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A '''nightmare''' is a dream which causes a strong unpleasant emotional response from the sleeper, typically fear or horror, or the sensations of pain, falling, drowning or death. Such dreams can be related to physical causes such as a high fever, or psychological ones such as psychological trauma or stress in the sleeper's life, or can have no apparent cause. If a person has experienced a psychologically traumatic situation in life, for example, a person who may have been captured and [[tortured]], the experience may come back to haunt them in their nightmares. Sleepers may waken in a state of distress and be unable to get back to sleep for some time.
[[Category:Definitions]]
[[File:John Henry Fuseli - The Nightmare.JPG|thumb|''The Nightmare'' (Henry Fuseli, 1781)]]
A '''nightmare''' is an unpleasant dream that can cause a strong emotional response from the mind, typically fear or horror but also despair, anxiety and great sadness. The dream may contain situations of danger, discomfort, psychological or physical terror. Sufferers often awaken in a state of distress and may be unable to return to sleep for a prolonged period.<ref>American Psychiatric Association (2000), Diagnostic and Statistical Manual of Mental Disorders, 4th ed, TR, p. 631</ref>
 
Nightmares can have physical causes such as sleeping in an uncomfortable or awkward position, having a fever, or psychological causes such as stress, anxiety, and as a side effect of various drugs. Eating before going to sleep, which triggers an increase in the body's metabolism and brain activity, is a potential stimulus for nightmares.<ref name=Stephens>{{cite journal |last=Stephen, |first=Laura |title=Nightmares  |url=http://web.archive.org/web/20070831193305/http://www.psychologytoday.com/conditions/nightmare.html |year=2006 |publisher=Psychologytoday.com}}</ref> Recurrent nightmares may require medical help, as they can interfere with sleeping patterns and cause insomnia.
 
 
==Etymology==
"Nightmare" evokes the modern word for a female horse but the terms are wholly unrelated. The word derives from the Old English "[[Mare]]", a mythological [[demon]] or goblin who torments others with frightening dreams.<ref>{{Cite book |title=Word Origins And How We Know Them |last=Liberman |first=Anatoly |year=2005 |publisher=Oxford University Press |location=Oxford |isbn=978-0-19-538707-0 |page=87 |url=http://books.google.com/books?id=sMiRc-JFIfMC&pg=PA87#v=onepage&q&f=false |accessdate=29 March 2012 }}</ref> Subsequently, the prefix "night-" was added to stress the dream-aspect. The word "nightmare" is cognate with the older German term ''Nachtmahr''.
 
 
==Incidence and Types of Nightmare==
Fearfulness in waking life is correlated with the incidence of nightmares.<ref name="npr">[http://www.npr.org/templates/story/story.php?storyId=15778923 The Science Behind Dreams and Nightmares], ''Talk of the Nation'', national Public Radio. 30 October 2007.</ref> Studies of dreams have estimated that about 75% of the time, the emotions evoked by dreams are negative.<ref name="npr"/> However, it is worth noting that people are more likely to remember unpleasant dreams.
 
One definition of "nightmare" is a dream which causes one to wake up in the middle of the sleep cycle and experience a negative emotion, such as fear. This type of event occurs on average once per month. They are not common in children under five, but they are more common in young children (25% experiencing a nightmare at least once per week), most common in teenagers, and common in adults (dropping in frequency about one third from age 25 to 55).<ref name="npr"/>
 
 
==Theories on the Causes of Nightmares==
Scientific research shows that nightmares may have many causes. In a study focusing on children, researchers were able to conclude that nightmares directly correlate with the stress in the children's lives. Children who experienced the death of family or a close friend or know someone with a chronic illness have more frequent nightmares than those who are only faced with stress from school or stress from social aspects of daily life.<ref>Schredl, Michael, et al. "Nightmares and Stress in Children." Sleep and Hypnosis 10.1 (2008): 19-25. ProQuest. Web. 29 Apr. 2014.</ref>


