Author: Dr. Leslie Ellis

Dr. Leslie Ellis is a leading expert in the use of somatic approaches in psychotherapy, in particular for working with dreams, nightmares and the effects of trauma. She is the author of A Clinician’s Guide to Dream Therapy (Routledge, 2019) and offers many training opportunities in embodied, experiential dreamwork based on her book. She has a PhD in Clinical Psychology from the Chicago School of Professional Psychology, with a specialization in somatic approaches. Her dissertation on using focusing-oriented therapy to treat PTSD for refugees with recurrent nightmares won the Ernest Hartmann award from the International Association for the Study of Dreams. Dr. Ellis has a Masters from Pacific Graduate Institute and worked as a therapist in private practice in Vancouver, BC for more than 20 years. Her approach to therapy combines Jungian and focusing-oriented techniques. She was adjunct faculty at Adler University where she taught clinical skills and developed a trauma course for the Masters of Counselling program. She is a Certifying Coordinator and past president of The International Focusing Institute. For many years she has offered a Vancouver-based certification program for practicing therapists who want to incorporate focusing-oriented therapy techniques into their practice. Dr. Ellis has published numerous book chapters and journal articles on the use of focusing and dreamwork in psychotherapy. She has also presented her work to a worldwide audience. For example, she offered a keynote address for the 2020 online conference for the International Association for the Study of Dreams, has presented on nightmare treatment at MIT and was a featured speaker and panelist at the 2020 FOT (Focusing-Oriented Therapy) Conference. She also offers courses through The Jung Platform and is vice president of the International Association for the Study of Dreams.
Posted in
Posted in

Influencing Dream Content and Creativity

By 0 on Influencing Dream Content and Creativity

Fascinating new research that confirms what creative minds like Salvador Dalí and Thomas Edison intuited long ago – the drowsy period as we drift off to sleep can supercharge our creative abilities. Researchers from MIT and Harvard (Horowitz et al., 2020, 2023) demonstrated that deliberately influencing dreams during sleep onset (known as N1 sleep or hypnagogia) can significantly boost creative thinking.

Using a sensor-laden glove called Dormio, that detects when people enter this generative sleep stage, the team conducted an targeted dream incubation (TDI) experiment in which they prompted participants think about trees as they dozed off. The results were remarkable. People who had tree-related dreams during sleep onset performed far better on subsequent creativity tests compared to those who stayed awake or slept without the tree suggestion. Even more intriguingly, the more that participants incorporated trees into their drowsy dreams, the more creative their later responses became.

In the hypnagogic state, our usual mental boundaries become more permeable and fluid, allowing novel ideas and strange combinations of thoughts to emerge. The research has shown that our minds naturally make broader, more distant connections between concepts during sleep onset. What is significant about this study is that it’s the first to demonstrate a direct causal link between specific dream content and enhanced creativity. Previous research has demonstrated that sleep boosts creative problem-solving, but this study shows that we can actually guide our dreams to offer creative new ideas and solutions in specific areas of inquiry.

The implications are exciting. The study shows what many of us dream afficionados already understand – that it’s possible to harness your sleep onset period to enhance creative thinking around specific questions. While more research is needed to fully understand how long these effects last and how they might apply to different types of problems, this study lends credence to the idea that ‘sleeping on it’ really does help us find solutions not available to our waking minds.

For those interested in experimenting with this yourself, the key period is that drowsy state just as you’re falling asleep. While you may not have access to the Dormio device, simply holding a specific problem or theme in mind as you drift off could spark creative insights. Dormio detects alterations in sleep states and offers timely prompts to capture a whole series of pre-sleep dream images. It then records verbal N1 dream reports immediately. If we wait until morning to write our liminal reams down, most of these early images will be forgotten. So taking a cue from this research, try using a smartphone to record verbal dream reports as soon as you are awake enough to become aware of them. You may find you record many dreams throughout the night, not only in sleep onset, and develop a fuller picture of your creative dreaming mind.

Dali and Edison were known to deliberately harness the dreams from sleep onset by napping in a chair with an object in their hands that would clatter to the floor as soon as the muscle relaxation in early sleep released the object. The noise would wake them up and they would then record dreams that became fodder for inventions for Edison and surreal images for Dali.

The next frontier in creativity research may well be in understanding how to better utilize these unique states of consciousness that we all experience every night. As this study shows, our dreams might hold more practical value than we ever imagined.

What are your experiences with creative insights during sleep onset? I’d love to hear about them in the comments below.

The paper describes Dormio, a novel device designed to study and influence dream content during the hypnagogic period (sleep onset). The device uses sensors to detect when users are falling asleep and delivers targeted audio prompts to influence dream content, a process called targeted dream incubation (TDI).

The researchers conducted a study with 49 participants divided into sleep and wake conditions, with and without prompting to think about “trees.” The Dormio device monitored heart rate, finger muscle tension, and electrodermal activity to detect sleep onset. When sleep was detected, the device would wake participants and ask them to report their mental experiences before providing new prompts.

Key findings:

  • 67% of prompted sleep condition reports contained references to trees
  • Only 3% of unprompted sleep condition reports mentioned trees
  • 52% of prompted wake condition reports mentioned trees
  • 0% of unprompted wake condition reports mentioned trees

The device successfully demonstrated its ability to influence dream content during sleep onset. Dream reports showed increasing bizarreness and immersion with subsequent awakenings, while maintaining the targeted theme.

