Imagery Rehearsal Therapy: Treating Nightmares

Nightmares cause anxiety, and they often wake people up. When they become chronic, however, they can seriously affect the quality of a person’s sleep. They can even affect their daytime performance. In this regard, imagery rehearsal therapy is one of the most effective techniques to treat this condition.

Who hasn’t had a nightmare at some point in their life? As you can see, this is a well-known phenomenon. It is a non-pathological phenomenon that does not cause problems outside of the dream experience. However, when these unpleasant dreams keep coming back, they qualify as a sleep disorder.

Nightmares are a parasomnia involving the repeated appearance of dreams that elicit intense fear in major diagnostic classification textbooks. These usually occur during the REM phase and their content is somehow threatening to a person.

Chronic nightmares have a major impact on the quality of a person’s sleep. They cause fear of the dark and insomnia in those who experience them. The person is also likely to develop behaviors that interfere with sleep, such as leaving the lights on and sleeping at irregular times.

What causes nightmares?

There is not enough scientific knowledge to determine the cause and origin of nightmares. However, scientists have discovered some factors that influence its recurrence.

• Nightmares are more common in children and, to a lesser extent, teenagers. They are part of their growth process and tend to disappear over time.

• They are also more common in periods when a person is dealing with high psychosocial stress. In this situation, nightmares are a coping mechanism. By imagining the stressor in the dream, a person can explore different ways of coping with it.
• In some cases, they are associated with other disorders, such as anxiety, depression, and post-traumatic stress disorder.
• Finally, people who have trouble properly regulating their emotions more often experience nightmares.

What is Imagery Rehearsal Therapy?

Imagery rehearsal therapy is one of the most researched procedures. It gives the best results in the treatment of nightmares. This is because it is a cognitive technique based on the modification of the sleep content.

So the goal is to consciously change some details of the nightmare. The aim is to turn them into pleasant stories. In this way, a person takes control of what happens in his dream and can modify them.

Imagery rehearsal therapy step by step

1. Changing Beliefs

First you need to change your beliefs about nightmares. You also need to convey the idea that nightmares are not out of your control, but rather a learned habit that you can change.

So you must understand that nightmares, once recorded, are no longer useful and serve no purpose. So it is time to approach them and adjust them during the night so that they become more pleasant.

2. Visualization

The next step is to evaluate one’s ability to imagine vivid scenarios. For this, a therapist may ask them to practice visualizing pleasant images in their minds. Thus, these techniques are useful to control the appearance of unpleasant images during this exercise.

3. Tackling a Nightmare

At this point, the therapist asks the person to choose the nightmare they are going to work with. The client has to write a story about it. Then the therapist encourages the patient to modify and rewrite whatever they want from their content. They must describe this new sequence of images in detail.

Finally, they instruct them to mentally spend between five and twenty minutes a day going through their altered history. The goal here is to transfer this version while they are awake so that it continues in their dream.

Success of imagery rehearsal therapy

Nightmares improve quickly with results that you can maintain over time if you practice enough and stay consistent. It also improves the quality of your sleep and reduces the discomfort associated with the nightmares you experience.