Occasional nightmares are commonplace, but recurrent nightmares can interfere with sleep and may cause people to seek medical help. A recently proposed treatment consists of ''imagery rehearsal''.<ref name="pmid15984916">{{cite journal |author=Davis JL, Wright DC |title=Case series utilizing exposure, relaxation, and rescripting therapy: impact on nightmares, sleep quality, and psychological distress |journal=Behavioral sleep medicine |volume=3 |issue=3 |pages=151-7 |year=2005 |pmid=15984916 |doi=10.1207/s15402010bsm0303_3}}</ref> This approach appears to reduce the effects of nightmares and other symptoms in [[acute stress disorder]] and [[post-traumatic stress disorder]].<ref name="pmid11476655">{{cite journal |author=Krakow B, Hollifield M, Johnston L, ''et al'' |title=Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with post traumatic stress disorder: a randomized controlled trial |journal=JAMA |volume=286 |issue=5 |pages=537-45 |year=2001 |pmid=11476655 |doi= |url=http://jama.ama-assn.org/cgi/content/abstract/286/5/537}}</ref>
Another study researching the causes of nightmares focuses on patients suffering from sleep apnea. The study was conducted to prove whether or not nightmares may be caused by sleep apnea, or not being able to breathe. In the nineteenth century, authors believed that nightmares were caused by not having enough oxygen, therefore it was believed that those with sleep apnea had more frequent nightmares than perfectly normal people. The hypothesis, however, was proven wrong and the results actually showed that healthy people have more nightmares than the sleep apnea patients.<ref>Schredl, Michael, et al. "Nightmares and Oxygen Desaturations: Is Sleep Apnea Related to Heightened  Nightmare Frequency?" Sleep and Breathing 10.4 (2006): 203-9. ProQuest. Web. 24 Apr. 2014.</ref>


Practitioners of [[lucid dreaming]] claim that it can help conquer nightmares of this type,<ref>http://www.ld4all.com/index.html#frames(content=while_nightmares.shtml)</ref> rather than of the traditional type (see below).


==Historic use of term==
==Possible Effects of Nightmares==
A study involving a large group of undergraduate students analyzes the effects of nightmares on the quality of sleep. The study showed that the participants experienced abnormal sleep architecture and that the results of having a nightmare during the night were very similar to those of people who suffer from insomnia. This means that, like insomniacs, people who suffer from nightmares do not get as much rest as those who do not suffer from chronic nightmares. Therefore, they experience a lesser quality of sleep than others. This is thought to be from frequent nocturnal awakenings and fear of falling or going back to sleep.<ref>Simor, Pé, et al. "Disturbed Dreaming and Sleep Quality: Altered Sleep Architecture in Subjects with  Frequent Nightmares."European archives of psychiatry and clinical neuroscience 262.8 (2012): 687-96. ProQuest. Web. 24 Apr. 2014.</ref>


[[Image:John Henry Fuseli - The Nightmare.JPG|thumb|280px|The Nightmare, Henry Fuseli, 1781 (The Detroit Institute of Arts, Detroit)]]


Nightmare was the original term for the state later known as ''waking dream'' (cf. [[Mary Shelley]] and [[Frankenstein#Shelley's inspiration|Frankenstein]]'s Genesis), and more currently as [[sleep paralysis]], associated with rapid eye movement ([[Rapid eye movement|REM]]) sleep. The original definition was codified by [[Dr Johnson]] in his ''[[A Dictionary of the English Language]]'' and was thus understood, among others by [[Erasmus Darwin]] and [[Henry Fuseli]],<ref name="isbn0-7139-0274-4">{{cite book |author=Powell, Nicolas |title=Fuseli: The Nightmare |publisher=Allen Lane |location=London |year=1973 |pages= |isbn=0-7139-0274-4 |oclc= |doi=}}</ref> to include a ''"morbid oppression during sleep, resembling the pressure of weight upon the breast."''
== Treatment of Nightmares ==
Both Sigmund Freud and Carl Jung seemed to have shared a common understanding that people frequently distressed by nightmares could be re-experiencing some stressful event from the past.<ref name="Coalson 1985, Web">Coalson 1985, Web</ref> Both perspectives on dreams suggest that therapy can provide relief from the dilemma of the nightmare experience.


