In vivo desensitization in the treatment of recurrent nightmares.

The literature, although sparse, suggests that behavioral interventions targeting the overt waking manifestations of the fear content of nightmares, can effectively reduce the frequency and intensity of these dreams. A 20-year-old female with recurrent nightmares centering on a fear of snakes, was treated by in vivo desensitization in which she approached a live, harmless snake. During treatment the client displayed habituation of fear of the snake and this corresponded to reductions in her nightmares. By the end of treatment and at 3-month and 1-year follow-up evaluations, she was free of fear and her nightmares had been eliminated. It is suggested that in vivo behavioral treatment of the content of nightmares may be a very effective way to eliminate these distressing dreams.