Dr. Jean-Jacques Dugoua Naturopathic Doctor PhD in Pharmacy

Imagery therapy may help with chronic nightmares

By Dr. JJ Dugoua ND PhD



Adults often forget what it was like to be a child.  We may remember the endless hours of fun and games, the birthday parties, and eating as much chocolate and ice cream as humanly possible.  We often forget some of the bad times, however.  For some, these bad times may have been recurrent nightmares or night terrors.  Nightmares are defined as a condition that occurs in sleep characterized by a sense of extreme uneasiness or discomfort, or by frightful or oppressive dreams, from which one wakes in extreme anxiety or in a troubled state of mind.  Night terrors are a disorder similar to nightmares, which occur in where the child awakes in a semi-conscious state screaming with fright and in the distress for a short period of time. 


Chronic nightmares and night terrors are very traumatic for young children.  These nightmares may lead to insomnia as the child fears going to sleep, to subsequent fatigue, irritability, apathy and poor grades at school.  Chronic nightmares may also disrupt the household as parents wake throughout the night to console their child.  Researchers have found that imagery therapy may be of use in the treatment of chronic nightmares.


A study was conducted at the Wyoming Girls School in Sheridan, Wyoming USA, on nineteen adolescent girls aged 13 to 18 years.  The girls had previously suffered a high prevalence of unwanted sexual experiences in childhood and adolescence, and suffered from nightmares, sleep complaints, and post-traumatic stress symptoms.  The girls in this study suffered from nightmares for an average of 4.5 years and they reported experiencing 20 nightmares per month, which is approximately one bad dream every other night.  One group of girls received imagery rehearsal therapy while the others received no treatment (control group).  The imagery rehearsal therapy consisted of three steps that were conducted 5 to 20 min each day while in the waking state: 1) select a nightmare, (2) change the nightmare any way you wish and (3) rehearse the images of the new version (rehearse a “new dream").  After 3 months, the girls receiving imagery rehearsal therapy reported a decrease in the number of nightmares per month while the girls who did not receive any treatment did not report any changes.  The researchers concluded that imagery rehearsal therapy was an effective method of treating chronic nightmares.



Krakow B, Sandoval D, Schrader R, Keuhne B, McBride L, Yau CL, Tandberg D. Treatment of chronic nightmares in adjudicated adolescent girls in a residential facility. The Journal of adolescent health. 2001 Aug;29(2):94-100.