David Baxter PhD
Late Founder
Rewriting Your Nightmares
New York Times Blog
October 31, 2008
Halloween is filled with the stuff of nightmares — costumed ghosts, vampires and slasher-movie monsters. But for some people, nightmares aren’t holiday fun. As many as 25 percent of adults have at least one nightmare a month. For a troubled 7 to 8 percent of the population, nightmares interrupt sleep at least once a week.
But many people don’t realize that having chronic nightmares is a medical problem that can be treated.
A nightmare is a complex dream that can cause high levels of anxiety and terror. Nightmares typically interrupt sleep as the mind plays out frightening scenes that involve imminent harm, like being chased, threatened or injured. For people who suffer from post-traumatic stress, nightmares tend to involve reliving the original horror of the traumatic event.
It’s believed that nightmares occur when the brain is struggling to process stress or severe trauma. But for some people, the bad dreams essentially become a learned behavior, and the brain gets stuck in a pattern of troubling nightmares.
In the past, therapists have encouraged patients to talk about their nightmares in hopes of resolving the underlying issues that cause them. But more recently, therapists have adopted “imagery rehearsal therapy,” a pioneering technique developed by Dr. Barry Krakow at the University of New Mexico School of Medicine.
Instead of focusing on the bad dream, imagery therapy looks for ways to rewrite a nightmare’s script. The concern is that talking too much about a troubling dream may serve to reinforce it. Imagery rehearsal therapy allows the dreamer to rewrite the nightmare during the day. After practicing basic imagery techniques — imagining yourself on a beach or eating a hamburger, for example — the troubled dreamer chooses a better version of the dream, explains Shelby Harris, clinical psychologist at the Sleep-Wake Disorders Center at Montefiore Hospital in New York.
“We mention the nightmare once and forget about it,” Dr. Harris said. “I tell patients to change it anyway they wish. You can change a tiny bit of it, or change the whole thing.”
The key is to “practice” the new version of the dream by imagining it a few times during the day. While the method is highly successful, helping about 70 percent of people who try it, it can work differently in different people. Some develop the ability to change the nightmare while they are having it. One patient of Dr. Harris was troubled by a dream in which she was attacked by sharks. During imagery therapy, the patient chose to change the sharks into dolphins. When she started to have the nightmare during her sleep, the sharks also changed into dolphins.
Other sufferers notice that after therapy the nightmares disappear and the general quality of all their dreams starts to turn more positive. The therapy treatment is typically brief, lasting only two or three sessions. Children can also be taught the technique.
“Practicing imagery during the day and changing imagery can really affect your imagery at night,” Dr. Harris said.
Dr. Harris said people suffering from occasional nightmares can try rewriting the script of their nightmares on their own. But people who are waking often from nightmares or who are developing insomnia or a fear of sleeping should seek professional help before the problem becomes severe.
“If you’re having a nightmare at night, you’re waking up, which makes you tired during the day, and you’re thinking about it,” Dr. Harris said. “Because it’s distressing, that causes more stress, which can cause more nightmares at night. It’s a cycle many people can’t break.”
To learn more, visit Dr. Krakow’s Nightmare Treatment Center Web page and take the nightmare quiz to help determine your risk for a nightmare disorder. And read Natalie Angier’s recent column on nightmares.
New York Times Blog
October 31, 2008
Halloween is filled with the stuff of nightmares — costumed ghosts, vampires and slasher-movie monsters. But for some people, nightmares aren’t holiday fun. As many as 25 percent of adults have at least one nightmare a month. For a troubled 7 to 8 percent of the population, nightmares interrupt sleep at least once a week.
But many people don’t realize that having chronic nightmares is a medical problem that can be treated.
A nightmare is a complex dream that can cause high levels of anxiety and terror. Nightmares typically interrupt sleep as the mind plays out frightening scenes that involve imminent harm, like being chased, threatened or injured. For people who suffer from post-traumatic stress, nightmares tend to involve reliving the original horror of the traumatic event.
It’s believed that nightmares occur when the brain is struggling to process stress or severe trauma. But for some people, the bad dreams essentially become a learned behavior, and the brain gets stuck in a pattern of troubling nightmares.
In the past, therapists have encouraged patients to talk about their nightmares in hopes of resolving the underlying issues that cause them. But more recently, therapists have adopted “imagery rehearsal therapy,” a pioneering technique developed by Dr. Barry Krakow at the University of New Mexico School of Medicine.
Instead of focusing on the bad dream, imagery therapy looks for ways to rewrite a nightmare’s script. The concern is that talking too much about a troubling dream may serve to reinforce it. Imagery rehearsal therapy allows the dreamer to rewrite the nightmare during the day. After practicing basic imagery techniques — imagining yourself on a beach or eating a hamburger, for example — the troubled dreamer chooses a better version of the dream, explains Shelby Harris, clinical psychologist at the Sleep-Wake Disorders Center at Montefiore Hospital in New York.
“We mention the nightmare once and forget about it,” Dr. Harris said. “I tell patients to change it anyway they wish. You can change a tiny bit of it, or change the whole thing.”
The key is to “practice” the new version of the dream by imagining it a few times during the day. While the method is highly successful, helping about 70 percent of people who try it, it can work differently in different people. Some develop the ability to change the nightmare while they are having it. One patient of Dr. Harris was troubled by a dream in which she was attacked by sharks. During imagery therapy, the patient chose to change the sharks into dolphins. When she started to have the nightmare during her sleep, the sharks also changed into dolphins.
Other sufferers notice that after therapy the nightmares disappear and the general quality of all their dreams starts to turn more positive. The therapy treatment is typically brief, lasting only two or three sessions. Children can also be taught the technique.
“Practicing imagery during the day and changing imagery can really affect your imagery at night,” Dr. Harris said.
Dr. Harris said people suffering from occasional nightmares can try rewriting the script of their nightmares on their own. But people who are waking often from nightmares or who are developing insomnia or a fear of sleeping should seek professional help before the problem becomes severe.
“If you’re having a nightmare at night, you’re waking up, which makes you tired during the day, and you’re thinking about it,” Dr. Harris said. “Because it’s distressing, that causes more stress, which can cause more nightmares at night. It’s a cycle many people can’t break.”
To learn more, visit Dr. Krakow’s Nightmare Treatment Center Web page and take the nightmare quiz to help determine your risk for a nightmare disorder. And read Natalie Angier’s recent column on nightmares.