Such nightmares were widely considered to be the work of [[demon]]s and more specifically [[incubus (demon)|incubi]], which were thought to sit on the chests of sleepers. In [[Old English language|Old English]] the name for these beings was ''mare'' or ''mære'' (from a [[proto-Germanic language|proto-Germanic]] ''*marōn'', related to [[Old High German]] and [[Old Norse language|Old Norse]] ''[[mara (folklore)|mara]]''), hence comes the ''mare'' part in ''nightmare''.
Halliday (1987), grouped treatment techniques into four classes. Direct nightmare interventions that combine compatible techniques from one or more of these classes may enhance overall treatment effectiveness:<ref>Halliday 1987</ref>


Folk belief in Newfoundland, South Carolina and Georgia describe the negative figure of the [[Hag]] who leaves her physical body at night, and  sits on the chest of her victim.  The victim usually wakes with a feeling of terror, has difficulty breathing because of a perceived heavy invisible weight on his or her chest, and is unable to move i.e., experiences [[sleep paralysis]]. This nightmare experience is described as being "hag-ridden" in the [[Gullah]] lore. The "Old Hag" was a nightmare spirit in British and also Anglophone North American folklore.  
* Analytic and cathartic techniques
* Story-line alteration procedures
* Face-and-conquer approaches
* Desensitization and related behavioral techniques.


Various forms of [[magic (paranormal)|magic]] and [[spiritual possession]] were also advanced as causes. In [[nineteenth century]] [[Europe]], the vagaries of diet were thought to be responsible. For example, in [[Charles Dickens]]'s ''[[A Christmas Carol]]'', [[Ebenezer Scrooge]] attributes the [[ghost]] he sees to "... an undigested bit of beef, a blot of mustard, a crumb of cheese, a fragment of an underdone potato..."  In a similar vein, the ''[[Household Cyclopedia]]'' (1881) offers the following advice about nightmares:
Recurring post-traumatic stress disorder nightmares in which real traumas are re-experienced respond well to a technique called '''imagery rehearsal'''. First described in the 1996 book ''Trauma and Dreams''<ref>ISBN 0-674-00690-9</ref> by Harvard psychologist Deirdre Barrett, this contemporary dream interpretation involves the dreamer coming up with an alternate, mastery outcome to the nightmare, mentally rehearsing that outcome awake, and then reminding themselves at bedtime that they wish this alternate outcome should the nightmare recur. Research has found that this technique not only reduces the occurrence of nightmares and insomnia,<ref name="pmid15984916">Davis, J. L.; Wright, D. C. (2005). "Case Series Utilizing Exposure, Relaxation, and Rescripting Therapy: Impact on Nightmares, Sleep Quality, and Psychological Distress". Behavioral Sleep Medicine 3 (3): 151–157.</ref> but also improves other daytime PTSD symptoms.<ref name="pmid11476655">Krakow, B.; Hollifield, M.; Johnston, L.; Koss, M.; Schrader, R.; Warner, T. D.; Tandberg, D.; Lauriello, J.; McBride, L. (2001). "Imagery Rehearsal Therapy for Chronic Nightmares in Sexual Assault Survivors with Posttraumatic Stress Disorder: A Randomized Controlled Trial". JAMA: the Journal of the American Medical Association 286 (5): 537</ref> According to Bret Moore and Barry Kraków, the most common variations of Imagery Rehearsal Therapy (IRT) "relate to the number of sessions, duration of treatment, and the degree to which exposure therapy is included in the protocol".<ref name="pmid19444882">Lu, M.; Wagner, A.; Van Male, L.; Whitehead, A.; Boehnlein, J. (2009). "Imagery rehearsal therapy for posttraumatic nightmares in U.S. Veterans". Journal of Traumatic Stress 22 (3): 236–239. </ref> Another kind of treatment not only helping the reduction of nightmares, sleep disturbance, and other PTSD symptoms is prazosin. There have been multiple studies conducted under placebo-controlled conditions. (Am J Psychiatry 2003; 160:371–373)
<blockquote>A comprehensive model has been put forth by Krakow and Zadra (2006) that includes four group treatment sessions, ~2.25 to 2.5 hr in length. The first two sessions focus on how nightmares are closely connected to insomnia and how they become an independent symptom or disorder that warrants individually tailored and targeted intervention. The last two sessions focus on the imagery system and how IRT can reshape and eliminate nightmares through a relatively straightforward process akin to cognitive restructuring via the human imagery system. First, the patient is asked to select a nightmare, but for learning purposes the choice would not typically be one that causes a marked degree of distress. Second, and most commonly, guidance is not provided on how to change the disturbing content of the dream; the specific instruction developed by Joseph Neidhardt is “change the nightmare anyway you wish” (Neidhardt et al., 1992). In turn, this step creates a “new” or “different” dream, which may or may not be free of distressing elements. Our instructions, unequivocally, do not make a suggestion to the patient to make the dream less distressing or more positive or to do anything other than “change the nightmare anyway you wish.” Last, the patient is instructed to rehearse the “new dream” through imagery and to ignore the old nightmare.<ref name="pmid19444882r">p. 234</ref></blockquote>


