Overcoming Trauma and PTSD

Worksheet 26: Imagery Rehearsal for Nightmares

Purpose: To learn how to cope with painful and frightening nightmares.

Instructions: During the daytime (at a time when you are not sleeping or napping),
in as much detail as you possible, write about your distressing dream. Rate your
distress level from 0 to 10 before and after writing an alternate ending. Choose one
of these options for practicing this ending (photocopy the worksheet so you can
repeat your practice as often as necessary):

Option 1: Repeat writing about the nightmare (and alternate ending) every time you
have it. You complete your writing in the daytime, at a time that you are not trying
to sleep or nap. Rate your distress level before and after the alternate ending.

Option 2: Repeat writing about the nightmare every day. Underline places where
you feel you are blaming yourself or places you feel stuck. Try to see if there are
alternate ways to think about the situation. Practice incorporating these thoughts
into the alternate ending.

Option 3: Use an audio recorder and read your alternate ending aloud. Listen to the
recording every day for two weeks. Rate your distress level before and after each
listening.

Example:

My dream: I am at work in the Twin Towers. I’m at my desk. There is a yellow

pad of paper on the desk. Suddenly I hear people talking louder and louder. It’s
chaotic. All of sudden I see James. I see Mr. Paudel. I can hear them screaming. I
see people falling down the staircase. I see James crushed under some kind of hot
cement. He’s crying. His leg is bleeding. I feel helpless. I wake up sweating.

My starting distress level: 9/10

The alternate ending: I hold on to James’s hand and pull him out from the cement.
We run down the stairs together. We run and can see the sunlight. We see our
families. There is Margie, and Dawn. They hug us and kiss us. We feel their hands
and faces. We are safe in their arms. We can feel them breathing.

My ending distress level: 6/10

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 Coping with Painful Memories, Flashbacks, Nightmares, and Intrusions

Exercise:

My dream:

My starting distress level:      /10

The alternate ending:

My ending distress level:      /10

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