改善惡夢！用意象預演療法 IRT 重寫夢境，回到安穩好眠

你是否常常被惡夢驚醒，整晚輾轉難眠？根據研究，約有4%的人長期受到惡夢的困擾，不僅影響睡眠品質，更可能對身心健康造成嚴重影響。尤其自從新冠疫情爆發後，全球民眾出現做惡夢和睡眠障礙的比例明顯上升。如果你也深受惡夢所苦，不妨試試「意象預演療法」(Imagery Rehearsal Therapy， IRT)，這個簡單有效的方法可以幫助你重新掌控夢境，擺脫惡夢的糾纏。

對於經歷過創傷事件的人來說，惡夢更是一種痛苦的折磨。有研究顯示，高達71%到96%的創傷後壓力症候群（PTSD）患者會出現反覆的惡夢。這些惡夢往往與創傷經歷有關，不斷重現可怕的場景，讓人陷入恐懼中無法自拔。

意象預演療法（IRT）如何幫助你改善惡夢影響？

意象預演療法（IRT）是一種認知行為療法，專門用於減少惡夢的頻率和強度。它的原理非常簡單——通過在清醒時重新想像和改寫惡夢內容，來「重新編程」你的夢境。這個療法相信白天的思想會影響夜晚的夢境，而通過有意識地改變對夢境的想像，可以影響實際的夢境內容。除此之外，意象預演治療不強調深入分析創傷細節，而是專注於改變夢境本身。

五步驟進行意象預演練習

想要嘗試IRT嗎？以下是幾個實用的小技巧：

1. 選擇一個較輕微的惡夢開始：不要一開始就挑戰最可怕的夢境，從情緒反應較小的惡夢練習起。
    
2. 找一個安靜、放鬆的環境：確保不會被打擾，讓自己完全沉浸在想像中。可以播放輕柔的背景音樂，或使用香薰等助眠方法。
    
3. 寫下原始夢境：簡單描述惡夢的主要情節，但不需要太多細節。重點是捕捉夢境的核心元素。
    
4. 思考想要的改變：問問自己「如果這個夢可以有不同的發展，我希望它怎麼結束？」你可以完全改變夢境，或只修改某些細節。
    
5. 重新想像夢境：閉上眼睛，用5-10分鐘時間想像新的夢境情節。可以改變任何細節，只要讓自己感到舒服、安全。想像時，盡量使用所有感官，讓新的夢境變得生動真實。
    

隨著持續練習，可以使用睡眠日誌或手機應用程序來追蹤，留意惡夢頻率和睡眠品質是否有所改善。

而創立者 Barry Krakow 表示，意象預演療法應分為知識教育和想像訓練兩部分。建議先教授睡眠和惡夢知識，再進行夢境改寫練習，可以增加患者對療程的信任，提升效果。這包括：

1. 知識教育：討論惡夢對睡眠的影響，解釋夢的功能，改變對惡夢的認知。
2. 想像訓練：從日常事物開始練習想像技巧，如想像改變居家擺設、想像演奏某個樂器等，在不受打擾的環境下，每天固定安排練習時間。練習之後，才進入處理惡夢的環節。

意象預演療法 IRT 改善惡夢的優勢

1. 不需要深入討論創傷細節，避免引發強烈情緒反應。
2. 給予患者主動權，自己決定如何改寫夢境。
3. 可以個別或團體進行，靈活性高。
4. 療程較短，通常4-8次就能見效。
5. 不依賴藥物，沒有副作用風險。
6. 學會技巧後可以自行練習，長期受益。
7. 可以與其他治療方法結合，如藥物治療或其他心理治療。