:"Great attention is to be paid to regularity and choice of diet. Intemperance of every kind is hurtful, but nothing is more productive of this disease than drinking bad wine. Of eatables those which are most prejudicial are all fat and greasy meats and pastry... Moderate exercise contributes in a superior degree to promote the digestion of food and prevent flatulence; those, however, who are necessarily confined to a sedentary occupation, should particularly avoid applying themselves to study or bodily labor immediately after eating... Going to bed before the usual hour is a frequent cause of night-mare, as it either occasions the patient to sleep too long or to lie long awake in the night. Passing a whole night or part of a night without rest likewise gives birth to the disease, as it occasions the patient, on the succeeding night, to sleep too soundly. Indulging in sleep too late in the morning, is an almost certain method to bring on the paroxysm, and the more frequently it returns, the greater strength it acquires; the propensity to sleep at this time is almost irresistible."<ref>http://www.mspong.org/cyclopedia/medicine.html#nightmare</ref>
A nightmare arises from one's complex that contains residue from some unresolved issue.<ref name="Coalson 1985, Web"/> Some people may experience recurring nightmares due to posttraumatic stress disorder (PTSD), or they may have some other source of anxiety that influences their dreams at night.<ref name="Coalson 1985, Web"/> Whatever the cause, there are treatments available, some of them medical and some psychological. While most treatments are meant for people who have a  true disorder, the techniques discussed above will work well for any person dealing with nightmares.<ref name="Coalson 1985, Web"/>


==See also==
==See also==
{{Commonscat|Nightmares}}
* [[Mare]]
{{Wikisource}}
* [[Mora (mythology)]]
{{Wiktionary}}
* [[Night terror]]
*[[Sleep disorder]]
* [[Sleep paralysis]]
*[[Night terror]]
*[[Sleep paralysis]]
*[[Mara (folklore)]]
*[[Hag]]
*[[The Nightmare]]
*[[Lucid dream]]
*[http://en.wiktionary.org/wiki/Appendix:Glossary_of_traumatology Glossary of Traumatology]


==Notes==
* [[Max Eastman]] visited [[Sigmund Freud]]'s apartment in [[Vienna]], in 1926. He saw a print of Fuseli's ''The Nightmare'', next to [[Rembrandt Harmenszoon van Rijn|Rembrandt]]'s ''The Anatomy Lesson''. [[Ernest Jones]] chose another version of Fuseli's painting as the frontispiece of his book ''On the Nightmare'', however neither Freud nor Jones mentioned those paintings in their writings about the classic nightmare.
* Recent exhibits: ''Gothic Nightmares: Fuseli, Blake and the Imagination.'' 15 February  –  1 May (2006); Tate Britain, Millbank, London SW1P 4RG.
* When considered a disease, nightmares are classified as follows:   
** ICD-10 code = F51.5   
** ICD-9 code = 307.47


==References==
==References==
{{reflist}}
{{Reflist}}
* Anch, A.M., & Browman, C.P., & Mitler, M.M., & Walsh, J.K. (1988). ''Sleep: A scientific perspective''. New Jersey: Prentice-Hall, Inc.
 
