May 25, 2026 dreams

Writing About Nightmares: Where Expressive Writing Meets Imagery Rehearsal

By Brian Nuckols, MA, LAPC

LAPC · Center for Discovery · Gottman Trained · EFT · DBT · Depth Psychology · Pittsburgh, PA

TL;DR: Writing about a nightmare can deepen the rut or begin to fill it, depending on what the writing does. Bare recording rehearses the fear. Imagery Rehearsal Therapy, the only nightmare treatment the American Academy of Sleep Medicine rates “Recommended,” has the dreamer write the nightmare and then write a rescription toward agency. The depth-psychological tradition asks the further question of what the dream is trying to say. The two traditions need each other: rescription without meaning is symptom management, meaning without rescription is rumination.

Forty-Seven Entries, One Dream

A woman I will not describe in any detail that could identify her keeps a notebook on the nightstand, a cheap spiral thing with a pen clipped to the wire, and every morning before the day takes her she writes the dream down. She has done this for months. When she counts the entries there are forty-seven, and when she reads them in sequence what she notices, with a flatness that has started to frighten her more than the dream itself, is that nothing has moved. The same corridor. The same door that will not hold. The same arrival of the thing behind it. She came to dream-work believing that writing would loosen the grip, because she had read somewhere that putting words to a feeling drains it, and instead she has built, page by faithful page, a more and more detailed transcript of her own helplessness.

Her question is the right one, and it is not the question the internet answers. The internet tells her to journal her dreams. It does not tell her that there are at least two distinct traditions for putting a nightmare into words, that they rest on incompatible theories of what a dream is, and that the version she has been practicing, recording without revising, is the version with the weakest evidence behind it and the clearest mechanism for making things worse.

Two Traditions That Do Not Agree

The first tradition is behavioral, and it treats the dream as content. In this view a recurring nightmare is a learned sequence, a piece of overrehearsed imagery that the sleeping brain runs because it has run it so many times before, the way a needle settles into the deepest groove of a worn record. The dream is not a message. It is a habit with pictures. The behavioral clinician does not ask what the corridor means; the clinician asks how to interrupt the rehearsal and lay down a different track. This is the tradition that produced Imagery Rehearsal Therapy and its descendants.

The second tradition is depth-psychological, and it descends from Jung, who held that the dream is compensatory, that the psyche produces at night precisely the material the waking ego has refused or been unable to hold during the day. In this view the recurring nightmare is not a malfunctioning tape. It is a letter that keeps being returned to sender because it has not yet been read, and it will keep arriving, with the patience of something that has nowhere else to go, until the person it was addressed to opens it. The depth clinician does ask what the corridor means, not because the meaning is decorative but because, in this frame, the meaning is the mechanism. The dream repeats because it has not yet been understood.

These traditions are usually presented as rivals, and a person searching for help is usually handed one or the other without being told the other exists. The more useful truth is that each names a real failure in the other. The behavioral approach can stop a nightmare and leave the person with no idea what it was for, which is symptom management dressed as cure. The depth approach can turn a nightmare into an endless object of contemplation, a thing the person circles and circles and never escapes, which is rumination dressed as insight. The woman with the notebook has fallen into the second pit by way of a practice she thought belonged to the first.

What Imagery Rehearsal Therapy Actually Does

Barry Krakow’s protocol is almost insultingly simple to describe and surprisingly hard to do. The dreamer writes out the nightmare. Then the dreamer writes a new version, a rescription, in which something is different, where the threat does not arrive or does not land or is met by a self that can, this time, act. The change need not be triumphant. It need not even make narrative sense. What matters is that the dreamer authors it. Then, for ten to twenty minutes a day, awake, the dreamer rehearses the new version in imagination, the way an actor runs lines, until the revised sequence is as practiced as the original was.

The evidence is unusually strong for a psychological intervention. Krakow’s 2001 randomized controlled trial, published in the Journal of the American Medical Association, showed durable reductions in nightmare frequency and in the daytime distress that nightmares drag behind them. On the strength of that trial and the replications that followed, the American Academy of Sleep Medicine’s 2018 position paper placed IRT alone at the “Recommended” tier for nightmare disorder, above every other psychological and pharmacological option it reviewed. When a person asks whether writing can help with nightmares, this is the writing the evidence is pointing at, and it is not the writing most people are doing.

