John R. Tkach, M.D.
300 North Willson, Suite 203B
Bozeman, MT 59715
(406) 587-5442

Treatment of Nightmares Without The Interpretation of Dreams

RRP Treatment of Nightmares by Dr. Tkach

Nightmares are bad dreams. From the RRP point of view, nightmares arise because some critical experience or event occurred in the past and left a psychological scar. Most of the time, we deal with it by ignoring it or suppressing it, stuffing it down in the back of the mind and coping with it. The problem is that this hidden, unresolved conflict is still there, and manifests itself through symptoms. Symptoms are uncomfortable or unwanted feelings and behaviors that we cannot control.

Traditional Psychoanalytic Treatment

The standard treatment of nightmares is dream interpretation. In 1899 Freud first published these concepts in a book, The Interpretation of Dreams. This psychoanalytic approach as used today requires going to the doctor one or more times a week for as long 11 years or more. Ironically, Freud limited it to 6 months for some of his patients. The interpretation of dreams and behavior is the cornerstone of all psychoanalytic therapy. That book was the start of psychoanalysis and psychoanalytic therapy.

RRP Treatment of Nightmares

In creating Rapid Reintegration Procedure (RRP), English trained, Canadian doctor Edgar A. Barnett, M.D. resolved to invent a form of therapy that eliminated all but the few absolutely necessary elements of treatment. He shortened therapy to one to six visits most of the time.

In RRP, we do not make interpretations. What we are talking about here is the treatment of nightmares without the interpretations of dreams. This is sort of a psychoanalytic heresy.

Freud felt elements of the dream were mysterious hidden symbols to be translated into what they represented in the repressed unconscious mind. Once the patient had the insight to the meaning of the dream, an Ah-Ha experience would occur and the symptoms would disappear. Freud was very good at interpreting dreams.

A few years ago, I met a man who had psychoanalysis 4 times a week for 4 years. He felt it really helped him. But is that practical?

Dr. Barnett's RRP approaches it differently. Firstly, the patient does not need to tell the doctor anything personal, private, secret or embarrassing. We identify the feeling accompanying the nightmare and let it lead you back to the first time it happened. Once the cause is uncovered, we resolve the conflict and reintegrate the distressed ego state.

Secondly, you do the work as I guide you. It is not something I do to you. I want to stress that you do not need to tell me anything private during RRP. Sometimes people choose to, but it is not required.

What is the RRP experience like? Dr. Barnett calls it waking hypnosis. It is sort of like daydreaming. In RRP you will be awake, alert, and in control.

My experience with using RRP to treat my nightmare:

I have had a recurrent nightmare over the past 20 years. It does not happen a lot, perhaps 3-5 times that I am aware of. It is always a variation on the same theme. Here's how it goes. I find myself coming to work in the morning and everything, unexpectedly, has changed. Without my knowledge or permission, all the rooms have changed. I cannot figure out how and where to see my patients. My surgical instruments also are misplaced. Some important aspects of this are that I do not have privacy to work with the patients, and the secretaries have changed to people I do not know. The patients are people I do not know. Where my exam rooms used to be, strangers have moved in and taken over. I am helpless to set things right. There are a lot of narrow hallways and no windows. The secretaries are uncooperative and one quits as soon as I walk in and ask for help.

This nightmare most recently occurred at 6AM January 4, 2006. I asked the unknown secretary where I was supposed to do my work. She led me through a maze of corridors to an enclosed area where the elevator lets people out. I said to her that this is not an office. It is a hallway in front of a service elevator. She said that is my new office and that's all of it. All my records and books were gone. I usually wake up at this point.

This dream is always very upsetting to me.

Using RRP, I was able to uncover an event when I was 2-3 years old when my father was in Japan at the end of WWII with General MacArthur. He was gone 22 months, and it was traumatic for the 2-3 year old me. My stable world was in my little town of Monongahela, Pennsylvania. My Grandmother Weller and all of her side of the family lived in a luxurious (by the standards of those days) house on main street. Grandmother Weller was distressingly Victorian. Across the street was my Grandmother Tkach who was warm, permissive, unconditionally loving and nurturing. She was always fun and interesting.

Both of these grandmothers and the rest of the family provided a stable, secure environment. Then my mother decided to move to Washington, D.C. where she went through a series of jobs and moved us from apartment to apartment. Each a little better than the last. The worst was a tiny closet under the stairs in a building full of unsympathetic hostile grownups, similar to the first Harry Potter movie. Very claustrophobic. To care for me in the daytime while she was at work, my mother took me to terrible day care places that I reacted violently to. The environment changed from stable to frighteningly unstable, unpredictable, hostile, and foreign. It changed often.

I went through the RRP steps and resolved the conflict. I reintegrated the 2-3 year old. This process took, I estimate, 4-6 minutes. It was not traumatic for me. In fact, I was pleased to have the opportunity to make the lemon into lemonade. I feel good about it.