 
==Further Reading==
* Anch, A. M., Browman, C.P., Mitler, M.M., & Walsh, J.K., ''Sleep: A scientific perspective'' (New Jersey: Prentice-Hall, 1988).
* Harris J.C. (2004). Arch Gen Psychiatry. May;61(5):439-40. ''The Nightmare''. (PMID 15123487)
* Harris J.C. (2004). Arch Gen Psychiatry. May;61(5):439-40. ''The Nightmare''. (PMID 15123487)
*Jones, Ernest (1951). ''On the Nightmare'' (ISBN 0-87140-912-7) (pbk, 1971; ISBN 0-87140-248-3).
* Husser, J.-M. et A. Mouton (Éd.),'' Le Cauchemar dans les sociétés antiques. Actes des journées d'étude de l'UMR 7044 (15-16 Novembre 2007, Strasbourg)'' (Paris, De Boccard, 2010).
* [http://www.kluweronline.com/article.asp?PIPS=300244&PDF=1 Forbes, D. ''et al.'' (2001)] ''Brief Report: Treatment of Combat-Related Nightmares Using Imagery Rehearsal: A Pilot Study'', Journal of Traumatic Stress '''14''' (2): 433-442
* Jones, Ernest (1951). ''On the Nightmare'' (ISBN 0-87140-912-7) (pbk, 1971; ISBN 0-87140-248-3).
* [http://www.kluweronline.com/article.asp?PIPS=300244&PDF=1 Forbes, D. et al. (2001)] ''Brief Report: Treatment of Combat-Related Nightmares Using Imagery Rehearsal: A Pilot Study'', Journal of Traumatic Stress '''14''' (2): 433-442
* [http://www.asdreams.org/magazine/articles/seigel_nightmares.htm Siegel, A. (2003)] ''A mini-course for clinicians and trauma workers on posttraumatic nightmares.''
* [http://www.asdreams.org/magazine/articles/seigel_nightmares.htm Siegel, A. (2003)] ''A mini-course for clinicians and trauma workers on posttraumatic nightmares.''
*Burns, Sarah (2004). ''Painting the Dark Side : Art and the Gothic Imagination in Nineteenth-Century America''. Ahmanson-Murphy Fine Are Imprint, 332 pp, University of California Press, ISBN 0-520-23821-4.
* Burns, Sarah (2004). ''Painting the Dark Side : Art and the Gothic Imagination in Nineteenth-Century America''. Ahmanson-Murphy Fine Are Imprint, 332 pp., University of California Press, ISBN 0-520-23821-4.hjhjhj* Davenport-Hines, Richard (1999). ''Gothic: Four Hundred Years of Excess, Horror, Evil and Ruin.'' North Point Press, p.&nbsp;160-61.
*Davenport-Hines, Richard (1999). ''Gothic: Four Hundred Years of Excess, Horror, Evil and Ruin.'' North Point Press, p160-61.
* Hill, Anne (2009). ''What To Do When Dreams Go Bad: A Practical Guide to Nightmares''. Serpentine Media, 68 pp., ISBN 1-887590-04-8
*Simons, Ronald C and Hughes, Charles C (eds.)(1985). ''Culture-Bound Syndromes.'' Springer, 536pp.
* Simons, Ronald C and Hughes, Charles C (eds.) (1985). ''Culture-Bound Syndromes.'' Springer, 536 pp.
*Sagan, Carl (1997). ''The Demon-Haunted World: Science as a Candle in the Dark .''
* Sagan, Carl (1997). ''The Demon-Haunted World: Science as a Candle in the Dark.''
*Coalson, Bob. "Nightmare help: Treatment of trauma survivors with PTSD." Psychotherapy: Theory, Research, Practice, Training 32.3 (1995): 381-388. PsycARTICLES. EBSCO. Web. 18 Mar. 2011.
*{{cite web |title=Dreams - Practical Dream Analysis & Waking Life Meaning." Dream Interpretation, Psychology & Research, Nightmares & Alternative Medicine. Dreams Foundation, 1996 |accessdate= 19 January 2011 |url= http://www.nightmares.info/nightmares.htm}}
*Halliday, G. (1987). “Direct psychological therapies for nightmares: A review.” Clinical Psychology Review, 7, 501–523.
*"Imagery Rehearsal Therapy (IRT)." The Encyclopedia of Trauma and Traumatic Stress Disorders. Ronald M. Doctor and Frank N. Shiromoto. New York: Facts on File, 2010. 148. Gale Virtual Reference Library. Web. 21 Feb. 2011.
*Mayer, Mercer. There's a Nightmare in My Closet. [New York]: Puffin Pied Piper, 1976.
*Moore, Bret A., and Barry Kraków. "Imagery rehearsal therapy: An emerging treatment for posttraumatic nightmares in veterans." Psychological Trauma: Theory, Research, Practice, and Policy 2.3 (2010): 232-238.  PsycARTICLES. EBSCO. Web. 18 Mar. 2011.


