Imagination Rehearsal Therapy For Nightmares

Nightmares cause us terror, anguish and wake us up with a start. But, in addition, when they become chronic, they seriously affect the quality of the person’s sleep, even influencing their daytime performance. Imagination rehearsal therapy is one of the most effective techniques for treating this phenomenon.

We have all experienced nightmares at some point in our life; therefore, we are talking about a known phenomenon. This is a non-pathological phenomenon that does not entail any problem beyond the discomfort experienced. However, when these unpleasant dreams recur, they are considered a sleep disorder.

In the main diagnostic classification manuals, nightmares are considered a parasomnia that involves the repeated appearance of dreams that generate intense fear. These generally occur during the REM phase and their content is somehow threatening to the person.

This chronification of nightmares has important consequences for the quality of sleep, leading the sufferer to suffer from insomnia, fear of sleep or the dark. In addition, the person is likely to develop behaviors that make it difficult to sleep, such as leaving the lights on or sleeping at irregular hours.

Why do nightmares occur?

Despite the fact that we still lack sufficient scientific knowledge to determine the cause and origin of nightmares, factors have been discovered that influence their appearance.

  • Nightmares are more common in children and, to a lesser extent, in adolescents. They are part of the ripening process and tend to disappear over time.
  • They occur more in periods in which the person is subjected to high psychosocial stress. In this situation, nightmares can act as a coping mechanism: when the stressor occurs in the dream, the person explores different ways of dealing with it.
  • They are often associated with other disorders such as anxiety, depression and, especially, post-traumatic stress disorder.
  • People who have difficulty regulating their emotions properly tend to experience nightmares more often.

What is Imagination Rehearsal Therapy?

Imagination Rehearsal Therapy is one of the most researched and most successful procedures in the treatment of nightmares. It is a cognitive technique based on the modification of the content of the dream.

The goal is to consciously alter some details of the nightmare ; the goal is for it to become an enjoyable story. In this way, the person manages to take control over the dreamed events and modify them.

Step by Step Imagination Trial Therapy

1. Modify beliefs

First, it is necessary to modify some beliefs that the person may hold about nightmares. We have to convey the idea that nightmares are not something uncontrollable, but rather an acquired habit that we can modify.

On the other hand, it is important for the person to understand that, once they become chronic, nightmares are no longer useful and serve no purpose. Therefore, it is time to address them, modifying them during the vigil so that they become something more pleasant.

2. Work the visualization

The next step is to assess the person’s ability to imagine scenarios in a vivid way. To do this, he is asked to practice pleasant imagination by generating pleasant scenes in his mind. In addition, techniques are taught to control the appearance of unpleasant images during visualization practice.

3. Address the nightmare

At this point the person is asked to select the nightmare with which they are going to work, writing a story about it. You are then encouraged to modify whatever you want in your content and to rewrite it, describing this new sequence of images in detail.

Finally, you are instructed to spend 5 to 20 minutes a day mentally reviewing the modified story. The idea is that, by repeating this modification during wakefulness, it is transferred to sleep by continuity.

Efficacy of Imagination Rehearsal Therapy

If you are constant in the application of the technique, the nightmares improve quickly with results that will last over time. It will also improve the quality of sleep and reduce the discomfort associated with nightmares that the person experiences.