What IRT does well is restore agency at the level of the image. The dreamer who writes a new ending is no longer only the one to whom the dream happens. The dreamer becomes, for twenty minutes a day, the one who decides. Whether or not the new content ever appears in sleep, and it often does, the rehearsal relocates the dreamer from the receiving end of the nightmare to its authorship, and that relocation is itself a kind of treatment.

ERRT and the Trauma Underneath

For nightmares rooted in trauma, Joanne Davis at the University of Tulsa built Exposure, Relaxation, and Rescription Therapy on Krakow’s foundation. ERRT keeps the writing and the rescription and adds two things: graduated exposure to the nightmare content, done under conditions of relaxation so the body learns it can hold the material without being overwhelmed, and explicit attention to the trauma themes that organize so much post-traumatic suffering, the domains of power, trust, intimacy, esteem, and safety. Three randomized controlled trials support it, and the AASM rates it “May Be Used.”

The reason ERRT matters for anyone thinking about writing as a treatment is that it is the closest a structured writing protocol comes to the depth tradition’s concern with meaning. ERRT does not treat the nightmare as a freestanding habit. It treats the nightmare as the visible edge of a trauma whose shape can be named, and it asks the dreamer to write toward those themes rather than away from them. This is why the question of what changes when trauma dreams begin to shift is not idle. The structure of the dream, the dreamer’s agency inside it, the distance of the threat, these are measurable, and they move as the underlying material is processed.

Why Bare Recording Fails

Return to the notebook. What the woman has been doing is the one form of dream-writing that no tradition recommends, and understanding why clarifies everything else. Bare recording surfaces the material without doing anything to it. Each morning she opens the wound, transcribes it in faithful detail, and closes the notebook, and the only thing the practice teaches her nervous system is that the corridor is real, the door is real, the thing behind it is real, and that she is the kind of person to whom this happens. She is rehearsing the nightmare as surely as an IRT patient rehearses the rescription, except that she is rehearsing the version with the threat intact.

This is the rumination feedback loop, and it is the precise mechanism by which a practice meant to help becomes a practice that harms. Rumination is not thinking about a problem. Rumination is circling a problem in a way that deepens the groove without moving toward resolution, and a dream journal that only records is a rumination engine with a leather cover. The research on expressive writing, the Pennebaker tradition, is often cited as proof that writing about distress helps, but Pennebaker’s own protocol asks the writer to construct a narrative, to move from fragmentary feeling toward an account with cause and sequence and meaning. Recording a nightmare verbatim is the opposite of narrative construction. It is transcription, and transcription metabolizes nothing.

What Writing the Dream Can Do Instead

Here the depth tradition earns its place, because it explains what the writing is for when the writing works. To write a dream down slowly, by hand, in the first minutes of waking, is to slow the dream from the speed of sleep to the speed of language, and in that slowing the dream becomes readable in a way it never is while it is happening. The corridor, on the page, can be looked at. The door can be described. The thing behind it can be approached one clause at a time, at a pace the waking self sets, which is the first time in the entire cycle that the dreamer rather than the dream has set the pace. This is what it means to bring a recurring dream across the threshold of memory, to move it from the place where it merely recurs to the place where it can be worked.

Then comes the rescription, and the depth reading of the rescription is not that it overwrites the dream with a more pleasant fiction. It is that the act of authoring an ending in which the self can act rehearses agency at the level where the trauma took it away. The dreamer who writes herself turning to face the door, or opening it, or walking past it, is not lying to herself about what happened. She is practicing, in the only theater available, the capacity to act that the original event foreclosed. The new version is not a denial of the old one. It is a correction made in the same medium where the injury lives.

And then she returns the next morning, not to transcribe the nightmare again but to see what the rescription brought, because the dream, in the depth frame, is in conversation. It answers. The clinician who works this way watches for the answer the way a therapist attends to dream content across the arc of treatment: the threat that moves a step further off, the door that holds for one beat longer, the new figure who appears at the edge of the corridor and was not there before. These are not random. They are the dream’s reply to having finally been read and answered.