About RRP

Dr. Barnett invented Rapid Reintegration Procedure (RRP) in 2003 and started training me April 2004. He was born and raised in England and went to Medical School in England. He has been doing hypnotherapy for over 40 years. He has written two books on psychotherapy. 1. ANALYTICAL HYPNOTHERAPY 2. UNLOCK YOUR MIND. His RRP evolved after 40 years of his experiences and ideas in treating patients with psychological problems. Based on his ideas, we wrote a book together, RAPID REINTEGRATION PROCEDURE.

What is RRP? At first we thought it was a type of hypnosis or "waking hypnosis," and it may very well be. The problem with that is that hypnosis traditionally requires a procedure called induction, induction of a hypnotic trance. In RRP, there is no hypnotic induction done. There is no trance. You retain full consciousness and complete control at all times. So, what do you call that? We are thinking of calling it "RRP State." By that, I mean a form of altered consciousness unique to RRP. Dr. Barnett thinks that, since the doctor is talking directly to the unconscious mind, RRP involves some sort of hypnotic features.

The Difference Between RRP and Other Standard Therapies

The reason traditional psychotherapies fail is that they require people to reveal their innermost, private, embarrassing, threatening, or frightening secrets and the details of those secrets. There is none of that with RRP. In RRP, you do not need to reveal any secret details about yourself. The procedure is between you and yourself. I, as therapist, guide you, and I am there with you so you do not need to go through it alone. You won't go through it alone. But, you are not required to tell me anything about the personal details. You will be doing a great deal of the treatment yourself with my guidance.

I have an interest in RRP, but I am not a trained psychotherapist or psychiatrist. I do not prescribe psychotropic drugs. I do not give interpretations or interpret dreams. I do not do marital counseling.

What is the RRP Experience Like?

Essentially, you sit in a chair with your eyes closed in a relaxed state, and I guide you through recalling feelings and old memories. It is very simple, it occurs very easily, and it is not threatening. In fact, you will find it fun.

During RRP you will still be in control at all times. If something about RRP puzzles you, just ask me. If you want to stop and backout, you will be able to do so easily with no harm.

Things to Consider about RRP

Dr. Barnett and I think RRP is safe. However, there is something you should think about before deciding to try RRP. What will your life be like once you have achieved freedom from your nightmare? If you have been suffering from your nightmare for years, you have built up a life style, and those around you have adjusted to it.

When RRP works, the results are immediate and dramatic. When you have achieved results in RRP therapy, there will be no question in your mind about it. Your whole attitude about your nightmare will change and surprise you and others. You will be delighted. It is like being released from jail and given all the respect, rights, and privileges of a regular first-class citizen.

If at some later time, you experience a recurrence of the old nightmare, I recommend another RRP session to find out what stirred it up and to correct it. During the trial period, I won't charge for that. But I will after the trial period.

How To Get Started With RRP

Dr. Barnett and I are doing a clinical trial of RRP in the treatment of nightmares, especially when standard treatments have failed. Because it is experimental, and because I am still learning it, there will be no charge for the trial sessions. To enroll in this limited trial, you must do the following things:

  1. Determine if you want me to help you.
  2. Make a commitment to cooperate with me. That will be very easy. I won't ask you to do anything difficult. You will find it easy to work with me.
  3. Obtain a letter of referral from your doctor at your expense. The letter should state clearly that the doctor is referring you to me for RRP therapy as an adjunct to the other treatments, briefly state what the symptoms are, present medicines and what drugs and treatments have been tried and failed. Your doctor must understand I am not an internist and I am NOT trying to take over your care or your medications management. Those things are up to you and your doctor.
  4. You must have already tried treatment that failed to give you long lasting results. We are seeking those people for whom standard treatments have failed.
  5. Be willing to have the sessions with me videotaped for Dr. Barnett to review, maybe for the Bozeman Hypnosis Study Group to study, and possibly for use in teaching RRP to therapists.
  6. Discuss with your family and friends how your life is about to change. Ask them to support you in this effort. Assure them that you will still love them. Think it over for about a week before you go on to the next step.
  7. Call my secretary to schedule yourself for RRP. 587-5442.
  8. Come to my home on a Saturday morning or several Saturdays. If you are not going to come, you must call my office two days in advance and cancel. I am doing this in my spare time, and I don't have much spare time. If you fail to show up for your session, you will be dropped from the study. I'd like you to bring a spouse, relative, or friend as a chaperone.
  9. Send me a letter at 6 months, one year, two years, and three years letting me know how you are doing.
  10. Sign a release of liability (availble from my office).
  11. To prepare for RRP, do this homework assignment. Every time you experience a nightmare, instead of bemoaning it, try hard to identify the feelings associated the nightmare.

You will have to read and sign a copy of this with the release form before being seen by Dr. Tkach for RRP.

Learn more about the Rapid Reintegration Procedure or buy a copy of Dr. Barnett and Dr Tkach's book.