Nightmares


"The treatment studied at the University of New Mexico is called "Imagery Rehearsal Therapy" and is classified as a cognitive-behavioral treatment. It does not involve the use of medications. In brief, the treatment involves helping the clients change the endings of their nightmares, while they are awake, so that the ending is no longer upsetting. The client is then instructed to rehearse the new, nonthreatening images associated with the changed dream. Imagery Rehearsal Therapy also typically involves other components designed to help clients with problems associated with nightmares, such as insomnia. For example, clients are taught basic strategies that may help them to improve the quality of their sleep, such as refraining from caffeine during the afternoon, having a consistent evening wind-down ritual, or refraining from watching TV in bed.
Some medications that have been studied for treatment of PTSD-related nightmares and may be effective in reducing nightmares include topiramate(Topamax), prazosin (Minipress), nefazodone (Serzone), trazodone(Desyrel), and gabapentin (Neurontin, Gabarone). Because medications typically have side effects, many patients choose to try a behavioral treatment first. If that does not help improve their symptoms, they may choose to try medication."
DREAMING THE DREAM ONWARD
Creative Exercises For Exploring Your Dreams
1. Dream Space: (Basic exercise that precedes all others below). Close your eyes, relax your body and imagine that you are re-entering and re-experiencing your dream complete with feelings and sensory experience. Spend from 1 to 5 minutes in the “Dream Space” before preceding to any of the other exercises below.
2. Automatic Writing: After completing the Dream Space exercise, take a pen and write all thoughts, ideas, feelings and associations. Write as fast as you can without censoring and without stopping the movement of your pen. Spend from 2 to 10 minutes or more.
3. Dialogue: Create a written dialogue, like a play script, between two characters or elements of your dream. Again keep your pen moving as fast as you can. Do not plan or censor and allow the unexpected.
4. Telling and Retelling Your Dream: Tell your dream in the present tense once or twice. Be aware of feelings, associations and body sensations. Tell your dream again from the perspective of an entirely different dream character. Note your feelings and how they change as you tell and retell your dream. Tell a dream you have written in your journal without looking and then read it out loud. Note what you have left out, embellished or change.
5. Dramatizing Parts of Your Dream: Dramatize parts of you dream playing two roles yourself or having others play one or more roles. Re-enact some of the key physical movements in the dream and note what feelings emerge.
6. Dream Drawing Technique: Have a group of people listen to a dream and all draw it as if it were there own dream. Share impressions. Draw pictures of a childhood dream or recurring nightmare. Don’t worry about being realistic. Concentrate on color and emotions in your drawings as well as characters and events.
7. Dreams and Creative Movement: Use dance, improvisational movement or other physical expression to elaborate your dream. Assume poses and positions of various dream characters and note your emotional and sensory reactions.
8. Creating a New Dream Ending: Use your imagination and continue your dream onward. Write it our or just fantasize a new ending. Take the dream in a different directions or try to bring the dream to a more resolved ending.
9. Dream Incubation and Problem Solving: Ask your dreams an important but open_ended question and sleep on it. Pose the question to yourself and form it into a mantra. Write the question or issue in your journal or put it on a slip of paper and put it under your pillow. The more you ponder the question consciously the more likely a dream will respond.
10. Sharing and Exchange Dreams: Share dreams and insights from exercises with a trusted friend, relative or your partner. Sharing dream will often stimulate more dreaming, more sharing and possibly mutual dreams.
11. Keep a Glossary of Common and Recurring Symbols in your dream journal. Note repetitive characters from the present and past, recurring locations, emotions and conflicts in your dreams. Ponder possible meanings.
12.Keep an Intensive Dream Journal For 2 Weeks During Periods of Crisis or Transition Looks for feelings, conflicts and solutions that may help you understand and resolve the emotional challenges you are facing. During a crisis, conscious feelings may be blocked or numb put unconscious, dream images reveal the stages of reactions to a crisis or transition such as recovering from grief or trauma or responding to a move or job transition.
Alan Siegel, Ph.D.
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