The nightmare rescripting programme

This is an educational adaptation of a clinical technique, not treatment. If nightmares are seriously affecting your life, particularly after trauma, please see a doctor or a therapist. Imagery rehearsal works best delivered properly, and it is available.

Imagery rehearsal therapy has the best evidence of any nightmare intervention, including in PTSD. The method is simple enough that a structured self-directed version is worth having.

The method

Step 1. Choose one nightmare. Not the worst one, if the worst is trauma-related. Start with a recurring one that is distressing but manageable.

Step 2. Write it down. Plainly, in the past tense, as it happens.

Step 3: Change it. Rewrite the dream with a different ending, or a different middle. The change is entirely yours. Common ones: turning to face the pursuer, someone arriving, the threat turning out to be something else, simply walking away.

There is no correct new version. It only has to be yours, and preferable.

Step 4: Rehearse. Five to ten minutes a day, awake, running the new version in your imagination. Not the old one.

Step 5, Track. Log nightmare frequency weekly. Change usually shows over weeks rather than days.

Why it works

The leading account is that it targets the nightmare as a learned imagery habit rather than as a symptom, and gives the mind a competing version to run.

Important limits

• Do not rehearse the nightmare itself. Rehearse the new version.
• If the exercise is distressing rather than merely difficult, stop, and take it to a professional.
• Trauma-related nightmares deserve proper support. This programme is not a substitute for it.