Curing Chronic Nightmares

A DIY fix that that's much simpler than an "Inception"-like intervention

Kids aren’t the only ones who have bad dreams. Eight percent of adults have nightmares on a regular basis. Many who do assume that there’s no fix for the problem—and so they simply put up with the nightmares, along with the disturbed sleep, anxiety and depression that often accompany them. That’s too bad, because help for chronic nightmares is available. In addition to psychotherapy and treatment with a blood pressure drug called prazosin, a simple three-step technique known as imagery rehearsal therapy (IRT) has been shown to be very effective. “Sixty to seventy-five percent of the people who try IRT see a noticeable improvement,” says one of the technique’s developers, Barry Krakow, M.D., director of the Maimonides International Nightmare Treatment Center in Albuquerque, NM, and the author of Sound Sleep, Sound Mind. “The success rate is close to ninety percent when people stick with it.” People whose nightmares occur in the context of post-traumatic stress disorder (PTSD) or another serious mental illness should try IRT only under the supervision of a doctor or therapist, Dr. Krakow says. Everyone else can use IRT on a do-it-yourself basis. Here are the basics of IRT:

1. Pick a nightmare. Think about some of the bad dreams you’ve had recently. Pick one. It doesn’t have to be the scariest one. In fact, it should be a dream you can contemplate without becoming upset. Let’s say the dream you pick involves a nighttime car chase. You’re careering through a maze of streets, trying desperately to elude a violent pursuer. After a series of near-crashes, you spin out of control while turning sharply at a familiar landmark. Your pursuer traps you. You feel powerless.

2. Think of a way to change the nightmare. Alter the way the way it ends, for example, or change the order of events. Maybe introduce different characters, or change the setting or another specific element. Trust your intuition, and don’t feel that you must transform the nightmare into something positive or triumphant.

3. Imagine the altered version of the nightmare. Spend between five and 15 minutes a day doing this – no more. Some people rehearse the new dream as soon as they wake up, while still in bed. But when you go over them and where don’t matter (though it is important to find a time and place where there won’t be any distractions). After a few days or weeks imagining the altered nightmare, you should see a change in your actual nightmares. Maybe they’ll be less disturbing or less frequent -- or both. Dr. Krakow says nightmare sufferers often have trouble believing that such a simple technique can be so powerful. “When I describe IRT, some patients look at me and say, ‘That’s weird.’ I tell them not to underestimate the power of the human mind. You really can work with the pictures in your mind’s eye to conquer bad dreams.”

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