Imagery Rehearsal Treatment for Nightmares Related to PTSD

Studies Show IRT Reduces Nightmares in People with PTSD

man waking up from nightmare in bed
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If you have post-traumatic stress disorder (PTSD), then you know that nightmares can have a tremendous negative impact on your life. In fact, nightmares are considered  the most commonly reported symptoms among people with PTSD.

Nightmares can greatly interfere with your amount and quality of sleep and can cause high levels of anxiety. Nightmares are also often unaffected by standard treatments for PTSD.

Because of this, specialized treatment for nightmares has been developed. One such treatment is Imagery Rehearsal Therapy (or IRT).

What is IRT?

IRT is considered a cognitive-behavioral treatment. In a nutshell, IRT uses techniques that helps people with PTSD "rescript" or alter the endings of their nightmares while they are awake. When you come up with an alternative, less distressing outcome, nightmares can become less upsetting and debilitating.

How Does IRT Work?

In IRT, you will be presented with information on sleep, nightmares, and what IRT entails. You will also learn how to monitor your nightmares. Your therapist will help you come up with detailed, alternative, non-distressing endings for nightmares that you've experienced. While awake, you can rehearse each nightmare with the altered ending.

IRT is a time-limited therapy, meaning that there is a defined duration of treatment. One reason for this is that IRT is focused specifically on nightmares and sleep difficulties.

It doesn't really address other symptoms of PTSD. Therefore, if you are seeking out treatment for a variety of PTSD symptoms, you may want a more comprehensive treatment, such as exposure therapy.

Does IRT Really Work?

Several studies have been completed to examine whether IRT reduces nightmares in PTSD sufferers.

One 2008 study looked at 15 male U.S. veterans with PTSD who were having trauma-induced nightmares. Each had not already completed trauma-focused PTSD treatment, but had attended six IRT group sessions. While no benefits were observed right after treatment, at three and six month follow-up appointments the participants said trauma-related nightmares had become less frequent.

Other studies have generally found that IRT is successful in reducing the frequency and intensity of nightmares, as well as PTSD symptoms. IRT has also been found to reduce insomnia.

Where Can I Find Someone Who Offers IRT?

You can learn more about IRT at the National Center for PTSD, which also provides a resource for finding cognitive behavioral therapists in your area who may offer IRT.

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