==External links==
 
==External Links==
* [http://en.wikipedia.org/wiki/Nightmare The original source of this article at Wikipedia]
* [http://www.nightmares.info The value of nightmares and common nightmare themes]
* [http://www.nightmares.info The value of nightmares and common nightmare themes]
* [http://www.pitt.edu/~dash/nightmare.html Night-Mares: Demons that Cause Nightmares]
* [http://www.pitt.edu/~dash/nightmare.html Night-Mares: Demons that Cause Nightmares]
* [http://scepticthomas.com/nightmares/nightmare.htm Elements of the Nightmare]
* [http://scepticthomas.com/nightmares/nightmare.htm Elements of the Nightmare]
* [http://www.tate.org.uk/britain/exhibitions/gothicnightmares/default.shtm Gothic Nightmares exhibit]
* [http://www.tate.org.uk/britain/exhibitions/gothicnightmares/default.shtm Gothic Nightmares exhibit]
[[Category:Definitions]]

Latest revision as of 19:21, 17 June 2017

The Nightmare (Henry Fuseli, 1781)

A nightmare is an unpleasant dream that can cause a strong emotional response from the mind, typically fear or horror but also despair, anxiety and great sadness. The dream may contain situations of danger, discomfort, psychological or physical terror. Sufferers often awaken in a state of distress and may be unable to return to sleep for a prolonged period.[1]

Nightmares can have physical causes such as sleeping in an uncomfortable or awkward position, having a fever, or psychological causes such as stress, anxiety, and as a side effect of various drugs. Eating before going to sleep, which triggers an increase in the body's metabolism and brain activity, is a potential stimulus for nightmares.[2] Recurrent nightmares may require medical help, as they can interfere with sleeping patterns and cause insomnia.


Etymology

"Nightmare" evokes the modern word for a female horse but the terms are wholly unrelated. The word derives from the Old English "Mare", a mythological demon or goblin who torments others with frightening dreams.[3] Subsequently, the prefix "night-" was added to stress the dream-aspect. The word "nightmare" is cognate with the older German term Nachtmahr.


Incidence and Types of Nightmare

Fearfulness in waking life is correlated with the incidence of nightmares.[4] Studies of dreams have estimated that about 75% of the time, the emotions evoked by dreams are negative.[4] However, it is worth noting that people are more likely to remember unpleasant dreams.

One definition of "nightmare" is a dream which causes one to wake up in the middle of the sleep cycle and experience a negative emotion, such as fear. This type of event occurs on average once per month. They are not common in children under five, but they are more common in young children (25% experiencing a nightmare at least once per week), most common in teenagers, and common in adults (dropping in frequency about one third from age 25 to 55).[4]


Theories on the Causes of Nightmares

Scientific research shows that nightmares may have many causes. In a study focusing on children, researchers were able to conclude that nightmares directly correlate with the stress in the children's lives. Children who experienced the death of family or a close friend or know someone with a chronic illness have more frequent nightmares than those who are only faced with stress from school or stress from social aspects of daily life.[5]

Another study researching the causes of nightmares focuses on patients suffering from sleep apnea. The study was conducted to prove whether or not nightmares may be caused by sleep apnea, or not being able to breathe. In the nineteenth century, authors believed that nightmares were caused by not having enough oxygen, therefore it was believed that those with sleep apnea had more frequent nightmares than perfectly normal people. The hypothesis, however, was proven wrong and the results actually showed that healthy people have more nightmares than the sleep apnea patients.[6]


Possible Effects of Nightmares

A study involving a large group of undergraduate students analyzes the effects of nightmares on the quality of sleep. The study showed that the participants experienced abnormal sleep architecture and that the results of having a nightmare during the night were very similar to those of people who suffer from insomnia. This means that, like insomniacs, people who suffer from nightmares do not get as much rest as those who do not suffer from chronic nightmares. Therefore, they experience a lesser quality of sleep than others. This is thought to be from frequent nocturnal awakenings and fear of falling or going back to sleep.[7]


Treatment of Nightmares

Both Sigmund Freud and Carl Jung seemed to have shared a common understanding that people frequently distressed by nightmares could be re-experiencing some stressful event from the past.[8] Both perspectives on dreams suggest that therapy can provide relief from the dilemma of the nightmare experience.