The research builds on previous studies showing that dream content can predict post-sleep memory enhancement and that sensory input during sleep can influence memory consolidation. While other techniques like Targeted Memory Reactivation (TMR) have shown that presenting sensory cues during sleep can enhance memory consolidation, Dormio provides a way to study the subjective experience of memory processing during sleep.

The researchers suggest several potential applications for Dormio and TDI:

  • Studying the causal relationship between dream content and memory consolidation
  • Enhancing creativity through directed dream experiences
  • Understanding the role of dreams in processing daily experiences
  • Investigating memory formation and integration during sleep

Limitations of the study include:

  • Limited age range of participants
  • Lack of polysomnographic validation of sleep stages
  • Reliance on subjective dream reports
  • Use of only one incubation theme (“tree”)

The researchers emphasize that while they can demonstrate correlation between dream incorporation and memory processing, they cannot yet prove whether dreaming itself causes memory consolidation or is simply a reflection of underlying processes.

The Dormio device represents a new tool for studying dreams and consciousness that is more accessible than traditional sleep lab equipment. It enables controlled manipulation of dream content, which could help answer fundamental questions about the role of dreams in memory, creativity, and cognitive processing.

The authors propose future studies using Dormio to investigate whether deliberately inducing specific dream content can enhance learning and memory consolidation, potentially opening new avenues for cognitive enhancement through dream engineering.

 

Horowitz, A. H., Cunningham, T. J., Maes, P., & Stickgold, R. (2020). Dormio: A targeted dream incubation device. Consciousness and cognition, 83, 102938.

Horowitz, A. H., Esfahany, K., Gálvez, T. V., Maes, P., & Stickgold, R. (2023). Targeted dream incubation at sleep onset increases post-sleep creative performance. Scientific reports, 13(1), 7319.

Posted in
Posted in

Do Dreams Predict the Future?

By

I was recently asked this question by Women’s Health magazine, and it led to some interesting further reading and provocative thoughts.

An amazing half of people asked will say they had a precognitive dream at some point in their lives. Does this mean dreams can predict the future? So far, there is no scientific evidence to back this statement up – and it may be impossible to actually run such an experiment. However, there are many possible explanations which point to the nature of dreaming itself.

What researchers have found is that most precognitive dreams are retrospective, meaning we recognize them as prescient after the fact. When you do the opposite – track dreams and then see if what we dream about actually comes to pass, the instances of precognition drop dramatically. However, there are still many astounding stories of dreams predicting events that actually happen.

I was once on a radio show, and a caller told me a story about a lifelong recurrent dream: they were rounding a curve in the highway and suddenly, there was a huge slide ahead that had washed out the road. He said one day, he found himself on this familiar stretch of road, and instinctively braked before the turn. The road indeed was washed away, and he credits the dream for saving his life.

Here is a quick survey of possible explanations:

  • Dreams are future-oriented simulations that depict likely scenarios; some of them may be accurate.
  • Our bodies and our subconscious are adept at picking up subtle early cues about things that matter to us such as our health and relationships.
  • Statistically speaking, given the sheer number of dreams, it is impossible not to have precognitive dreams. (For more on this, see Matt Walker’s podcast: https://podcasts.apple.com/us/podcast/76-precognitive-dreaming/id1578319619?i=1000659367737)
  • Dreams are our connection to the wider world of psyche and operate outside the bounds of rationality and linear time.

Notice that all of these could be true, although the last item asks us to step outside of the rational, evidence-based perspective that dominates our culture.  This bias toward what is visible and measurable has demoted dreams to the sidelines (even in psychology), and yet there remains a yearning to connect with their wider wisdom. So many people I encounter wish for a deeper connection to their dreaming lives and a way to make sense of them.  I suspect this us why I am often asked questions that point to the mysterious nature of dreaming. I typically search for the answers from both within the realm of science and also from those who relate to dreams as sacred, and not bounded by what can be seen and measured.

As luck would have it, as I was writing this short post, I picked up a new book, The Dreaming Way by Toko-pa Turner. In it, she eloquently offers her perspective on the purpose of dreaming: as a bridge between physical and sacred realities, a bridge that she says has “fallen into disrepair.” When dreams are viewed as sacred communication from the imaginal realm, they are taken seriously, as pointing to one’s deeper life purpose, and potentially as prophetic. Ancient texts from many cultures (including Greek philosophy, the Bible, the Upanishads) feature accounts of important, prophetic dreams.

The biggest problem with precognitive dreams is that you don’t know they are actually predicting something until after the fact. Still, because of the ability of our subconscious mind to pick up early warning signs, I suggest acting on any dreams that seem insistent, especially if they are pointing to potentially serious issues with your health or emotional life. Many people have credited such dreams with saving their life by pointing to a malignant cancer or other serious illness.

With other dreams that seem like warnings, it’s hard to know how to respond. A friend who was about to go on a road trip dreamt of not one, but several massive car crashes. She asked if this meant she should postpone her trip (she did). However, the dream could have been a metaphor for other things: at a personal level, a loss of control, or relational conflict. At the collective level, a portent of danger or disaster?

