“If counting sheep is an abstract concept to you, or you are unable to visualize the faces of loved ones, you could have aphantasia.”[1] The origin of the word is “a” from the English “without” and the Greek “phantasia” meaning imagination or appearance.

The phenomenon was first described by Francis Galton in 1880 and remained relatively unknown until publication of a study conducted by a team led by Professor Adam Zeman of the University of Exeter. Hyperphantasia, the condition of having extremely vivid mental imagery, is the opposite of aphantasia. In a research report by Professor Zeman published in 2020, he describes hyper vivid visual imagery as allowing one to inspect absent items in the mind’s eye, somewhat as if one was seeing them.[2]

My experience with aphantasia began with a report by the BBC of the condition described above. I was a practising anesthesiologist who retired in 2018 and realized that the description of aphantasia applied to me. I subsequently took a number of tests online under the heading of Vividness of Visual Imagery Questionnaire (VVIQ), which confirmed my poor visual imagination.

During my career in anesthesia, I made extensive use of atlases to aid me in the performance of regional anesthesia such as spinal and epidural anesthetics. Although moderately proficient in such techniques, I would often call on colleagues when I had an especially challenging patient with obesity. In particular, one colleague who would reliably be successful in cases where I struggled had what I thought of as X-ray vision.

I write this short report to bring awareness of this condition to the general medical community, especially in areas where visualization may play an important role. Diagnosis of this condition is initially established by the VVIQ, which I mention above. Establishing this condition in medical students may help learning in areas where visualization is important and also in specialty selection. Finally, there are many resources on the Internet to explore this condition.
—Thomas M. D’Arcy, LRCP&SI, FRCPC


1.    University of Exeter. Can’t count sheep? You could have aphantasia: Some people are born without the ability to visualize images. ScienceDaily, 26 August 2015. Accessed 25 September 2021. www.sciencedaily.com/releases/2015/08/150826101648.htm.

2.    Zeman A, Milton F, Della Salla S, et al. Phantasia–The psychological significance of lifelong visual imagery vividness extremes. Cortex 2020;130:426-440.

Thomas M. D’Arcy, LRCP&SI, FRCPC. Aphantasia. BCMJ, Vol. 63, No. 10, December, 2021, Page(s) 408 - Letters.

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