A cognitive-behavioural therapy called imagery rehearsal therapy (IRT) can help persons with posttraumatic stress disorder’s nightmares by lowering their frequency and intensity (PTSD). One of the most typical PTSD symptoms is having nightmares or terrible dreams. For PTSD sufferers, IRT focuses specifically on assisting in lessening the severity of their nightmares.
If you’ve ever had a nightmare, you likely awoke right as it was feeling the most terrifying. That’s because, as you’re well aware, a nightmare typically becomes worse until the sufferer is too afraid to keep sleeping and wakes up. You are assisted in IRT therapy to reimaging your nightmares with different, less terrifying consequences. Your nightmares are supposed to be “reprogrammed” to become less terrible if and when they recur.
The use of imagery rehearsal therapy (IRT), a type of cognitive behavioural therapy (CBT), can help you sleep better by treating nightmares. In fact, it is the treatment method for severe nightmares that is most usually advocated. There are two primary types of nightmares: idiopathic nightmares and post-traumatic nightmares. Trauma or a terrifying experience might cause post-traumatic nightmares. There is no known cause of idiopathic nightmares. No matter what the underlying reason is, having nightmares may be quite upsetting. They can also interfere with your sleep and leave you feeling worn out when you wake up.
Working Principles of Imagery Rehearsal Therapy
To “create the stage” for learning to manage your nightmares and sleep problems, your IRT therapist will first educate you about sleep and nightmares. In collaboration with your therapist, you will next:
For dreams you’ve had a lot, make elaborate, non-frightening endings.
Dreams with the new resolutions should be recorded and practised.
Get adept at keeping track of your nightmares to gauge the effectiveness of your IRT therapy.
It is common for someone with PTSD to have considered whether it could be beneficial to “defuse” or reinterpret their nightmares in order to make them less terrifying. Although it isn’t necessary for the technique to be effective, it can make beginning IRT feel more at ease and optimistic.
What is the process?
IRT sessions usually last 60 to 90 minutes each. You and your therapist will discuss your most frequent reoccurring nightmare during your appointment. In order to come up with a different ending, you and your therapist will first talk about any pressures or traumas that may be fuelling the dream. You’ll practise this conclusion at home for 10 to 20 minutes every day while you’re awake, of course. A more precise rehearsal time frame might be suggested by your therapist. If your nightmare doesn’t completely go away by the end of two weeks, it will probably get less terrible. Not everyone requires numerous sessions, but they can help you work through any issues that arise or deal with new nightmares.
What varieties of nightmares does IRT handle?
Treatment options for IRT include:
- Dreams that don’t appear to have a cause
- Nightmares caused by PTSD
- Dreams brought on by depression
IRT can lessen the frequency of nightmares and the anxiety that occurs during any sort of nightmare. Although PTSD and depression-related dreams are still significantly impacted, its advantages seem to be greatest for idiopathic nightmares. This is significant because 30% of individuals with psychiatric illnesses experience nightmares. The impacts of nightmares often make your other symptoms worse by interfering with sleep and elevating stress levels. Other mental health problems could also improve if IRT helps lessen nightmares and enhance your sleep.
Why does it assist?
IRT can make your nightmares less frightful thanks to a process called desensitisation. After a nightmare, you can find yourself alone—or at the very least, the only person awakes. Nonetheless, a therapist is present to provide support during an IRT session. Your brain gradually learns to react to the content of the nightmare with a calmer frame of mind when you continually expose yourself to the nightmare while engaging in relaxation techniques.
Here’s another way to consider it: It might start to seem less like an enigmatic terror and more like a big reptile you’ve talked about endlessly as you discuss the dragon you keep dreaming about. There another process in action? The feeling of mastery you get. The fact that nightmares appear more like an event you must suffer than one you can control may contribute to why they are so terrifying.
Rewriting the conclusion might therefore give you a feeling of control and agency. Your brain is given another choice to consider when you ask your awake self to see your sleeping self-addressing the issue in your dream. The happier endings you picture, the simpler it is for your mind to switch to that happier course mid-dream.
IRT is widely regarded by sleep specialists as the preferred treatment for nightmares, and for good reason: It is adaptable, effective at reducing symptoms, and has a low risk of adverse effects. Even by yourself, you can give IRT a try. You might wish to start working with a therapist if the procedure seems intimidating. There is no need for you to accept nightmares as a given. IRT can help you change the story in your dreams and re-establish the feeling of security in your sleep.
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