Insomnia

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Don Crawford, Ph.D.
Careful assessment is the key to developing a successful intervention for all kinds of insomnia, i.e. onset, wake-up. A good assessment will include detailed information regarding: a) food and chemical intake, b) physical exercise pattern, and c) a sleep log. The client's sleep log should include wake-up times or going to bed time, behavior at wake-up, thought content at wake-up, behavior tried to get back to sleep, emotional state at wake-up, and physiological state at wake-up.

Behavioral interventions may include cut off of a stimulant ingestion at noon; stop all daytime naps; increased exercise and changing the client's behavior associated with trying to go to sleep or following middle of night awakening (the assumption here is that their current behavior isn't working).

Images should be developed from the ongoing assessment process. The basic rule for developing images is to incorporate experience, which results in behavior and thoughts which are incompatible with the sleep-blocking experience. For example, if the client reports high muscle tension, develop images which produce or involve low muscle tension. Or, if the client is emotionally anxious, draw upon past life experiences to create images associated with calm, peaceful activities or create a new quiet, relaxing experience.

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