生活習慣也會影響做惡夢的頻率

除了使用IRT，調整日常生活習慣也能幫助減少惡夢：

1. 避免賴床：睡眠時間過長反而容易增加做惡夢的機會。保持規律的作息，每天固定時間起床。
2. 學習情緒管理：壓力和焦慮是引發惡夢的常見原因。平時多練習放鬆技巧，如深呼吸、冥想或漸進式肌肉放鬆。
3. 注意身體狀況：生病時容易做惡夢，要多加休息，及時就醫。
4. 檢視用藥：某些抗憂鬱藥可能增加做惡夢的機率，可與醫師討論是否需要調整用藥。
5. 飲食調整：避免睡前食用高脂或辛辣食物。晚餐盡量在睡前3小時完成，避免睡前進食。
6. 戒菸酒：菸酒會影響睡眠品質，增加做惡夢的風險。如果難以戒除，至少避免在睡前使用。
7. 營造良好的睡眠環境：保持臥室安靜、黑暗和涼爽。使用舒適的床墊和枕頭。
8. 建立睡前放鬆儀式：如閱讀、聽輕音樂、泡澡等，幫助身心放鬆。
9. 適度運動：規律運動有助改善睡眠品質，但避免在睡前3小時內進行劇烈運動。
10. 控制螢幕使用：睡前1小時避免使用手機、電腦等電子設備，藍光會干擾睡眠。

尋求專業協助很重要

雖然意象預演訓練是一個相對簡單的技巧，但如果你長期被惡夢困擾，特別是有創傷經歷，建議先諮詢專業醫師或心理師。他們可以幫你評估惡夢的原因和嚴重程度，以及排除其他可能的睡眠障礙，如睡眠呼吸中止症等等。不要害怕尋求幫助，這是邁向健康睡眠的重要一步。

重寫夢境，擁抱美好睡眠

惡夢雖然可怕，但並非無法改變。通過意象預演療法，我們可以主動改寫夢境，不再被可怕的情節所困。美好的睡眠不再是遙不可及的夢想，只要堅持練習，你也能重新掌控自己的夢境，擁抱安寧的夜晚。

Goodbye Nightmares! Rewrite Your Dreams with Imagery Rehearsal Therapy (IRT) for Peaceful Sleep

Do you often wake up startled by nightmares, tossing and turning all night? Research shows that about 4% of people suffer from long-term nightmare disturbances, which not only affect sleep quality but can also seriously impact both physical and mental health. Since the outbreak of the COVID-19 pandemic, there has been a noticeable increase in the proportion of people experiencing nightmares and sleep disorders worldwide. If you're also suffering from nightmares, you might want to try "Imagery Rehearsal Therapy" (IRT), a simple and effective method that can help you regain control of your dreams and break free from the grip of nightmares.

For those who have experienced traumatic events, nightmares can be particularly tormenting. Studies have shown that up to 71% to 96% of patients with Post-Traumatic Stress Disorder (PTSD) experience recurring nightmares. These nightmares are often related to traumatic experiences, constantly replaying frightening scenes, trapping people in a state of fear they can't escape.

How Does Imagery Rehearsal Therapy (IRT) Help You Overcome Nightmares?

Imagery Rehearsal Therapy (IRT) is a cognitive behavioral therapy specifically designed to reduce the frequency and intensity of nightmares. Its principle is simple—by reimagining and rewriting nightmare content while awake, you can "reprogram" your dreams. This therapy believes that daytime thoughts influence nighttime dreams, and by consciously changing your imagination of dreams, you can affect the actual dream content. Moreover, IRT doesn't emphasize deep analysis of trauma details but focuses on changing the dreams themselves.

Five Steps to Practice Imagery Rehearsal

Want to try IRT? Here are some practical tips:

1. Start with a milder nightmare: Don't challenge the scariest dream right away. Begin with nightmares that evoke less emotional response.
    
2. Find a quiet, relaxing environment: Ensure you won't be disturbed, allowing yourself to be fully immersed in imagination. You can play soft background music or use aromatherapy to aid relaxation.
    
3. Write down the original dream: Briefly describe the main plot of the nightmare, without too many details. The key is to capture the core elements of the dream.
    