Halliday (1987), grouped treatment techniques into four classes. Direct nightmare interventions that combine compatible techniques from one or more of these classes may enhance overall treatment effectiveness:[9]

  • Analytic and cathartic techniques
  • Story-line alteration procedures
  • Face-and-conquer approaches
  • Desensitization and related behavioral techniques.

Recurring post-traumatic stress disorder nightmares in which real traumas are re-experienced respond well to a technique called imagery rehearsal. First described in the 1996 book Trauma and Dreams[10] by Harvard psychologist Deirdre Barrett, this contemporary dream interpretation involves the dreamer coming up with an alternate, mastery outcome to the nightmare, mentally rehearsing that outcome awake, and then reminding themselves at bedtime that they wish this alternate outcome should the nightmare recur. Research has found that this technique not only reduces the occurrence of nightmares and insomnia,[11] but also improves other daytime PTSD symptoms.[12] According to Bret Moore and Barry Kraków, the most common variations of Imagery Rehearsal Therapy (IRT) "relate to the number of sessions, duration of treatment, and the degree to which exposure therapy is included in the protocol".[13] Another kind of treatment not only helping the reduction of nightmares, sleep disturbance, and other PTSD symptoms is prazosin. There have been multiple studies conducted under placebo-controlled conditions. (Am J Psychiatry 2003; 160:371–373)

A comprehensive model has been put forth by Krakow and Zadra (2006) that includes four group treatment sessions, ~2.25 to 2.5 hr in length. The first two sessions focus on how nightmares are closely connected to insomnia and how they become an independent symptom or disorder that warrants individually tailored and targeted intervention. The last two sessions focus on the imagery system and how IRT can reshape and eliminate nightmares through a relatively straightforward process akin to cognitive restructuring via the human imagery system. First, the patient is asked to select a nightmare, but for learning purposes the choice would not typically be one that causes a marked degree of distress. Second, and most commonly, guidance is not provided on how to change the disturbing content of the dream; the specific instruction developed by Joseph Neidhardt is “change the nightmare anyway you wish” (Neidhardt et al., 1992). In turn, this step creates a “new” or “different” dream, which may or may not be free of distressing elements. Our instructions, unequivocally, do not make a suggestion to the patient to make the dream less distressing or more positive or to do anything other than “change the nightmare anyway you wish.” Last, the patient is instructed to rehearse the “new dream” through imagery and to ignore the old nightmare.[14]

A nightmare arises from one's complex that contains residue from some unresolved issue.[8] Some people may experience recurring nightmares due to posttraumatic stress disorder (PTSD), or they may have some other source of anxiety that influences their dreams at night.[8] Whatever the cause, there are treatments available, some of them medical and some psychological. While most treatments are meant for people who have a true disorder, the techniques discussed above will work well for any person dealing with nightmares.[8]