In general, I advocate for all of us to develop a deeper relationship with our dreaming worlds. When we have a sense of the ongoing trajectory of our dreaming lives, what they are telling us or asking of us can become much clearer. Whether you adopt the rational or sacred view of dreams, or bridge them both, viewing dreams as depictions of a possible future is a valid approach that invites reflection and possible course correction.

Posted in
Posted in

Psychedelic Medicine and Dreams: A conversation with Katherine Lawson

By

The use of psychedelic substances as therapeutic agents is a trend with great promise, and a work in progress. There is an exciting but nascent body of research on efficacy and best practices, and there remains many legal and ethical obstacles.  In the meantime, the use of plant medicines is growing like a weed – quickly, organically and not always in the most desirable way.

“It’s the wild West,” says Dr. Katherine Lawson, a pioneer in using embodied dreamwork practices to facilitate integration of psychedelic experiences. She notes that since people are using plant medicines anyway, and have been for ages, there is a need to help facilitators offer safe, constructive and respectful ways to help clients prepare for and integrate their experiences. This is why she founded Awake in the Dream School.

 

Psychedelic Therapies Show Promise

Anecdotally, Lawson has witnessed dramatic changes in her clients as a result of the use of plant medicine, and in a much shorter time frame than is typical with more traditional talk therapy. “One of the main reasons for that, is that while you are under the influence of the medicine (in this example, MDMA), you do not have much access to shame, fear and guilt. And if you are a skilled facilitator, you can help your client go back and heal things that are not approachable in normal waking consciousness, with all the layers of protective mechanisms. Those are gone. Your clients can see things so differently — from a loving, empathic perspective. That’s the gift of these medicines.”

Research backs this up and is demonstrating the efficacy of these substances in addressing conditions like depression, anxiety, PTSD, and addiction (Carhart-Harris & Goodwin, 2017; Mithoefer et al., 2018; Palhano-Fontes et al., 2019). The proposed mechanisms of action for psychedelics in therapeutic settings include their ability to reduce negative cognitive biases, enhance emotional processing, and promote neuroplasticity (Rucker et al., 2018).

Studies have shown that a single dose of psilocybin can produce rapid and sustained reductions in depressive and anxiety symptoms in patients with life-threatening cancer (Griffiths et al., 2016). MDMA-assisted psychotherapy has demonstrated promising results in the treatment of PTSD, with participants experiencing significant and lasting improvements in symptoms (Mithoefer et al., 2018). Psychedelics may also facilitate mystical-type experiences that can lead to profound personal insights and shifts in worldview, which some researchers believe can catalyze lasting positive changes in attitudes, mood, and behavior (Carhart-Harris & Goodwin, 2017).

The research on psychedelics is still in its early stages, and more large-scale, rigorous clinical trials are needed to establish their efficacy and safety profiles. The specialized nature of psychedelic-assisted therapy, which often involves extensive preparation, guidance during the experience, and integration support, can also limit accessibility and scalability.

 

Education Needed

Lawson has been working with users of plant medicine for a decade, and has learned much about the incredible potential for transformation these substances can bring about. But there is also much of concern in practices stemming from lack of knowledge, desire for a quick fix, and in the worst cases, dangerous and unethical practices. She established her school to educate mental health professionals who want to help those taking psychedelic substances to prepare for the journey and integrate the experiences afterwards. She said without these crucial pre- and post-journey steps, the experience can be no different from taking a drug trip – amazing, terrifying or anything in between.

She does not work with any of the substances directly, nor does she teach about how to administer the medicine and support the actual experiences (‘trip-sitting’). This is because so many of the substances are illegal. And yet there is a grey area, because they are also widely accessible. “The National Institute of Health (NIH) estimates 50 million Americans have interacted with these medicines since 2021, and that figure is probably very low,” according to Lawson.

 

Adapting Dreamwork for Integration

As someone who teaches embodied experiential dreamwork to therapists, I was particularly intrigued by how Dr. Lawson has adapted dreamwork techniques to support the integration of plant medicine journeys. She was one of the early providers of integration sessions via MAPS, the Multidisciplinary Association for Psychedelic Studies.

Over the past decade, Dr. Lawson has worked with hundreds of individuals navigating psychedelic experiences and has used her depth of experience to develop a training program to equip practitioners with the skills to support this process. A key distinction in her approach is the emphasis on preparation and integration, rather than facilitating the psychedelic journeys themselves. Her training, for those in the mental health and wellness industries, educates facilitators on 8 different medicines – learning what to expect and how to support clients through the experience. Lawson, said the specific substance and the nature of its use can vary so widely – from deep ceremonial practice to recreational highs. Most often, therapeutic plant medicine experiences are offered in facilitated group or one-on-one guided sessions.

The core post-session integration practice Lawson teaches is based on Embodied Imagination as developed by Dutch psychoanalyst Robert Bosnak. She has found that working with psychedelic visions requires some adaptation. “There’s an intensity to it, there’s a possession by it that’s got a different quality than a dream,” she explained. “If you guide someone back into their dream in a hypnagogic state, they always have a certain awareness of being in a dual state of consciousness. But with a psychedelic experience, for a while, they’re just in it — you can still guide them, but you might have to be more assertive, more directive.”

Another key difference, according to Dr. Lawson, is the need to be particularly mindful of scope of practice and ethical boundaries when working with clients who have had intense psychedelic experiences. “There’s a lot of people out there abusing the power imbalance that’s implicit in serving these medicines,” she said. “So we really lean into things like being trauma-informed and understanding contraindications.” Acute adverse effects can include anxiety, panic, and psychotic episodes, particularly in individuals with a history of mental health conditions (Carbonaro et al., 2016).

