mental health conditions like mood disorders or depersonalization/derealization disorder. People with this kind of aphantasia usually can still have mental imagery, but they can’t form the images intentionally. Experts aren’t sure how or why aphantasia can happen with mental health conditions or why it may only affect deliberate attempts to form mental images.

How is aphantasia diagnosed?

Most people with congenital aphantasia don’t realize they have it until they’re teenagers or adults. Because they don’t “see” how other people form (or don’t form) mental images, many assume everyone thinks the same way they do. People with congenital aphantasia rarely need a formal diagnosis because that’s how their mind has worked their entire life.

Acquired aphantasia is something that generally needs diagnosis. Experts can use a combination of imaging and diagnostic tests and specific questionnaires that measure how strongly you experience mental imagery.

Diagnostic and imaging scans can include:

• Computed tomography (CT) scans.
• Magnetic resonance imaging (MRI) scans.
• Electroencephalogram (EET).

The most common questionnaire experts use to “score” mental imagery abilities 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:

The VVIQ then adds up the score from each answer. The lowest possible score is 16, and 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.

How is aphantasia treated?

Aphantasia isn’t a medical or mental health condition, so it doesn’t need treatment.

Acquired aphantasia due to another condition affecting your brain isn’t curable or directly treatable. Healthcare providers generally treat the underlying condition or issue causing your aphantasia. Those treatments can vary widely. Your healthcare provider is the best person to explain treatment options and offer recommendations if you have acquired aphantasia.

When should a healthcare provider treat aphantasia?

Acquired aphantasia almost always needs diagnosing and treatment. That’s because it’s possible with several brain-related conditions that are serious or dangerous.

Congenital aphantasia is unlikely to need medical treatment.

Mental healthcare and aphantasia

Research shows that people with aphantasia of any type may be more likely to experience emotional effects like anxiety or depression. These often relate to their aphantasia and/or the challenges it presents.

If you know you have aphantasia (or suspect you may have it) and think it’s contributing to mental health concerns, you should talk to a healthcare provider. They can either offer suggestions directly or help you find a mental health provider who can help you.

What does someone with aphantasia see?

What a person with aphantasia sees depends on the degree of its effects. Those effects can also vary widely among people with aphantasia.

For example, someone with a VVIQ score of 32 might have very limited mental images. To them, their images may be dim, vague, fuzzy or otherwise hard to make out.

Someone with a VVIQ score of 16, meaning total aphantasia, can’t form any mental images. Some who have this degree of aphantasia describe it like being blind or having their eyes closed.

Is aphantasia a type of autism?

No, autism and aphantasia are entirely different conditions. Autism is a recognized neurodevelopmental disorder with specific definitions and criteria. Aphantasia isn’t a medical or mental health condition of any kind. For now, experts classify it as a characteristic, like being right- or left-handed.

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 if the participants were actually autistic. It also didn’t measure if autism causes or contributes to aphantasia or vice versa.

Is congenital aphantasia a disability?

Available research indicates that congenital aphantasia isn’t a disability (or even a medical condition). While it can create certain challenges for people, there isn’t enough evidence to justify classifying it as a medical condition or disability.

People with aphantasia often compensate for their lack of mental imagery in other ways. Many choose career paths that lead them into mathematics or sciences.

But aphantasia doesn’t have to stop creativity or artistic pursuits. Among those with aphantasia is Glen Keane, who designed and animated the lead character Ariel in Walt Disney Pictures’ 1989 animated film, “The Little Mermaid.” Keane’s achievements include an Academy Award for work as an animator and director, and the National Cartoonist Society’s “Cartoonist of the Year” award.

A note from Cleveland Clinic

Aphantasia means you can’t picture things in your mind, and while most people don’t have it, it isn’t a disease or disability. Just as being left-handed isn't a disability in a world where most people are right-handed, having congenital aphantasia is no more than a difference in how you use your mind. Some people develop it due to illness or injury, but that’s rare.

Most people with aphantasia don’t experience issues from it (and many don’t even realize their minds work differently). Many people with it find success in science and math-related fields, but there’s no shortage of artists and other creative professionals with it, too. That means having aphantasia doesn’t have to hold you back from seeing and pursuing the things you want in life.