Imagery Rehearsal Therapy: An Effective Treatment For PTSD

Last Update on June 22, 2022 : Published on April 21, 2021
Image Rehearsal therapy

Imagery rehearsal therapy is a kind of cognitive-behavioral treatment that is known for its empirical support to treat post-traumatic stress disorder. PTSD is a cause of high-intensity nightmares which also causes terrifying dreams. Such nightmares create frightening conditions in the middle of the night and one cannot take a deep sleep post-nightmare leading to insomnia.

In the past 20 years, Imagery Rehearsal Therapy has been used repeatedly and successfully to cut down nightmares and relieve recurrent and PTSD nightmares. The studies have shown consistent success in decreasing psychiatric disorders like:

  • Stress
  • Anxiety
  • Depression
  • PTSD symptoms
  • Frightening nightmares

Imagery Rehearsal Therapy basically helps in reimagining the nightmares with different outcomes that are also very less frightening and more relaxing. The overall agenda is to reprogram the nightmares in such a manner that even if they occur again, your brain is ready to tackle them with positivity.

How Rehearsal Therapy Is Helpful?

How Rehearsal Therapy Is Helpful

When you visit the therapist providing imagery rehearsal therapy, they will explain to you about IRT with background information in order to create the scene. As the client gets comfortable with the understanding of the process, they are able to:

  • Make non-frightening endings of a nightmare that has been bothering you repeatedly.
  • Write down the nightmares with new endings and rehearse them.
  • Monitoring own nightmares in order to find how well the treatment is going.

While we are uncovering the layers of Imagery Rehearsal Therapy, you can also have a look at 5 other PTSD treatment techniques covered by doctors and self-coping strategies to deal with PTSD.

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Are There Any Steps Of Image Rehearsal Therapy?

After getting the whole context of image rehearsal therapy, find that it’s a 4-step process to treat PTSD and other psychiatric disorders. Before attempting these steps, make sure that you consult with your therapist or ask for other professional support before as some of the moments could not be easily handled.

Step 1: Writing It All Down

Writing It All Down

The person is asked to write down the central elements of their bad dream. It is always recommended that one write down on a piece of paper instead of noting it on a smartphone, laptop or tablet. In fact, if you have had a nightmare suddenly then you can record it in your phone’s audio.

In the later stages, you can write the details about what happened including injuries, deaths, horrifying images, sound, or any end.

Step 2: Rewriting or Reframing

It’s up to you to change the arc of your story. Yes, it means that you will be writing a positive end to the negative world you have faced. Mix your imagination with positive stories, movie heroes or a fictional character to bring the twist.

IRT even lets you take help from your favorite inspirational movies as a reference so that you can use superpowers, defense mechanisms and much more techniques that fascinate.

Step 3: The Intention Of Re-dreaming Right Before Sleeping

To take this step, you need to follow the technique of a phenomenon called lucid dreaming which makes you aware of your thoughts, even when you are dreaming. It has to be noted that you don’t need to feel discouraged if this technique is still not used successfully.

Follow the steps below for more.

Say this before sleeping, ‘Whenever I have the beginning of the same bad dream, I will be able to INSTEAD have this much better dream with a positive outcome.’

And if you think that you are a lucid dreamer then say, ‘If I see a bad dream again, I will be aware of having it and not only I can dream a better version but I will shape it more positively too.’

1. Now imagine the details of a rewritten dream and review its parts to feel or see it.

2. Repeat the first statement again before diving into a deep sleep.

Step 4: Rejoice The Re-dreaming Experience

If you are successful in the above step then rejoice in your mastery. Although if you couldn’t achieve success in a few attempts, don’t get discouraged. Keep experimenting and keep rewriting. Make sure that you note the challenges you are facing and explain it to your therapist, including consumption of alcohol or any other narcotic substances.

Could Imagery Rehearsal Therapy Upset You?

Image rehearsal therapy for nightmares of PTSD is meant to build your confidence and keep you away from being frightened as you wake up. This is why therapists mostly ask you to begin with less-frightening nightmares amongst your other dreams.

It is because therapists do not want to trigger an emotional response within you suddenly but keep you calm with a new view. The therapy may be upsetting for a while but therapists use various techniques to keep a check on you.


After learning about Image rehearsal therapy and steps used in the therapy, you must be able to find out why it becomes an effective treatment trick to deal with nightmares. You can also find out how to stop PTSD nightmares and sleep peacefully while having a healthy discussion with your guide.

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About The Author

Akanksha Soni
Akanksha Soni

Akanksha is an active lifestyle blogger and writer at Calmsage. She has learnt various lessons on happiness and methods to fight depression through 'Gurus' as well as own experiences. An ardent practitioner of Yoga and meditation, she keeps traveling, writes and interacts with people to feel alive.

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