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What are Nightmares, and How Are They Treated?

Nightmares not only disrupt sleep but, in some people, they can also be the cause of fearing going to sleep, which obviously would have a detrimental impact on well-being. Fortunately, there is an evidence-based approach to treatment, known as “Imagery Rehearsal Therapy for Nightmares” (IRT). IRT can reduce nightmare intensity and frequency. Sometimes, as it did with mine, it eliminates the repetitive nightmares altogether.


Imagery Rehearsal Therapy for Nightmares

Imagery Rehearsal Therapy (IRT) is a cognitive-behavioural treatment approach intended to reduce the frequency and intensity of nightmares. Since its introduction, the technique has gained recognition as an effective treatment for nightmares, including those associated with post-traumatic stress disorder (PTSD), anxiety, and depression.


The Process of IRT

The process of IRT involves a sequence of steps that help you learn to manage and change the content of your nightmares, making them less distressing. Here’s an overview of an average IRT process – though it may vary depending on your circumstances. And – amazingly – you do not even need to share the content of the dream with me for the process to be helpful.

Dream Recall and Documentation: The first step is to recall and document the dream from start to finish. By writing down the details of the dreams, you learn to identify common themes and triggers.

Identifying Triggers: In this stage, you identify potential triggers. These triggers could be related to past experiences or stressors in daily life.

Rewriting the Nightmare: With my support, you rewrite the nightmare in a way that removes the distressing elements and changes them in ways that lead to a different theme.

Mental Rehearsal: The ‘new’ dream is then rehearsed in your mind during the day. This helps the brain become familiar with the new imagery, plot, and themes.

Incorporating Relaxation Techniques: Throughout the day, you will be encouraged to manage stress more effectively, perhaps by being more organized, by practising relaxation techniques or using various tools to handle your overall stress levels.

Repeating the Process: The process of rewriting and rehearsing the new dream is repeated over several weeks until you are experiencing fewer and less intense nightmares.

The Science Behind IRT

Imagery Rehearsal Therapy is based on the concept of “memory reconsolidation.”

Memories are not static things – they are dynamic sets of connections that are activated when they are retrieved and after ‘use’ the memory is then ‘reconsolidated’ and re-stored in the brain.  When a memory is fetched in the brain, it becomes open to change, and imagery rehearsal therapy takes advantage of this.

By retrieving the memory and adapting it with new imagery, themes and emotions, the brain is encouraged to consolidate the memory of the dream as a new and different dream when it is re-stored in the brain.  The more this is practiced the more likely it is to reinforce the new dream being stored – like any kind of learning.

When the usual ‘trigger’ for the dream occurs in the brain, and the connection is made to ‘fetch’ the dream, the dream that is retrieved is more likely over time, and with practice, to be the new dream rather than the old dream. 

The old dream is less likely to be fetched as it has been significantly adapted by your new ‘memory’ of it, and the new feelings attached to it.  


The Benefits of Imagery Rehearsal Therapy

IRT can offer you a range of benefits that can help you if you suffer from repetitive nightmares:

Improved Sleep Quality: Reducing the intensity of dreams can help improve and deepen sleep, leading to better levels of energy during the day.

Reduced Anxiety and Distress: Nightmares can cause significant distress and anxiety. IRT can help reduce the impact of nightmares.

Feeling Better During The Day: Better sleep quality and lowered emotional distress help you function better during the day, with less emotional ‘nightmare hangover’.

Personal Power: IRT empowers you to build the muscles necessary to take control over habitual dream loops such as nightmares. This can help you feel less like an ‘unconscious sleeping victim’ of your fears, anxieties, and stressors.

Non-Invasive: IRT is not invasive and doesn’t involve medication.

If you or someone you know suffers from repetitive nightmares, consider exploring Imagery Rehearsal Therapy under the guidance of a qualified therapist.



The information contained above is provided for information purposes only. The contents of this post are not intended to amount to advice and you should not rely on any of the contents of this post. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this post. Tracy Hannigan disclaims all liability and responsibility arising from any reliance placed on any of the contents of this post.