Scripting a Nightmare for Those Suffering PTSD

At least 4 percent of adults report experiencing nightmares, perhaps as often as once a week or more, according to sleep researchers. But the rate is as high as 90 percent among groups like combat veterans. One technique being used to treat a growing number of nightmare sufferers is called imagery rehearsal therapy. Researchers say this kind of cognitive therapy can help reduce the frequency and intensity of nightmares or even eliminate them.

But this approach is controversial among scientists.

Recurring nightmares are a common symptom of post-traumatic stress disorder. When people who suffer from post traumatic stress disorder (PTSD) fall asleep, they often experience the exact replica of the traumatic event in their dreams.

In imagery rehearsal therapy (IRT), patients – while awake – change the endings of their remembered nightmares so that the ending is no longer upsetting. They then rehearse the new, nonthreatening images associated with the changed dream in their minds.

Two randomized controlled trials – one in the Journal of the American Medical Association and another in the Journal of Traumatic Stress – reported similar results: IRT-treated groups showed improvement in nightmare frequency and PTSD symptoms relative to controls.

But some therapists take issue with changing nightmares’ content, arguing that dreams send crucial messages to the waking mind.

Nightmares are important because they “bring up issues in bold print,” said Jane White-Lewis, a psychologist in Guilford, Conn., to The New York Times.

Other scientists believe that nightmares serve a therapeutic effect for most people. They think reliving the upsetting experience helps to strip the emotion from the memory, making it feel less raw as time goes on.

But according to New Scientist, this emotion-stripping process seems to fail in people with PTSD, where traumatic memories are recalled in all their emotional detail. []