Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD
Mary P. Koss
Barry Krakow
Michael A. Hollifield
TEDDY D WARNER
Anne Germain
Abstract
Exposure, abreaction, and mastery have been proposed as the therapeutic processes of nightmare (NM) reduction. Imagery rehearsal therapy (IRT) effectively reduces NMs but involves minimal exposure and abreaction. The authors investigated the use of mastery in the scripting of new dreams (NDs) elaborated during IRT. NM and ND reports were collected from 44 female sexual assault survivors with chronic NMs during their initial application of IRT. Mastery was assessed with a standardized dream coding system and a multidimensional mastery scale. NDs contained significantly fewer negative elements and more occurrences of positive elements and mastery than did NMs. NDs were not devoid of negative dream elements. An increase in mastery over negative dream elements is a core process involved in NM reduction.