“I have had dreams and I have had nightmares, but I have conquered my nightmares because of my dreams.” Jonas Salk

Nightmares can be extremely unpleasant, causing fear and anxiety and affecting quality of your sleep. This can lead to physical tiredness and mental stress. However, it’s important to understand the cause of your nightmares before you can begin to treat them. Start with Step 1 below to understand the source of your nightmares and take steps to to prevent them from recurring…—-and-how-to-stop-them

And interestingly, he argues that nightmares are as bad as they are in order to help us cope with more realistic adversity.

Evolutionary psychology aside, the most proximate cause of nightmares is not known. Neuroscientists still need to develop a more sophisticated model of consciousness and the dream-state to make this sort of determination. What they do know, however, is that high frequency nightmares tend to run in the family, which could indicate a possible genetic link…

And indeed, it is well established that people suffering from the effects of post traumatic stress disorder (PTSD) and mild head injuries have more nightmares than average. In fact, the heightened frequency of nightmares in these individuals can result in a chronic condition…

One technique that’s increasingly being used is “imagery rehearsal treatment” where individuals are encouraged to alter the endings of their nightmares while they’re awake. It’s a form of cognitive therapy in which people can create an alternative, less distressing outcome to their dreams. Follow-up studies have shown that these kinds of therapies are effective, with upwards of 70% of people claiming to have experienced benefits (including people with PTSD and insomnia).

Similarly, chronic bad dreamers are told to write down the details of their nightmare, or to draw or paint them. They’re also encouraged to talk in fantasy to the characters of their dreams. And in all cases, they are told to imagine a more pleasant ending…

Selby and his collaborators believed that this association could be explained by what they called the Emotional Cascade Model. In this model, negative emotional experiences during the day can contribute to nightmares made worse by two processes. First is rumination, or going over things again and again in your mind. Rumination keeps the pain of those negative experiences fresh.

The second process is catastrophizing, in which you imagine the worst possible outcome from a negative experience. As you do, the magnitude of the experience skyrockets beyond its original negative impact…

Scientists wanted to find out the reason why people with PTSD can’t sleep and dream normally. One theory comes from Matthew Walker, a psychology researcher at the University of California, Berkeley. His particular interest lies in rapid eye movement, or REM. It’s the time during sleep when a lot of dreaming occurs.

It’s also a time when the chemistry of the brain actually changes. Levels of norepinephrine — a kind of adrenaline — drop out completely. REM sleep is the only time of day when this happens. That struck Walker as a mystery. “Why would rapid eye movement sleep suppress this neurochemical?” he asks. “Is there any function to that?”

Walker’s theory suggests that in people with PTSD, REM sleep is broken. The adrenaline doesn’t go away like it’s supposed to. The brain can’t process tough memories, so it just cycles through them, again and again…

They argue that PTSD develops when the person believes they are still seriously threatened by the trauma they have experienced. Why should someone assume they are still endangered by an event that happened months or even years previously? Ehlers and Clark identify two factors.

First is a negative interpretation of the trauma and the normal feelings that follow, for example believing that “nowhere is safe”, “I attract disaster”, or “I can’t cope with stress”. These interpretations can make the person feel in danger physically (the world seems unsafe), or psychologically (their self-confidence and sense of well-being feel irreparably damaged).

Second are problems with the memory of the trauma. Partly because of the way the person experiences the event, the memory somehow fails to acquire a properly developed context and meaning. As a result, it constantly intrudes. Ehlers and Clark liken the traumatic memory to “a cupboard in which many things have been thrown in quickly and in a disorganised fashion, so it is impossible to fully close the door and things fall out at unpredictable times”.

PTSD can be treated with antidepressants or various kinds of psychotherapy, including prolonged exposure therapy and eye movement desensitisation and reprocessing. However, a recent meta-analysis of 112 studies conducted over the past 30 years found that cognitive behavioural therapy (CBT) was the single most successful type of treatment…

Most importantly, the benefits lasted: 40 weeks after entering the study, about two-thirds of the CBT patients were still free from the symptoms of PTSD. The therapy isn’t easy – it confronts highly distressing events and feelings, after all – but it works.

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