A major symptom of CPTSD / PTSD is nightmares. I myself have suffered from these and they have led to frequent waking during the night, sheets and pillow cases damp with sweat, thrashing around in my sleep to the extent that I have, on several occasions, knocked the lamp (and several other items, such as piles of books, the alarm clock, cups of cold, unfinished tea etc) off my bedside table with arms wildly flailing about like those of a crazed and demented windmill and, even, falling out of bed a few times. I have also woken myself up shouting and, even, screaming, more than once.
A particular torment of nightmares is, of course, that after a day spent in mental anguish in a state of wakefulness, they prevent one from escaping this mental pain even in sleep so there is no respite from one’s suffering. Indeed, when one has intense and terrible nightmares, one fears going to sleep ; for us, it is not a time of mental recuperation, but of continued psychological torture. This can be so devastating to the morale that one may fear one will go permanently and irrevocably insane.
According to the Harvard psychologist, Dr D Barrett, an expert on dreaming and dream analysis, PTSD nightmares tend to contain the following types of themes / symbols :
The Themes And Symbols Of PTSD Nightmares
– being chased
– being in danger
– being punished
– being isolated
– being powerless
– being trapped
– physical injury
Nightmares, Suppression, Repression And Dissociation :
If we have extremely painful memories relating to our traumatic childhood then we may, as a means of psychological self-protection, cut off from them mentally.
In order to achieve this we may suppress the memories (i.e. try to put them to ‘the back of our minds’). This takes conscious effort and can be counterproductive – see The Rebound Effect below).
Alternatively, we may repress the memories ; this is an automatic / unconscious process that stores the memories away so deeply in the mind that they become inaccessible to conscious awareness. Mentallly cutting ourselves off from painful memories in such a manner is known as dissociation.
Processing Of Traumatic Memories
However, because these memories are dissociated, they remain unprocessed by the brain and a leading theory as to why dreams/nightmares occur is that they represent the brain’s attempt to process the dissociated memories.
Barrett’s research has led her to the view that, immediately following traumatic events, a person’s nightmares about them tend to quite closely reflect what actually occurred. However, as the traumatic events that triggered the nightmares recede further and further into the past, the PTSD nightmares relating to them become increasingly symbolic.
What Can We Do To Alleviate Nightmares?
If our nightmares do not result in effective processing of our traumatic memories they can become ‘stuck’ ; this can lead to recurring nightmares that tend to centre upon the same themes.
To alleviate such nightmares, it is necessary to attempt to process the traumatic memories in our waking lives (assuming they have been suppressed rather than repressed – see above).
We can attempt to process the material contained within our nightmares in the following ways :
– by keeping a written record of the nightmares (e.g. by recording our recollections of them or writing these down using a pen and pencil kept by the bed etc)
– by describing our nightmares to another person (who is emotionally supportive, such as a therapist) and trying to work out what their themes and images may represent.
– going through the nightmare in our minds when awake but changing its ending to a positive one – then mentally replaying/rehearsing this new, positive ending. It is then helpful to write out what happens in the nightmare, including writing out the new, positive ending. Alternatively, we could draw a series of pictures representing the nightmare, but, again, incorporating the new, positive ending.
– by imagining, when awake, carrying out a simple action in our dream, such as taking a single step, and saying to ourselves : ‘You are completely safe, this is just a dream’. If we then mentally rehearse this before we go to sleep we may find this action, carried out in our dream, will cue the comforting and reassuring thought (the action that is to act as the cue can be anything simple that is likely to recur in the nightmare).
Nightmares And The Rebound Effect
In relation to some of what has been said above, it is useful to look at a psychological phenomenon known as the rebound effect :
If we try very hard not to think about something, this, paradoxically, frequently increases the probability that we will think about it. The classic example that is given to first year psychology undergraduates is the instruction NOT to think about a pink elephant for the next minute. Of course, this instruction is impossible to carry out (try it if you don’t believe me!).
This is known as the rebound effect and research suggests the phenomenon may apply to nightmares, too. One possible technique to reduce the probability of having a nightmare is, therefore, to actually think about whatever it is the nightmare represents (if this has been inferred from reflection / dream analysis) for a few minutes before going to sleep as trying not do so, because of the rebound effect, may actually increase the chances that the nightmare will occur, however counterintuitive this may sound.
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David Hosier BSc Hons; MSc; PGDE(FAHE).