Nightmare Reduction in a Vietnam Veteran Using Imagery Rehearsal Therapy

Abstract

Following exposure to traumatic events, approximately 19% of combat veterans develop posttraumatic stress disorder. One of the main symptoms of this mental illness is reexperiencing the trauma, which is commonly expressed in the form of chronic trauma-related nightmares. In these patients, nightmares can fragment sleep, decrease sleep quality, and even cause fear about going to sleep. One promising psychological treatment for chronic nightmares is imagery rehearsal therapy. Imagery rehearsal therapy presumes that nightmares are a learned behavior and that activating the visual imagery system may facilitate emotional processing of the trauma. This treatment involves deliberately rewriting a nightmare and mentally rehearsing images from the newly rescripted scenario while awake. Imagery rehearsal therapy has been found to reduce nightmares and associated distress. We present a case study demonstrating the use of imagery rehearsal therapy in a Vietnam-era veteran with posttraumatic stress disorder and chronic nightmares. Nightmares were considerably reduced and the quality of sleep greatly improved after treatment.