4. Consider the changes you want: Ask yourself, "If this dream could develop differently, how would I want it to end?" You can completely change the dream or modify only certain details.
    
5. Reimagine the dream: Close your eyes and spend 5-10 minutes imagining the new dream scenario. You can change any details, as long as it makes you feel comfortable and safe. When imagining, try to use all your senses to make the new dream vivid and real.

As you continue practicing, you can use a sleep diary or mobile app to track and notice if there's any improvement in nightmare frequency and sleep quality.

Barry Krakow, the founder of IRT, suggests that the therapy should be divided into two parts: knowledge education and imagination training. It's recommended to first teach knowledge about sleep and nightmares before practicing dream rewriting, which can increase patients' trust in the therapy and enhance its effectiveness. This includes:

1. Knowledge education: Discuss how nightmares affect sleep, explain the function of dreams, and change perceptions about nightmares.
2. Imagination training: Start by practicing imagination techniques with daily objects, such as imagining changing home decor or playing a musical instrument. Set a fixed practice time every day in an undisturbed environment. Only after this practice should you move on to dealing with nightmares.

Advantages of Imagery Rehearsal Therapy (IRT) in Treating Nightmares

1. No need to discuss trauma details in depth, avoiding triggering strong emotional reactions.
2. Gives patients autonomy to decide how to rewrite their dreams.
3. Can be conducted individually or in groups, offering high flexibility.
4. Short treatment course, usually effective in 4-8 sessions.
5. Not dependent on medication, no risk of side effects.
6. Patients can practice on their own after learning the technique, benefiting in the long term.
7. Can be combined with other treatment methods, such as medication or other psychotherapies.

Lifestyle Habits That Affect Nightmare Frequency

Besides using IRT, adjusting daily habits can also help reduce nightmares:

1. Avoid oversleeping: Sleeping too long can actually increase the chance of having nightmares. Maintain a regular sleep schedule, waking up at the same time every day.
2. Learn emotional management: Stress and anxiety are common causes of nightmares. Practice relaxation techniques regularly, such as deep breathing, meditation, or progressive muscle relaxation.
3. Pay attention to physical condition: It's easier to have nightmares when you're sick. Rest more and seek medical attention promptly.
4. Review medications: Some antidepressants may increase the likelihood of nightmares. Discuss with your doctor if medication adjustment is needed.
5. Adjust diet: Avoid high-fat or spicy foods before bed. Try to finish dinner 3 hours before bedtime and avoid eating right before sleep.
6. Quit smoking and drinking: Tobacco and alcohol affect sleep quality and increase the risk of nightmares. If quitting is difficult, at least avoid using them before bed.
7. Create a good sleep environment: Keep the bedroom quiet, dark, and cool. Use a comfortable mattress and pillow.
8. Establish a pre-sleep relaxation ritual: Activities like reading, listening to soft music, or taking a bath can help relax both body and mind.
9. Exercise moderately: Regular exercise helps improve sleep quality, but avoid intense exercise within 3 hours before bedtime.
10. Control screen use: Avoid using phones, computers, and other electronic devices 1 hour before bed, as blue light can interfere with sleep.

Seeking Professional Help is Important

Although Imagery Rehearsal Training is a relatively simple technique, if you've been troubled by nightmares for a long time, especially if you have a history of trauma, it's advisable to consult a professional doctor or psychologist first. They can help you assess the cause and severity of your nightmares, and rule out other possible sleep disorders, such as sleep apnea. Don't be afraid to seek help; this is an important step towards healthy sleep.

Rewrite Your Dreams, Embrace Peaceful Sleep

Nightmares may be scary, but they're not unchangeable. Through Imagery Rehearsal Therapy, we can actively rewrite our dreams and no longer be trapped by frightening scenarios. Peaceful sleep is not an unreachable dream. With persistent practice, you too can regain control of your dreams and embrace tranquil nights.