Working through Reoccurring Nightmares

Written By Natasha Saini, MCPRP

Last week I talked about how traumas can leave us with reoccurring dreams/nightmares and why individuals who have PTSD or trauma symptoms are particularly prone to struggling with nightmares. This week we’ll get into some techniques and strategies that can help decrease or stop the reoccurrence of the nightmares.

An important thing to note if you do have a diagnosis of PTSD or if you’re struggling with trauma that you may need the support of a mental health professional as you work through these strategies. Trauma is complicated and the pain we experience from trauma is very real. Trying to address this pain alone can be overwhelming and in some cases may exacerbate the existing trauma. A therapist can help you slow things down and work through the trauma and trauma symptoms in manageable chunks within your window of tolerance. I also recognize that not everyone is able to afford or has access to therapy, and in those cases learning about the window of tolerance and trauma can help you as you work through some of the techniques. It is important to know when you need to reach out for support, and to communicate with your support people so they also know to check in with you as well. At the end of this post, there are resources for crisis/support lines that you can access if you find yourself feeling overwhelmed.

One of the ways to work through reoccurring nightmares is called the “The Imagery Rehearsal Technique” or IRT. This is a CBT technique developed to help people reprocess traumas and dreams. It’s a well-studied technique and research has shown that individual with moderate to severe PTSD who use this technique experience a reduction in their nightmares and PTSD symptoms.

IRT is a way to retrain your brain to work through the nightmare. What you do is you take the dream or the memory and your write it down and your rewrite it and change something about it. You can change the theme, the ending, the storyline, or any part of the dream to make it more positive. This helps you retrain your brain on how to handle the stressful dream. If thinking about your nightmare is overwhelming you can work with someone (like a therapist or trusted family member or friend). I recommend starting first with a nightmare or a bad dream that is not connected to the trauma and slowly building up from there.

Imagery Rehearsal Technique:

Before you start the IRT first do something to ground yourself into the moment and relax your body. You can do a mindfulness exercise, a breathing exercise, or progressive muscle relaxation. Whatever helps calms your mind and body and connects you the present moment.  

1.       Choose a nightmare and write out the script. Go into detail about what you’re feeling in your body, your thoughts, and your emotions.  You want to be as detailed as possible, and because of that this part of the exercise can be particularly triggering. Don’t rush through it, and if you need to stop and ground yourself that’s okay. If you’re working with a therapist, they will help you to stay within your window of tolerance as you are working on writing your script.  

2.       Rewrite the nightmare with a different outcome, this different outcome can prevent the bad thing from happening or it can present a solution after the bad thing happened. The resolution does not have to be moral or realistic. Dreams are not reality and your solution can break the laws of physics, it can be pure fantasy, it can be silly, it can be serious, whatever you decide you want it to be. Feel free to experiment and try different scenarios. Again it is best to go into a lot of detail into the new ending that has a resolution

Now that you have written all this down you are going to practice rehearsing this new dream throughout the day. Read it out loud, listen to a playback of yourself reading it, go through it multiple times in the day. Remember to practice grounding and relaxation as you read through the script.  IRT is a strategy that gives us some feeling of control over our dreams and also gets us to face the difficult thoughts and feelings during the day so we are not avoiding them only to be confronted with them at night. Our body and brain is retraining how it reacts to the dream and allows you to complete the nightmare so you’re not jolted awake or feel helpless at the lack of a resolution at the end of the dream.

IRT may take some time to take effect and if you’re still being woken up by your nightmares in a state of anxiety and fear it can help to have sensory objects nearby to help you ground and get back in to the window of tolerance. Having essential oils on your bedside table, a soft teddy bear, really whatever works to bring your back to the present moment and remind you that you are safe.

It can also help to shift your perspective about the nightmare and to remind yourself that you are safe. After experiencing reoccurring nightmares, we may start to feel afraid of going to sleep and avoid bedtime because it feels like we can’t handle the painful feelings. You can remind yourself that even though you had the nightmare that you are safe and while it is uncomfortable it is not dangerous.

The harder we try to distract from our feelings and avoid them, the worse the nightmares can get but if we are able to find ways to turn toward those difficult emotions, develop ways to cope and face them, we can process them and they do not have the same control over us as they had in the past.

Resources:

Natasha Saini, MCPRP
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Nightmares and Trauma