The night Yael Levy turned a circle of menacing sharks into a ring of harmless dolphins, she knew she had achieved mastery over a life-long foe: her nightmares.
"I was able to change my nightmare while it was happening," says the 29-year-old New York City graduate student. "I had control over my dreams."
That relief was more than Levy expected when she showed up at the Sleep-Wake Disorders Center at Montefiore Medical Center two years ago. Levy says she just wanted help for her insomnia. She had no idea her nightmares were treatable, too.
That's typical, says Shelby Freedman Harris, the Montefiore psychologist who helped Levy. But she and other experts say they often can relieve nightmares, even when the disturbing dreams are coupled with insomnia, depression, post-traumatic stress disorder (PTSD) or other problems.
"Traditionally, the idea was that you treat the main problem first and the nightmares will go away. With depression, often the nightmares and sleep disturbances are the last symptoms to go," Harris says. But addressing nightmares directly may help ease depression and other ills.
"In the past, the nightmares weren't targeted specifically," says Bret Moore, a former Army psychologist who now practices in Wilston, N.D. But when Moore treated soldiers for acute post-traumatic stress in Iraq, he found many craved rapid relief from disturbing nightmares. Using the same techniques Harris uses, he often was able to help, he says. He published case reports in the American Journal of Psychiatry in 2007.
The treatment is called imagery rehearsal therapy (IRT). It's a form of cognitive behavioral therapy, which focuses on changing harmful thought patterns. It's not the only nightmare therapy, but it is gaining ground, says physician Barry Krakow, a sleep specialist who runs the Maimonides International Nightmare Treatment Center in Albuquerque.