Overall, Dr. Lawson’s approach seems to strike an important balance — honoring the profound potential of psychedelics for healing and transformation, while also recognizing the need for skilled, ethical, and trauma-informed support. As someone who has seen the benefits of dreamwork in clinical practice, I’m intrigued by the possibilities of integrating these modalities to help clients navigate their most profound experiences.

To learn more about Awake in the Dream School and Dr. Lawson’s work, check out awakeinthedream.co  For those on my email list, Lawson has generously offered a 10% discount on her 6-month certification program if you use this code upon checkout: AWAKE-Drleslieellis

 

References

Carbonaro, T. M., Bradstreet, M. P., Barrett, F. S., MacLean, K. A., Jesse, R., Johnson, M. W., & Griffiths, R. R. (2016). Survey study of challenging experiences after ingesting psilocybin mushrooms: Emphasis on context and impairment. Journal of Psychopharmacology, 30(12), 1268-1278. https://doi.org/10.1177/0269881116662634

Garasic, M. D., & Lavazza, A. (2021). Moral and social reasons to access psychedelic-assisted psychotherapy. BMC Medical Ethics, 22(1), 1-11. https://doi.org/10.1186/s12910-021-00588-x

Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., … & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), 1181-1197. https://doi.org/10.1177/0269881116675513

Mithoefer, M. C., Feduccia, A. A., Jerome, L., Mithoefer, A., Wagner, M., Walsh, Z., … & Doblin, R. (2018). MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology, 235(11), 3137-3144. https://doi.org/10.1007/s00213-018-4988-2

Palhano-Fontes, F., Barreto, D., Onias, H., Andrade, K. C., Novaes, M. M., Pessoa, J. A., … & Araújo, D. B. (2019). Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial. Psychological Medicine, 49(4), 655-663. https://doi.org/10.1017/S0033291718001356

Rucker, J. J., Iliff, J., & Nutt, D. J. (2018). Psychiatry & the psychedelic drugs. Past, present & future. Neuropharmacology, 142, 200-218. https://doi.org/10.1016/j.neuropharm.2017.12.040

Posted in
Posted in

Become An Exquisite Listening Partner with Focusing

By

Are you interested in deepening your ability to listen in a way that enables another person to touch into their body’s wisdom? Whether you are a mental health professional, partner, coach, parent, friend (or all of these!), focusing is a gift you can bring to every relationship – including your connection with your own self.

In this live, 8-week course, you will learn and practice focusing with master teacher Dr. Leslie Ellis. Join before Sept. 15 for a significant discount for the Proficiency in Focusing Partnership award program (aka How to Become an Exquisite Listener).

For those not familiar with Focusing, it is an amazing method for discovering what the body knows about your life and world.  It’s a profound yet gentle way of getting a sense of yourself from the inside.

Focusing is not designed to do alone – it is inherently a relational listening process – and in this course you will not only learn focusing, but also how to listen in a focusing-oriented way. That is, you will learn to attune in a way that naturally deepens your listening partner’s relationship with their inner world.

In my first course for the Jung Platform, I offered the basics of focusing as a way of Accessing the Body’s Wisdom, mainly as a form of self-inquiry. This course takes you a step further so you can both listen to your own embodied wisdom and guide a partner in this process.

Focusing founder Eugene Gendlin said that the intangible magic of human connection is what makes focusing so effective at moving us toward new understandings. When we, as a listener, absorb and reflect back what the focuser is saying, our receptive presence adds more to the equation. This is felt by the person focusing, and allows them to say something further, to take a step they may not have arrived at on their own. There is a beautiful rhythm that is created, a conversation that is greater than the sum of its parts.

In this live course, we will meet for eight experiential sessions. In each, I will teach you an aspect of focusing, and will demonstrate it. Then you will have the chance to practice in small groups, one skill at a time.

You will learn how to deepen your listening partner’s experience of their own depths, but in a way that is safe and guided by the focuser. I will offer suggestions to help keep the process moving, but also manageable. For example, in one session, we will work with the inner critic, that derogatory voice that often pipes up when we first turn our attention inside.

We will also have fun with creative aspects of focusing, and there will be lots of time for debriefing your practice and for your questions, reflections and sharing of the magical moments that often arise in focusing.

Prior courses or experience are not required, although I do recommend that you read Gendlin’s little book Focusing as an introduction.

For those who want to, you can use this course as a stepping stone toward a deeper practice of focusing. When you complete the course and practice sessions, you will be eligible to apply to the International Focusing Institute for the Proficiency in Focusing Partnership Award. This award demonstrates your ability to listen in a focusing way, and enables you to connect with other focusing partners from around the world.

The PFP award is optional. And regardless of whether you choose to pursue it, you will leave this course with a deeper connection to your own body’s wisdom, and a reliable way to access it. And you will have the ability to guide others in this process so you can continue focusing as a practice well beyond the duration of the course.

Focusing pairs well with dreamwork, can help you as a therapist, coach or teacher to help your client or students find their own answers. It can be used to deepen creativity and connection.

