Imagery rehearsal therapy is described as which of the following?

• A. A therapy that involves real-time exposure without nightmares
• B. A treatment involving rewriting a nightmare by visualizing positive images while awake
• C. A pharmacologic agent to suppress dreams
• D. A mindfulness technique to reduce anxiety during sleep

Answer: (B)

Imagery rehearsal therapy is a cognitive-behavioral technique used to reduce nightmare distress. It involves recalling a recurrent nightmare, then rewriting it with a positive or non-threatening ending, and practicing vivid visualization of this new dream while awake. Repeated rehearsal helps the brain form a new mental image, which often leads to fewer nightmares and less fear around sleep. This approach is distinct from pharmacologic suppression of dreams, real-time exposure during sleep, or mindfulness strategies, as it centrally relies on rewriting and rehearsing a positive scenario during waking hours.