Dream therapy helps ease stress disorder

Rehearsing sweet dreams may quell the frequent nightmares that plague many post-traumatic stress disorder sufferers, researchers said on Tuesday.

Three sessions of image rehearsal therapy, a dream therapy that instructs patients to rewrite the endings to their most feared nightmares, was more effective at improving sleep quality than other treatment methods, said researchers at the Sleep and Human Health Institute in Albuquerque, New Mexico.

“Nightmares are functioning like a sleep disorder in people with PTSD,” or post-traumatic stress disorder, said lead author and institute director Barry Krakow in a telephone interview.

“What we do is directly target that disturbing dream with imagery they can do on their own. These people with PTSD are desperate to sleep and to sleep well — some of them have had nightmares for 20 years,” he said. The US National Institute of Mental Health estimates about 3.6 per cent of US adults suffer from PTSD during any given year, a behaviour disorder common among war veterans and victims of violence or accidents. Though frequent nightmares afflict about 60 per cent of them, nightmares are often considered a secondary condition and rarely addressed in treatment, said the report, which appeared in this week’s issue of the Journal of the American Medical Association. In the six-month study, a total of 168 women victims of sexual abuse suffering from PTSD responded to questionnaires on their progress after three and six months.

Doctors treated 88 of the subjects with three sessions of image rehearsal therapy, while the others continued with drug treatment and regular counselling. While none of the patients were completely rid of their nightmares, Krakow said many patients in the image therapy programme experienced fewer frightening dreams and PTSD symptoms than patients undergoing traditional treatments.

In the first image therapy session, doctors encouraged the women to recognise that their dreams were both trauma-induced and a learned behaviour. Then the women were told to imagine pleasant thoughts. A week later, each participant wrote about a single nightmare but was instructed to change the ending. Then they were told to rehearse the new dream, while awake, for five to 20 minutes a day.

Dream rehearsal could be used in conjunction with other treatments, the report said.

“Post-traumatic stress disorder treatment studies comparing IRT, exposure therapy and psychotropic medications are needed to examine differences between these regimens as well as their potential therapeutic synergy,” it said.