The course is available at an early bird price of $295 until Sept. 15. Regular price is $345. Classes are 8 Tuesdays starting Oct. 8, 10:30am to 12:45. (90 minutes of class time, plus 45-minute focusing practice sessions).

For full details and to register, click here.

Posted in
Posted in

Are Nightmares Bad for Your Heart?

By

John’s nightmares visit often, and when they wake him up, he can feel his heart racing and his palms sweating. He has been putting off therapy to address the trauma he knows is fueling his nightmares because it’s just so hard face it. What he doesn’t realize is that this avoidance not only disrupts his peace of mind, but also puts him at higher risk for a heart attack or stroke.

It’s well-known that nightmares can disrupt sleep and affect daytime mood, and that they are associated with a wide range of mental health diagnoses, including post-traumatic stress and increased risk of suicide. What is more recently becoming clear is that nightmares are bad for physical health as well — specifically an increased risk of cardiovascular disease. While I have long been advocating for increased awareness and treatment of nightmares, heart health is yet another reason to pay attention to nightmares. This post summarizes some of the key findings on the intricate relationship between cardiovascular health and nightmares from the past five years.

Nightmares and Increased Cardiovascular Risk

Several studies have shown that frequent nightmares are associated with an increased risk of cardiovascular problems. For instance Nadorff and colleagues (2020) found that those who experience persistent nightmares have a higher likelihood of developing cardiovascular disease. This study involved a large cohort of over 3,000 participants and utilized self-reported questionnaires to assess the frequency and intensity of nightmares, as well as the incidence of cardiovascular events. The key finding was that those with frequent nightmares had a significantly higher risk of experiencing cardiovascular events, such as heart attacks and strokes. The study suggests that the stress and anxiety associated with nightmares can lead to increased sympathetic nervous system activity, which, in turn, negatively affects heart health.

Heart Rate Variability (HRV) and Nightmares

HRV, a measure of autonomic nervous system function and cardiac health, has been a focal point in understanding the link between nightmares and cardiovascular health. A study by de Zambotti et al. (2021) included 200 participants and indicated that lower HRV is often observed in individuals with frequent nightmares. Participants underwent polysomnographic sleep studies along with HRV monitoring. The researchers found that decreased HRV, reflecting reduced parasympathetic activity and increased sympathetic dominance, is associated with poor sleep quality and higher nightmare frequency. This imbalance in autonomic function is a potential pathway through which nightmares contribute to cardiac stress and disease.

Nightmares, Sleep Apnea, and Cardiac Stress

Sleep apnea, a condition often co-occurring with nightmares, has also been linked to increased cardiac stress. A study by Basta et al. (2021) involved 150 patients diagnosed with obstructive sleep apnea (OSA) and examined the presence of frequent nightmares. The research utilized polysomnography to monitor sleep and assessed cardiac stress markers such as blood pressure and heart rate. The study showed that patients with both OSA and frequent nightmares exhibited significantly higher levels of cardiac stress markers compared to those without nightmares. The researchers suggest that the intermittent hypoxia and fragmented sleep characteristic of OSA, compounded by the psychological stress of nightmares, can exacerbate cardiovascular strain.

Psychological Stress, Nightmares, and Heart Health

Psychological factors play a crucial role in the relationship between nightmares and heart health. An analysis by Li et al. (2022) reviewed the interplay between psychological stress, nightmare frequency, and cardiovascular outcomes. This review included data from multiple studies, covering a combined participant pool of over 5,000 individuals. The review concluded that the chronic stress response induced by frequent nightmares can lead to hypertension and other cardiovascular issues. The persistent arousal and anxiety from nightmares activate the hypothalamic-pituitary-adrenal (HPA) axis, leading to prolonged cardiovascular strain. These findings were derived from a meta-analysis that consolidated results from various studies, providing a robust understanding of the link between psychological stress from nightmares and cardiovascular health.

Prospective Studies and Longitudinal Data

Longitudinal studies have provided further evidence of the impact of nightmares on long-term cardiac health. A notable study by Ohayon et al. (2021) followed a cohort of 4,500 individuals over ten years. Participants were regularly assessed for nightmare frequency, sleep quality, and cardiovascular health through clinical examinations and self-reported surveys. The study found that those with chronic nightmares had a significantly higher incidence of cardiac events, including heart attacks and strokes, compared to those without frequent nightmares. This study emphasizes the potential long-term cardiovascular risks associated with untreated sleep disturbances like nightmares.

Taken together, these recent studies underscore a significant link between nightmares and cardiac health, strongly supporting the notion that frequent nightmares can be a risk factor for heart disease. This relationship is mediated by mechanisms that include increased sympathetic nervous system activity, reduced HRV, and heightened psychological stress. Beyond the well-understood need to reduce stress to promote heart health, directly addressing nightmares using established dream therapy methods has the potential to mitigate some of these risks.

