Hypnotherapy for a problem

Hypnotherapy for Nightmares and Bad Dreams

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Hypnosis is among the methods the American Academy of Sleep Medicine has said may be used for nightmare disorder. The treatment it describes as useful for both nightmare disorder and trauma-related nightmares is image rehearsal therapy: rewriting the nightmare while awake and rehearsing the new version. Hypnosis can be a way to practice that rehearsal in a calm state.

When are nightmares a disorder?

Everyone has bad dreams sometimes. According to the AASM’s patient guide to treating nightmare disorder, about 4 percent of adults have nightmare disorder, either on its own or as part of another condition such as post-traumatic stress disorder. It can significantly disturb sleep and quality of life, and can worsen an underlying mental illness such as depression or anxiety.

What does the AASM recommend?

A 2018 AASM position paper, summarized in the same guide, reported that image rehearsal therapy is useful for nightmare disorder and for nightmares associated with post-traumatic stress disorder. Its task force also found that various methods may be used, including cognitive behavioral therapy, hypnosis and some prescription medicines, and it concluded that two medicines, clonazepam and venlafaxine, are not recommended for nightmare disorder.

How does image rehearsal therapy work?

The guide describes it as altering the content of a nightmare by creating a new set of positive images, then rehearsing the rewritten dream while awake. In practice, you choose a nightmare and change its content into something that is no longer frightening, then go over that version regularly.

Can hypnosis change a recurring nightmare?

In the rehearsal step. A session, or a self-hypnosis routine you learn, can help you:

  • Settle your body before revisiting the dream, so the rewrite does not start in a state of alarm.
  • Rehearse the new version vividly, in a focused, absorbed state.
  • Wind down at bedtime, with the rewritten ending as the last image you go over.

Used this way, hypnosis supports image rehearsal rather than replacing it.

What if the nightmares replay a trauma?

Then start with a clinician who treats post-traumatic stress disorder. Nightmares that replay a real event can be part of that condition, and the AASM position paper addresses them specifically. Rewriting them should be done with professional support, especially if going over the memory brings back intense distress.

Rewrite one dream this week

Choose a recurring bad dream that is unpleasant but not your most distressing one. Write it out in the present tense. Change one thing, such as how it ends, who is with you or where it takes place, and write the new version. Read or rehearse it once a day, using a short relaxation or self-hypnosis routine first. Note how often the dream returns over the following weeks.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.

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