Imagery Rehearsal Therapy for Nightmares

25 December, 2019
Imagery rehearsal therapy helps a person affected by recurrent nightmares to take control of their content. Continue reading to find out more about it.
 

Nightmares cause terror and anguish and people often wake up startled by them. But when they become chronic, they can seriously affect the quality of a person’s sleep. They can even influence 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 throughout their lives? As you can see, this is a well-known phenomenon. It’s a non-pathological one that doesn’t lead to any problems beyond the dreaming experience. However, when these unpleasant dreams become recurring, they qualify as a sleep disorder.

Nightmares are a parasomnia that implies the repeated appearance of dreams that generate intense fear in the main diagnostic classification manuals. These usually occur during the REM phase and their content is somehow threatening to a person.

Chronic nightmares greatly affect a person’s quality of sleep. They instill fear of the dark and insomnia to those who experience them. It’s also likely that the person will develop behaviors that hinder sleep, such as leaving the lights on and sleeping at irregular times.

A woman hiding under the sheets.
 

What causes nightmares?

There isn’t enough scientific knowledge to determine the cause and origin of nightmares. But scientists discovered some factors that influence their recurrence.

  • Nightmares are more common in children and, to a lesser extent, in teenagers. They’re part of their growing process and tend to disappear over time.
  • Also, they occur more in periods in which a person is dealing with high psychosocial stress. In this situation, nightmares are a coping mechanism. By presenting the stressor in the dream, a person can explore various ways of addressing it.
  • In some instances, they’re associated with other disorders such as anxiety, depression, and post-traumatic stress disorder.
  • Finally, people with difficulty properly regulating their emotions experience nightmares more frequently.

What’s imagery rehearsal therapy?

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

Thus, the goal here is to consciously alter some details of the nightmare. This is because the goal is to turn them into pleasant stories. This way, a person takes control of what happens in their dream and can modify them.

Imagery rehearsal therapy step by step

1. Modification of beliefs

First, you must modify any beliefs you may have about nightmares. Also, you must convey the idea that nightmares are not beyond your control but rather an acquired habit you can modify.

 

Thus, you must understand that once chronicled, nightmares are no longer of use and don’t fulfill any purpose. Thus, it’s time to approach them and modify them during the vigil so they become more pleasant.

2. Visualization

The next step is to evaluate a person’s ability to imagine vivid scenarios. To do so, a therapist may ask them to practice visualizing pleasant imagery in their minds. Thus, these techniques are helpful for controlling the appearance of unpleasant images during this practice.

A woman and a therapist.

3. Addressing a nightmare

At this point, the therapist asks the person to select the nightmare they’re going to work with. They need to write a story about it. Then, they encourage their patients to modify everything they want from their content and rewrite it. They must describe this new sequence of images in detail.

Finally, they instruct them to spend between five and 20 minutes a day mentally reviewing their modified history. The goal here is to transfer this version while they’re awake so it continues into their dream.

Imagery rehearsal therapy success

Nightmares improve quickly with results you can maintain over time if you practice enough and remain consistent. It’ll also improve your sleep quality and reduce any discomfort associated with the nightmares you might experience.

 

Morales, E. M., & de Vaca, P. M. N. C. (2004). Tratamientos psicológicos de las pesadillas: una revisión. International journal of psychology and psychological therapy4(1), 11-36.

Gállego Pérez-Larraya, J., Toledo, J. B., Urrestarazu, E., & Iriarte, J. (2007). Clasificación de los trastornos del sueño. In Anales del Sistema Sanitario de Navarra (Vol. 30, pp. 19-36). Gobierno de Navarra. Departamento de Salud.