References

Basta, M., Lin, H. M., Peppard, P. E., & Young, T. (2021). Cardiovascular disease prevalence in patients with obstructive sleep apnea and frequent nightmares. Journal of Clinical Sleep Medicine, 17(1), 17-23. https://doi.org/10.5664/jcsm.8616

de Zambotti, M., Goldstone, A., Colrain, I. M., & Baker, F. C. (2021). Cardiac autonomic regulation during sleep and the relation with nightmares in women with PTSD. Psychosomatic Medicine, 83(3), 299-306. https://doi.org/10.1097/PSY.0000000000000895

Li, S. X., Lam, S. P., Yu, M. W., & Wing, Y. K. (2022). Nightmares and cardiovascular health: A review of recent evidence. Sleep Medicine Reviews, 58, 101453. https://doi.org/10.1016/j.smrv.2021.101453

Nadorff, M. R., Liu, X., & Germain, A. (2020). Nightmares and cardiovascular health: A longitudinal study. Sleep, 43(5), zsz247. https://doi.org/10.1093/sleep/zsz247

Ohayon, M. M., Carskadon, M. A., Guilleminault, C., & Vitiello, M. V. (2021). Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep, 44(5), zsab012. https://doi.org/10.1093/sleep/zsab012

Posted in
Posted in

The Alarming Nightmare-Suicide Link: Review just published

By

In my continuing bid to get the word out about the alarming link between frequent nightmares and increased suicide risk, I wrote a review paper that was just published. In it, I cover the growing body of research documenting evidence of this strong connection. I also explore the potential mechanisms at work that make nightmare sufferers more prone to suicide, and discuss treatment and the need for more research.

Recently, I’ve had conversations with several psychotherapists who came across my writings on this topic. I have been consulting with some of them about clients who fit the typical profile of concern: a person suffering from posttraumatic stress who has nightmares almost every night, and has attempted suicide, or is in danger of doing so.

Much of my work involves keeping abreast of nightmare research, developing and honing a treatment protocol based on current evidence and my depth of clinical experience. I also share this information via my writing and courses, including an online course specifically covering nightmares and suicide, and what clinicians need to be aware of.

Here is the abstract and citation for the paper. Please share it with anyone who might benefit from knowing about this.

The Alarming Nightmare-Suicide Link: Evidence, Theories, and Implications for Treatment

A robust link has been established between frequent nightmares and increased risk of suicide, both in adult and adolescent populations. Yet nightmares remain vastly undertreated for a confluence of reasons: patients rarely talk about their nightmares, clinicians rarely ask about them, and too few clinicians are trained to treat disturbing dreams. Current clinical research shows that nightmares are not only associated with posttraumatic stress disorder (PTSD), but also are more prevalent in most psychiatric disorders. There are myriad reasons for clinicians to inquire about and treat nightmares: Patterns of disturbed dreaming, and content of nightmares can provide warning signs of suicide; dream content can aid in diagnosis, treatment, and assessment of response to treatment; and there are established, evidence-based treatments for nightmares that appear to reduce nightmare frequency and distress, as well as other symptoms of post-traumatic stress. Mechanisms of action remain unclear, and the range of treatment options could be expanded, so further research is needed. In the meantime, viable nightmare screening and treatment options currently exist that have the potential to mitigate suicide risk. This review summarizes the extant body of research in this clinical area.

Ellis, L. (2024). The Alarming Nightmare-Suicide Link: Evidence, Theories, and Implications for Treatment. SIS Journal of Projective Psychology & Mental Health, 31(2).

Posted in
Posted in

Dreams and Psychedelics: Similarities and potential therapeutic benefits

By

Research into the therapeutic potential of psychedelic (serotonergic) substances is experiencing a resurgence after lying dormant in North America for more than 50 years. Early research suggests these once-vilified substances show great promise in treating depression, anxiety, alcohol addiction, and potentially many other challenging conditions. This emerging area is ripe for the use of dreamwork techniques to help with the integration of psychedelic visionary experiences that have much in common with dreams.

Psychedelic visions and dreams: Vehicles for attenuating fear memories

From a neurobiological perspective, dreams and psychedelic visions (PVs) share similar forms of perception, mental imagery, fear memory extinction, emotional activation and distorted senses of self and body. This is according to a comprehensive review of the literature on the neurophenomenology of both dreams and psychedelic experiences (Kraehenmann, 2017). A major difference the author noted is that there is greater clarity of consciousness and meta-cognition in PVs, suggesting these experiences are closer to lucid dreaming (the ability to become aware of the dream state while still in it).

One of the areas of overlap that has significant therapeutic potential is the attenuation of fear memories. During dreaming, the brain’s limbic emotion processing network is more active than in wakefulness; in dreams, fear memories are often revisited, but broken into more isolated units, and associated with novel contexts. These are also the steps that lead to fear memory extinction, with a final step being emotional expression of the new experience, which consolidates the updated version. Even better, Kraehenmann states that “Dreaming might also directly rewrite fear memories via memory reconsolidation.” This process involves activation of an emotional memory, followed by a new, less fearful experiencing of it within the ‘reconsolidation window’ which permanently updates old fear memories.

In my decades of work as a trauma therapist, I have found that dreams provide excellent fodder for further therapeutic effects when reactivated while awake. In those who suffer from frequent nightmares, the dreams are remain fear-laden over time because the memory reconsolidation process is often interrupted as the emotion is so strong it wakes the dreamer up mid-process. But in a dream therapy session, the fear memory can be opened up again via dream re-experiencing. Then, in a supportive environment where fear is significantly reduced, the dream story can be metabolized and rewritten, permanently updating the original fear memory. When I have worked with nightmares in this way, the most common reported effect the removal of the emotional charge from the dream/memory. The memory is still accessible, but no longer activates a fear response, and this changes the dream itself.