Holding Both at Once

The integration is not complicated to state, though it asks more of a person than either tradition alone. Write the dream, slowly, to make it readable. Sit with it long enough to ask what it is bringing and to whom it is addressed, which is the depth question and the one that keeps rescription from becoming mere distraction. Write the rescription toward agency, which is the behavioral move and the one that keeps meaning from becoming the rut a person paces forever. Return the next morning to see what came, and treat what came as a reply rather than a symptom. This is how the same practice that filled forty-seven pages with the unchanged dream can begin, in the forty-eighth, to change it.

A caution belongs here, and it is the caution the search results omit. This work is not safe for everyone to do alone. A person with active post-traumatic stress, or with the dissociative subtype, or whose dream content is itself a faithful replay of a real event, can be dysregulated by exposure to the material without the relaxation and pacing that ERRT builds in deliberately. The depth tradition’s own first principle is that the dream brings material because some part of the self can receive it, and that principle has to be checked rather than assumed. The capacity to hold the corridor is not the same as the willingness to open the notebook. One can be present without the other, and writing under those conditions, as with nightmares that arrive after a relationship ends and reopen older losses, can deepen the very thing the writing was meant to ease. If the dreams trace to untreated trauma, the right first move is a clinician, not a pen.

The notebook is not the problem. What gets written in it, and what gets done with what is written, is the whole of the difference between a transcript of helplessness and a record of a self learning, slowly and in the dark, to act.

The writing app’s dream-content workflow integrates IRT-style rescription with depth-psychological processing, the recording, the rescription, and the return: open the dream module.

Frequently Asked Questions

Can writing help with recurring nightmares?

Yes, when it carries structure. Imagery Rehearsal Therapy, developed by Barry Krakow, asks the dreamer to write out the nightmare and then write a rescription, a deliberate alternative in which the threat resolves differently, and to rehearse that new version daily. Exposure, Relaxation, and Rescription Therapy, developed by Joanne Davis, extends this with trauma-themed processing. Bare expressive writing about nightmare content, without a rescription component, has weaker evidence and can deepen rumination. The American Academy of Sleep Medicine's 2018 position paper places IRT at its 'Recommended' tier for nightmare disorder, the only psychological treatment to reach that level.

What is dream journaling for trauma?

Dream journaling is the practice of recording dreams, especially recurring nightmares, for clinical or self-reflective use. In trauma populations the practice cuts two ways: recording a nightmare without a clinical frame can intensify distress by rehearsing the threat, while recording the same nightmare inside a structured process can turn the dream into material a person can work on rather than only suffer. The depth-psychological tradition descending from Jung treats the dream as compensatory communication, an attempt by the psyche to say what waking life has not let itself hear; the behavioral tradition treats the dream as rehearsable content. A good practice borrows from both.

Should I write down my nightmares?

It depends on the conditions you write under. If you are working with a trauma-trained clinician and the dream content carries meaning your waking self has not yet metabolized, then writing it down, slowly and with support, can move the work forward. If you are writing alone, with active post-traumatic stress or a dissociative subtype, and no plan beyond recording the fear, the practice can dysregulate you and reinforce the loop it was meant to interrupt. The question is never only whether to write. It is whether you have built the conditions under which writing metabolizes rather than rehearses.

What is the difference between IRT and ERRT?

Imagery Rehearsal Therapy, from Barry Krakow, has the dreamer write the nightmare, write a new version in which the threat does not occur, and rehearse that revised version for ten to twenty minutes a day across four to six sessions. The American Academy of Sleep Medicine rates it 'Recommended.' Exposure, Relaxation, and Rescription Therapy, from Joanne Davis at the University of Tulsa, builds on that base with graduated exposure and explicit trauma-themed processing across the domains of power, trust, intimacy, esteem, and safety. It carries three randomized controlled trials and an AASM rating of 'May Be Used.' ERRT is the closest writing-based competitor to any expressive-writing protocol aimed at nightmares.

Is dream journaling safe?

For non-clinical populations using dreams for self-reflection, generally yes. The risk rises along a gradient: when the dreams are processing untreated trauma, when the writer has dissociative tendencies, or when the dream content is itself retraumatizing, recording it without support can do harm. The depth-psychological frame holds that a dream brings difficult material because some part of the self has the capacity to receive it. That capacity is not a given. It is the thing to assess, honestly, before deciding how and whether to write.

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