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> Does it mean that a person is unable, even with a lot of training, to form any visual images in their heads?

Joel Pearson, one of the top researches, speculates it could be possible to “start” the visualisation by training and electrical impulses. Electric impulses on the prefrontal cortex and visual cortex are known to make visual imagination less or more vivid. But how well and whether this works at all, is unknown.

Maybe it only works with acquired aphantasia, only for people with weak aphantasia or for people whose aphantasia has a specific cause. (These are my thoughts on this, not Joel Pearson’s).