The same kinds of mechanisms may be at work in psychedelic journeys – the activation and recombination of fear memories in a way that has the potential to remove the element of fear from the experience. As with experiential therapy for dreams, a similar process can be used for PVs to integrate the visions and hallucinations that have arisen, and to help reduce the emotional charge from the experience if there is residual fear present.

Optimism and Caution

Although psychedelic substances are still illegal in most countries (as was the case with cannabis before widespread legalization), there is an underground community already using these substances for therapeutic benefit. Legal permission is being granted for use in research in limited, but rapidly-expanding ways as early results show both promise and acceptable safety.

There is a dark side, however, to this mostly good news story. Recent studies are mainly small and many of them not well-designed. Within the community already using psychedelics, often in group therapy sessions, there are varying degrees of safety and levels of appropriate supervision. From those pioneering psychedelic journeyers, we mainly hear about the successes, and less about the frightening and disorienting experiences that can also result.

What the community of psychedelic pathfinders are discovering is that preparation, setting and post-treatment integration are key elements of success. Best practices, although still a work in progress, are emerging.  A scoping review by Golden and colleagues (2022) found that the main aspects of setting that can positively impact the experience include music/sound, religious or ritual contexts, group versus individual sessions, socio-cultural norms/expectations, and physical environment. Unfortunately, researchers found the existing data is too patchy, sparse or observational to establish evidence-based practices. Adding to the complexity, responses vary across individuals.

Despite the lack of empirical evidence about the factors that lead to success, early research into use of psychedelics for specific clinical conditions is quite promising. A recent meta-analysis of current research shows that psychedelics (psilocybin, LSD, ayahuasca) can be a part of safe, effective treatment protocol for depression, even in treatment-resistant, life-threatening cases (Ko et al., 2023). Another systematic review of 16 studies conducted between 2000 and 2020 showed that psychedelic substances were safe and effective for depression, anxiety, OCD, and tobacco and alcohol use disorders. They noted that the effects appeared to last weeks or even months after just 1-3 sessions, with no severe adverse effects reported (Andersen et al., 2021).

As someone who works with dream material and teaches therapists how to help clients navigate these rich imaginative realms, I believe these same methods can help with the integration of the dream-like aspects of psychedelic journeys. This feels like a rich potential extension of methods developed for experiential dream therapy and in particular, a way to continue the process of taking the charge out of frightening memories and images.

 

Andersen, K. A., Carhart‐Harris, R., Nutt, D. J., & Erritzoe, D. (2021). Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies. Acta Psychiatrica Scandinavica, 143(2), 101-118.

Golden, T. L., Magsamen, S., Sandu, C. C., Lin, S., Roebuck, G. M., Shi, K. M., & Barrett, F. S. (2022). Effects of setting on psychedelic experiences, therapies, and outcomes: A rapid scoping review of the literature. Disruptive Psychopharmacology, 35-70.

Ko, K., Kopra, E. I., Cleare, A. J., & Rucker, J. J. (2023). Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis. Journal of Affective Disorders, 322, 194-204.

Kraehenmann, R. (2017). Dreams and psychedelics: neurophenomenological comparison and therapeutic implications. Current neuropharmacology, 15(7), 1032-1042.

Posted in
Posted in

Can AI Interpret Your Dreams?

By

With AI flooding the world with all kinds of applications, of course there are now several AI apps on the market for recording and interpreting dreams – my current favorites are Elsewhere and Temenos. Some of the questions that immediately arise: Does AI do a good job with helping us explore our dreams? What are the pros and cons of using this technology as a way to engage in our dreaming lives?

John Temple, the creator of Temenos, a dream tracking and interpretation app, says the technology is useful, but has limits. He spoke at length on this on the June 20 podcast episode of This Jungian Life (well worth a listen). He said that in the process of testing this program, he sent numerous dreams to be interpreted and found it exhausting. “Your psyche recognizes that it’s not another human soul responding.” He suggests Temenos as a useful tool, but not to overdo it. His sense is that what’s healing in the process of dreamwork is the human connection, something AI can’t replace.

That said, an app can offer interesting suggestions you may not have thought of. If you treat its analysis as coming from one of many members of a dream group, as a reflection to consider and take or leave, it can carry your understanding of the dream forward, sometimes in creatively helpful ways. Temple notes that in dreams, our blind spots are often so evident to others and, by definition, invisible to us. Other voices, including the possible interpretations via an app, enlarge our perspective and may enable us to see the very aspects that we’re missing.

Interpretation aside, dream apps can also be used as a way to record dreams easily and store them all in a single, searchable database – much more efficient than searching through stacks of old dream journals. For example, using the Temenos app, you can speak your dream into your phone and it will transcribe it and store it, and it prompts you to add notes about emotional tone and associations, even generates an image of the dream. Over time, you have a long-term, detailed, searchable record of your dream life, and with this, different questions you can explore – like how a dream element or symbol appears and evolves over time. A premium (ie paid) version of the app lets you join a dream community to share dreams with small groups, or the whole community.

Another great dream AI app is Elsewhere, which offers most of the same functions as Temenos (although its community functions are still under development). I tested it out with a dream I had of an Irish Setter that turns into a fox, a slightly wild and unkempt little creature that is ambivalent about being held by me. The app takes care to offer its interpretation as something to consider, not as gospel, beginning its response with: “If it were my dream, I would interpret is as follows…” It then describes the fox as a “cunning, adaptable, and resourceful” aspect of myself that is perhaps undernourished.

