When Trauma Follows You into Your Nightmares

July 8th, 2014   |  

They are frightening, disturbing, inconvenient, and happen when you are supposed to be rejuvenating your body and brain: the nightmares that follow a traumatic experience.

Nightmares are quite common among people who have experienced a traumatic event. The aftereffects of a nightmare often follow them into the next day, which can affect their emotional well-being and ability to function. Nightmares can be quite scary and negatively impact the amount of restful sleep a person is getting. They can feel like one is re-experiencing the traumatic event, and the thought of going to sleep can become anxiety-provoking. The less sleep a person gets, the more difficult it is for the brain to process a traumatic event and file it away correctly. Sometimes the symptoms that are present due to trauma are the very barriers that get in the way of a person’s ability to heal.

The Function of Dreams

According to Hartmann (1996), one theory regarding the function of dreaming is that it allows the brain to make connections more efficiently and effectively than the conscious mind. In other words, it is the time when the brain reviews information that has been observed and then sorts and organizes it in a way that makes sense.

Hartmann (1998) also states that dreaming is a way for the brain to work through trauma, and the dreams are often based on the main emotion the person experienced during the trauma or experiences when they recall the trauma. This is important to the healing process but, as discussed above, can be problematic when the person’s nightmares interfere with their sleep and their ability to function day-to-day. According to Leskin et al. (2002), people who had a diagnosis of posttraumatic stress had a significantly higher rate of sleep problems. They state that 96% of participants in their study who were diagnosed with PTSD experienced nightmares and 100% experienced insomnia.

So what can a person do to work through unwanted trauma nightmares?

1. Keep track of your dreams and nightmares and discuss them with your therapist. Dreams can contain information that is significant in therapy work. I often encourage people in therapy to write down the basic themes of their dreams and nightmares so we can investigate their significance to the trauma treatment work we are doing. I often find that the information gathered from dreams is directly related to the themes that are increasing or continuing the disturbance related to trauma (for example, a sense of helplessness).
2. Develop coping and self-soothing skills. Practice self-soothing and anxiety-reduction techniques before sleep and/or if you wake up from a nightmare. Continue self-soothing throughout the day as needed to deal with the aftereffects of a nightmare. Some of the tools people in therapy have found most useful include guided meditations, body scans, progressive muscle relaxation, and mindfulness exercises. Another tool that many find particularly useful is called “container.” Essentially, the person experiencing the disturbance creates a container (real or imagined) wherein they can keep the things that bother them most (thoughts about the event, flashbacks, or even the nightmares or other disturbing material) until a time when he or she able to sort through the material with his or her therapist. When the disturbing material comes up, the person can allow whatever it is to go into container until therapy, where we can decide what should be addressed. Some containers that are common are safes, boxes, vaults, and jars. The container should have a lid or door of some type. A person can imagine this container in the form of a picture in the mind and imagine the disturbing material going into the container. Alternately, the person can have a physical container and write down the disturbing material on a piece of paper and then place it in the container.
3. Don’t stay in bed if you can’t sleep. Often, when awakened from a nightmare, going back to sleep may be difficult. Also, the act of initially going to sleep may be anxiety-provoking for fear that the nightmares or other symptoms the person may be experiencing will return. If you are not able to go to sleep in a reasonable amount of time, get up and do something self-soothing. It may take time before sleep comes, but it is better to engage in self-soothing exercises than to get yourself worked up and more anxious because sleep won’t come.
4. Make changes to your sleep environment to avoid associating anxiety with the place you sleep. When a person has repeated nightmares, the sleep environment may become a trigger for anxiety and other trauma symptoms. Making changes to the sleep environment, such as moving furniture around, getting new bedding, or changing the decor, may be helpful in starting with a clean slate when it comes to sleep.
5. Remind yourself that your brain is trying to heal. Healing is not always a comfortable process and it takes time. As uncomfortable as nightmares are, your brain is giving you the information it needs you to work through. Nightmares can bring to light issues that you may have been unaware of during your awake time. Work with a therapist so you do not feel alone in this process. A therapist can normalize what you are going through and can help you to process your symptoms in a way that may make them less overwhelming.

References:

1. Hartmann, E. (1996). Outline for a theory on the nature and functions of dreaming. Dreaming, 6(2), pp 147-170.
2. Hartmann, E. (1998). Nightmare after trauma as a paradigm for all dreams: A new approach to the nature and functions of dreaming. Psychiatry: Interpersonal and Biological Processes, 61(3), pp223-238.
3. Leskin, G.A., Woodward, S.H., Young, H.E., and Sheikh, J.I. (2002). Effects of comorbid diagnoses on sleep disturbance in PTSD. Journal of Psychiatric Research, 36(6), pp 449-452.