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If you’ve ever had a nightmare, you probably woke up just at the moment when it felt most frightening. That’s because, as you probably know, the intensity of a nightmare usually builds untilthe sleeper is too terrifiedto continue–and wakes up.

In IRT treatment, you’re helped to reimagine your nightmares with different, less frightening outcomes. The goal is to “reprogram” your nightmares to be less terrifying if and when they occur again.

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How Imagery Rehearsal Therapy Works

In IRT, your therapist first provides you with background information on sleep and nightmares to “set the scene” for learning to manage them. Then, working with your therapist, you:

Often aperson with PTSDhas already thought about whether it might help to reimagine and “defuse” nightmares so they’re less frightening. That can help make starting IRT feel more comfortable and hopeful, but it isn’t necessary for the technique to be successful.

Coping With PTSD

Could This Therapy Be Upsetting?

PTSD Triggers and Coping Strategies

How Long Does It Last?

It’s important to be aware that IRT is not an open-ended therapy. It lasts for a specific length of time because it’s focused only on nightmares, which are just one symptom of PTSD. If you are having a number of PTSD symptoms, consider looking into more broad-based treatments, such as exposure therapy.

What Is Exposure Therapy for PTSD?

Is This Approach Right for You?

You can work with IRT alone with your therapist or as part of group therapy.

Although the usual goal of IRT is achieving less frightening endings to nightmares, different people with PTSD may have different ideas about what they want from it. For example, you may want to change an entire nightmare, or a large portion of it, while someone else wants to reimagine only a few small details.A therapistwill work with you to choose the IRT approach that best fits your needs.

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3 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kunze, A.E., Lancee, J., Morina, N.et al.Efficacy and mechanisms of imagery rescripting and imaginal exposure for nightmares: study protocol for a randomized controlled trial.Trials. 2016;17:469. doi:10.1186/s13063-016-1570-3El-Solh AA.Management of nightmares in patients with posttraumatic stress disorder: current perspectives.Nat Sci Sleep. 2018;10:409–420. doi:10.2147/NSS.S166089American Psychological Association.Clinical practice guideline for the treatment of posttraumatic disorder. Prolonged exposure.

3 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kunze, A.E., Lancee, J., Morina, N.et al.Efficacy and mechanisms of imagery rescripting and imaginal exposure for nightmares: study protocol for a randomized controlled trial.Trials. 2016;17:469. doi:10.1186/s13063-016-1570-3El-Solh AA.Management of nightmares in patients with posttraumatic stress disorder: current perspectives.Nat Sci Sleep. 2018;10:409–420. doi:10.2147/NSS.S166089American Psychological Association.Clinical practice guideline for the treatment of posttraumatic disorder. Prolonged exposure.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Kunze, A.E., Lancee, J., Morina, N.et al.Efficacy and mechanisms of imagery rescripting and imaginal exposure for nightmares: study protocol for a randomized controlled trial.Trials. 2016;17:469. doi:10.1186/s13063-016-1570-3El-Solh AA.Management of nightmares in patients with posttraumatic stress disorder: current perspectives.Nat Sci Sleep. 2018;10:409–420. doi:10.2147/NSS.S166089American Psychological Association.Clinical practice guideline for the treatment of posttraumatic disorder. Prolonged exposure.

Kunze, A.E., Lancee, J., Morina, N.et al.Efficacy and mechanisms of imagery rescripting and imaginal exposure for nightmares: study protocol for a randomized controlled trial.Trials. 2016;17:469. doi:10.1186/s13063-016-1570-3

El-Solh AA.Management of nightmares in patients with posttraumatic stress disorder: current perspectives.Nat Sci Sleep. 2018;10:409–420. doi:10.2147/NSS.S166089

American Psychological Association.Clinical practice guideline for the treatment of posttraumatic disorder. Prolonged exposure.

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