Eye movement desensitisation treatment of nightmares: A case report

The literature is burgeoning with outcome studies that suggest the application of imagery rescripting or imagery rehearsal techniques to trauma-related nightmares. In Imagery Rehearsal therapy (IRT), the patient is instructed to modify a recurrent nightmare while awake by verbal and written rehearsal of a new script in which the unpleasant ending or other portions of the nightmare are replaced with a more pleasant one. While there has been a wealth of data about pharmacological and behavioral interventions for the treatment of nightmare disorder, it is a little disconcerting that much of the data surrounding the efficacy of EMDR in the treatment of nightmares is not at the level of randomized controlled trials as stipulated by the AASM. Despite the present lack of good evidence base surrounding EMDR treatment of nightmares, this author is of the persuasion that there are, nonetheless, common features between EMDR and IRT for EMDR to be considered at the same level of evidence efficacy as IRT. While IRT mediates a cognitive shift through the rehearsing of a new positive dream scenario, EMDR installs the positive cognitions after the desensitization to tap into an adaptive network of positive cognitions. EMDR also shares elements of desensitization with IRT and provides a structure to probing progress in anxiety ratings with repeated recalls of the traumatic distressing scenarios. The present study is an attempt to describe EMDR treatment of nightmare, and will highlight various aspects of EMDR that has been helpful for the patient.

Conference

English

M. Woo

Woo, M. (2014, January). Eye movement desensitisation treatment of nightmares: A case report. In EMDR Case studies complex PTSD/dissociation (Dr. Jinsong, Chair). Presentation at the 2nd EMDR Asia International Conference, Manila, The Philippines