The perspective on images presented in this article grows out of an understanding of the brain and mind as image-based. Building on the work of neurobiology, linguistics, and cognitive neuroscience, this article explores the mind’s natural proclivity for imagination and creativity. These capacities for creativity and imagination are applied to the work of psychotherapy. Clinical material is provided to illustrate the approach. What will emerge from this article is a realization that patient and therapist can lean upon the imaginative potentials of the mind to further the overall psychodynamic goals of change and healing.