See also


References

  1. ↑ American Psychiatric Association (2000), Diagnostic and Statistical Manual of Mental Disorders, 4th ed, TR, p. 631
  2. ↑ Stephen,, Laura (2006). "Nightmares". Psychologytoday.com. 
  3. ↑ Liberman, Anatoly (2005). Word Origins And How We Know Them. Oxford: Oxford University Press. Retrieved on 29 March 2012.
  4. ↑ 4.0 4.1 4.2 The Science Behind Dreams and Nightmares, Talk of the Nation, national Public Radio. 30 October 2007.
  5. ↑ Schredl, Michael, et al. "Nightmares and Stress in Children." Sleep and Hypnosis 10.1 (2008): 19-25. ProQuest. Web. 29 Apr. 2014.
  6. ↑ Schredl, Michael, et al. "Nightmares and Oxygen Desaturations: Is Sleep Apnea Related to Heightened Nightmare Frequency?" Sleep and Breathing 10.4 (2006): 203-9. ProQuest. Web. 24 Apr. 2014.
  7. ↑ Simor, Pé, et al. "Disturbed Dreaming and Sleep Quality: Altered Sleep Architecture in Subjects with Frequent Nightmares."European archives of psychiatry and clinical neuroscience 262.8 (2012): 687-96. ProQuest. Web. 24 Apr. 2014.
  8. ↑ 8.0 8.1 8.2 8.3 Coalson 1985, Web
  9. ↑ Halliday 1987
  10. ↑ ISBN 0-674-00690-9
  11. ↑ Davis, J. L.; Wright, D. C. (2005). "Case Series Utilizing Exposure, Relaxation, and Rescripting Therapy: Impact on Nightmares, Sleep Quality, and Psychological Distress". Behavioral Sleep Medicine 3 (3): 151–157.
  12. ↑ Krakow, B.; Hollifield, M.; Johnston, L.; Koss, M.; Schrader, R.; Warner, T. D.; Tandberg, D.; Lauriello, J.; McBride, L. (2001). "Imagery Rehearsal Therapy for Chronic Nightmares in Sexual Assault Survivors with Posttraumatic Stress Disorder: A Randomized Controlled Trial". JAMA: the Journal of the American Medical Association 286 (5): 537
  13. ↑ Lu, M.; Wagner, A.; Van Male, L.; Whitehead, A.; Boehnlein, J. (2009). "Imagery rehearsal therapy for posttraumatic nightmares in U.S. Veterans". Journal of Traumatic Stress 22 (3): 236–239.
  14. ↑ p. 234


Further Reading

  • Anch, A. M., Browman, C.P., Mitler, M.M., & Walsh, J.K., Sleep: A scientific perspective (New Jersey: Prentice-Hall, 1988).
  • Harris J.C. (2004). Arch Gen Psychiatry. May;61(5):439-40. The Nightmare. (PMID 15123487)
  • Husser, J.-M. et A. Mouton (Éd.), Le Cauchemar dans les sociétés antiques. Actes des journées d'étude de l'UMR 7044 (15-16 Novembre 2007, Strasbourg) (Paris, De Boccard, 2010).
  • Jones, Ernest (1951). On the Nightmare (ISBN 0-87140-912-7) (pbk, 1971; ISBN 0-87140-248-3).
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  • Siegel, A. (2003) A mini-course for clinicians and trauma workers on posttraumatic nightmares.
  • Burns, Sarah (2004). Painting the Dark Side : Art and the Gothic Imagination in Nineteenth-Century America. Ahmanson-Murphy Fine Are Imprint, 332 pp., University of California Press, ISBN 0-520-23821-4.hjhjhj* Davenport-Hines, Richard (1999). Gothic: Four Hundred Years of Excess, Horror, Evil and Ruin. North Point Press, p. 160-61.
  • Hill, Anne (2009). What To Do When Dreams Go Bad: A Practical Guide to Nightmares. Serpentine Media, 68 pp., ISBN 1-887590-04-8
  • Simons, Ronald C and Hughes, Charles C (eds.) (1985). Culture-Bound Syndromes. Springer, 536 pp.
  • Sagan, Carl (1997). The Demon-Haunted World: Science as a Candle in the Dark.
  • Coalson, Bob. "Nightmare help: Treatment of trauma survivors with PTSD." Psychotherapy: Theory, Research, Practice, Training 32.3 (1995): 381-388. PsycARTICLES. EBSCO. Web. 18 Mar. 2011.
  • "Dreams - Practical Dream Analysis & Waking Life Meaning." Dream Interpretation, Psychology & Research, Nightmares & Alternative Medicine. Dreams Foundation, 1996". http://www.nightmares.info/nightmares.htm. Retrieved 19 January 2011. 
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  • "Imagery Rehearsal Therapy (IRT)." The Encyclopedia of Trauma and Traumatic Stress Disorders. Ronald M. Doctor and Frank N. Shiromoto. New York: Facts on File, 2010. 148. Gale Virtual Reference Library. Web. 21 Feb. 2011.
  • Mayer, Mercer. There's a Nightmare in My Closet. [New York]: Puffin Pied Piper, 1976.
  • Moore, Bret A., and Barry Kraków. "Imagery rehearsal therapy: An emerging treatment for posttraumatic nightmares in veterans." Psychological Trauma: Theory, Research, Practice, and Policy 2.3 (2010): 232-238. PsycARTICLES. EBSCO. Web. 18 Mar. 2011.


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