My entry into sleep medicine began in 1988 when I was most fortunate to be mentored by two psychiatrists (Drs Robert Kellner and Joseph Neidhardt) at the University of New Mexico School of Medicine. The specific projects we worked on involved the development and testing of an older therapeutic technique for chronic nightmares called “image rehearsal.” Subsequently, we conducted and published many studies on what came to be known as IRT or Imagery Rehearsal Therapy. IRT is now considered first-line, non-pharmacologic therapy for chronic nightmares, including posttraumatic nightmares.
As we progressed in our research in the 1990s, my wife and I published a self-help nightmare treatment guide, which also turned out to be a useful training manual for healthcare professionals interested in learning to treat nightmares without resorting to medication. The work, Turning Nightmares into Dreams, is available through our website www.nightmaretreatment.com or on Amazon and comprises a 100-page workbook and 4 hours of audio instructions. One of the more satisfying testimonials we have received about the manual is that several Veteran’s Medical Centers have been using it successfully in group therapy sessions among PTSD patients with chronic nightmares.
In writing Sound Sleep, Sound Mind, I added a section specifically on the use of imagery techniques for sleep, and throughout the book there are also many tips on imagery, because we use it regularly in our clinic and lab to treat insomnia and facilitate adaptation to PAP therapy. The nightmare treatment section is much shorter than the manual described above, yet it still provides the gist of the IRT treatment.
Depending on the type of patient we see in our clinic, we will recommend the nightmare treatment manual when the individual presents with disturbing dreams as one of their major sleep complaints; whereas, if the individual suffers from nightmares but is more interested in first treating their insomnia and sleep-disordered breathing, we will encourage them to read the Sound Sleep, Sound Mind book for these problems, which then introduces them to IRT for nightmares.