By Julia Medew for The Age, Oct 18 2012

EVER wanted to erase a horrific nightmare from your mind? Australian doctors believe they’ve found a way to do it.

Dr Andrea Phelps, from the Australian Centre for Posttraumatic Mental Health, said a technique called imagery rehearsal treatment was allowing people with post-traumatic stress disorder to literally rewrite the script of distressing nightmares to change their dreams or get rid of them.

Regular and repetitive nightmares are a defining feature of PTSD, especially for soldiers who have experienced extreme fear and trauma during combat.

In some cases, sufferers have had the same dream regularly for more than 30 years, causing a fear of sleep and insomnia which affects their ability to function during the day.

Advertisement The nightmares can be disturbing for partners, too, because unlike most people who dream during a stage of sleep that paralyses their body, people with PTSD often move during their dreams, scaring people around them.

”Some people will often have to sleep in separate beds because they’ve woken up trying to strangle their partner … It can be really distressing for their relationships,” Dr Phelps said.

However, imagery rehearsal treatment is starting to help. Dr Phelps said a pilot study of the technique in Vietnam veterans with PTSD found it led to significant improvement for 11 out of 12 patients with the nightmares disappearing altogether for seven of them. For some of them, the dream stopped suddenly while others experienced a gradual change. When they were followed up one year after treatment, all seven patients’ nightmares had still not returned.

The treatment involves patients writing the script of their nightmare in all its sensory detail. They are then asked to workshop different endings to the dream to replace the worst aspects of it. This new script is rehearsed and imagined before they go to bed.

Dr Phelps is now overseeing a study of about 100 American soldiers who served in Iraq and Afghanistan to further test the technique. All of the soldiers are having nightmares at least once a week with most having them four to five times a week. In some cases, they are reliving real experiences in their dreams, but sometimes they involve imagined trauma.

She said one soldier’s nightmare involved him being chased by hundreds of angry dogs in the night while patrolling a familiar area where he served. To change the script, the patient started imagining the dogs were the 101 dalmatians as seen in the children’s film.

Another patient whose nightmare involved an explosion leading him to discover a body on the ground that was his own body changed his dream to replace the explosion with loud party poppers at a surprise party where everyone was happy.

Dr Phelps said she did not know why the technique was working, but said it could involve a change of attitude towards the dream that comes from talking about it and throwing ideas around about how to change it.

”Instead of going to bed feeling terrified of the prospect of having this same nightmare again, they’re going to bed rehearsing the new dream and feeling ready for it,” she said.

PTSD can develop in people who have experienced an event which threatened their life or safety, or that of others and led to feelings of intense fear, helplessness and horror.

Read more: http://www.theage.com.au/national/new-treatment-stops-nightmares-20121017-27rgl.html

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