Introduction
Nightmares are unpleasant dreams which often result in the person waking from sleep. When this becomes clinically significant and disrupts daily function, it may be diagnosed by a sleep specialist as a nightmare disorder.
Dream Rehearsal Therapy
Dream rehearsal therapy, also called Imagery Rehearsal Therapy (IRT) is a self-guided treatment which can be used to treat nightmare disorder. As with any treatment, both instruction and frequent practice are required to develop this skill and it does take time. This is a small guide to get you started.
Since nightmares frequently involve scenes of danger in which the dreamer experiences a sense of helplessness, dream rehearsal therapy is about changing that feeling of helplessness and rewriting the ending. You rewrite the nightmare to finish with a different and more satisfying ending to the dream.
Example of Rewriting and Rehearsing Your Dream
Original Nightmare
Include sensory descriptions (sights, smells, sounds, tastes, etc.). Also include any thoughts, feelings, and assumptions about yourself during the dream. It is important is to capture the most frightening elements of the dream on paper: this might even mean the actual injury or death, horrific images or sounds, and what led up to the dramatic ending. This may be difficult for some people who have a history of trauma or posttraumatic stress disorder, and you may want to speak with a mental healthcare professional first if this is difficult.
I’m running down a dark, narrow alley, and I can hear heavy footsteps behind me. The footsteps get closer, and I feel a cold, clammy hand grab my shoulder. I turn, and a faceless figure with glowing red eyes lunges toward me. I try to scream, but no sound comes out. I fall to the ground, and the figure towers over me, and everything fades to black.”
Original Nightmare
Rewritten Nightmare (Dream Rehearsal Therapy)
Rewrite the dream the changes the arc of the story so that it results in a positive and happy ending. This may need some imagination. If you are stuck, you can think of heroic stories of survival you remember from books, movies, or other sources media. Your story can be as realistic or as outlandish as fits your rewrite of the dream (e.g., rescuers, your own Super Hero superpowers or realistic use of self-defense, martial arts, weaponry and/or the help of well-trained defenders such as the military or law enforcement).
The change in the dream should occur before anything traumatic or bad happens to you or others in the nightmare. Essentially, you want to come up with a change that will prevent the bad outcome of the usual nightmare from occurring. Write an ending that will give you a sense of peace when you wake up.
“I’m walking down a dark alley, but I notice that the street lamps are now giving off a warm, golden light. I hear footsteps, but when I turn, it’s my dog Spot that runs up to me and wags his tail. Spot begins to run down the alley, and I follow it. At the end of the alley, a bright, open park appears. I see friends and family there, and they welcome me with open arms. I feel safe and happy.”
Rewritten Nightmare
The changes made to the nightmare were the following:
- Changing the threatening figure: The faceless figure is replaced with your dog, removing the source of fear.
- Changing the setting: The dark, threatening alley is transformed with warm lighting, and then changed into a bright and safe park.
- Changing the emotional outcome: The feelings of fear and helplessness are replaced with feelings of safety, joy, and connection.
- Taking a positive action: Instead of being chased, the person in the dream instead takes action by following the dog, and then is rewarded with a safe environment.
Before You Go To Sleep
- Get into bed
- Rehearse this sentence while you are in bed:
If or when I have the beginnings of the same bad dream or nightmare, I will be able to instead have this much better dream with a positive outcome.”
3. Now replay and imagine the details of the rewritten dream from beginning to end. Close your eyes. Review any part to make sure you can really see it or feel it.
4. Repeat to yourself the statement in Step 1 above once more time, before you allow yourself to fall asleep.
Common Questions
How Often Do I Rewrite My Dreams?
If you have multiple or different recurring dreams each night, you may wish to rewrite each of those dreams in great detail. The more detail is better, down to any smells, sounds, textures, or other sensations that you notice.
When Do I Rehearse This New Dream?
It is most effective to rehearse the dream in bed each night before going to sleep. Rehearse the rewritten dream by visualizing the entire dream with the changes each night. You can also do this in combination with relaxation techniques (such as mindfulness or deep breathing). You should also do this as often as you can during the day if you can, but it is less important.
What if I Wake Up From The Original Nightmare Again?
If you wake up from the original nightmare, then as soon as you realize what has happened, practice some strategies to relax and take deep breaths. Then return to sleep with the again with the intention of returning to the dream in order to carry out a new, revised ending.
How Long Does This Take?
It is recommended to do this consistently for at least 2 weeks in a row minimum. Some people may take longer and others may take shorter.
What If It Doesn’t Work?
Other treatments such as medications may need to be considered. Substances use such as alcohol or cannabis use can also interfere with the effectiveness of dream rehearsal. If you have other sleep disorders such as restless legs or sleep apnea, it will also be important to ensure this is being properly treated. Finally, some people may want to speak with a psychiatrist if they continue to have nightmares as it may be related to another psychiatric disorder.