This feels both plausible and a little too reliant on generic meaning. It doesn’t resonate. But a later phrase does seem worth pondering, a suggestion that the dream “could be a reflection of your own desire to balance your wild and free-spirited nature with the need for stability and nurturing.” This feels a little closer to home, and yet again, something is lacking for me. I tend to work with dreams in an embodied experiential way, in this case, to enter into a direct experience of this little fox. What I come away with may be similar in sentiment, but reading the interpretation rather than experiencing my own neglected wild-animal nature is qualitatively so different. Another person holding the space for my direct experience is simply richer and more supportive of what can arise in the field between two people.

What Temple concludes about AI dream analysis is that it is a highly useful tool, but does not replace the human-to-human connection that takes place when we experience our dreams in the presence of another soul. There is something intangible and crucial about the intersubjective field that AI is incapable of generating. It is excellent at recognizing patterns, and is getting more sophisticated so quickly. But human beings are more than pattern recognition machines.

As an aside, I just had a relevant discussion about another kind of AI – active imagination – and intersubjectivity with Serge Prengel that you can listen to here: https://activepause.com/ellis-prengel-active-imagination/

There are now AI-supported apps that can provide therapy – usually the more formulaic forms like cognitive behavioural therapy. Although this cannot take the place of another human, it can offer help that is affordable and accessible. The same is true of dreamwork – although deeply sharing dream experience with another person creates a shared field not possible with a machine, not everyone has access to a dream analyst or dream partner. And the insights and avenues to consider that apps like Elsewhere and Temenos offer can often carry the dreamer further in their own exploration.

Dreams often depict our blind spots and areas to consider that we can be surprisingly obtuse about. Having another viewpoint can widen our perspective, regardless of its source. I find the dream apps useful as records of my dream life. And as interpreters, they are like another voice in a dream group – they offer ways to consider a dream that can lead somewhere or fall flat, and how to respond is entirely up to me.

Posted in
Posted in

REM Rebound: Dream Intensification in Early Recovery in NOT a Bad Sign

By

The road to recovery from addiction has many challenges, but the intensification of dreams does not have to be one of them. The return of one’s dreams is normal, a good sign, and can be an ally in processing the upwelling of emotion that occurs during the recovery process.

Those who vow abstain from using their addictive substance of choice face many challenges in the early stages – cravings, loss of a familiar way of coping, boredom, periods of emotional intensity and a need to shift away from familiar habits and social patterns that went along with their substance use. What those in recovery don’t expect is to be further challenged (or helped) by their dream life.

Dreams of substance use are common among those in early recovery. They are often vivid enough to feel entirely real. For example, early in his abstinence from alcohol, ‘John’ dreamt of being at a party, carousing with his friends, downing a drink and reaching for another, firmly embedded in his pre-recovery life… only to wake and realize he had been dreaming. According to Kelly & Greene (2019), a ‘using dream’ leads to initial feelings of guilt and remorse, as if one had actually stepped off the wagon. This is typically followed by a sense of relief that the relapse didn’t happen in waking life, and that relief is a good sign.

Counsellor Aubrey Johnson, a student in my Embodied Experiential Dreamwork program, specializes in working with clients in addiction recovery. As her project for the class, she presented on the ‘using dreams’ of those in the recovery process. She said the research validates what she has often witnessed: the intensification of dreaming, especially in the early stages of recovery. In fact, these dreams are so intense they can be characterized as nightmares, and are a known phenomenon in addiction medicine.

One study (Millios, 2016) found that a full 84% of those pursuing sobriety were having substance-related dreams at 7 weeks’ abstinence. After a couple of months, the frequency of using dreams begins to diminish quickly, but they can revisit for a lifetime. Johnson says this make sense because recovery is also a life-long process. And although the study found REM rebound dreams peak at 7 weeks, she has seen the intense dreaming last for several months in some cases, and for the dreams to bring up challenging emotions associated with addiction.

 

What Induces Dreams of Using?

On a physiological level, REM Rebound accounts for much of the increased dream frequency and intensity. Many addictive substances, including alcohol, cannabis and benzodiazepenes suppress REM sleep and dreams. These substances can also disrupt natural sleep cycles, creating a deficit in REM/dreaming. When a person stops using a REM suppressant, their body immediately begins to make up for the REM deficit. Until natural sleep rhythms are restored, the person in early recovery will experience longer and more intense dream-rich sleep.

This explains why there are so many dreams, but why dreams of using? If Freud was right that some dreams express fulfillment of wishes, these dreams can be an unconscious reflection of the desire to use, and return to memories of euphoric experiences while under the influence. We tend to dream about powerful emotions, and especially those we repress, so it’s not surprising that memories of substance use will be woven into the dreams of those in recovery. It’s similar to the common experience of dreaming of one’s ex-partner in the weeks and months following a difficult break-up.

Addiction is now being understood not as a disease but as a way to self-regulate, often a response to trauma and overwhelming emotions (eg. Winhall & Porges, 2022). Addictive behaviors can stall emotional growth as challenging feelings are not being processed, but rather bypassed or numbed. The recovery process involves acknowledging hard feelings that have long been avoided, and learning alternative ways to be with and metabolize them. One of the functions of dreaming is emotional regulation; more turbulent feelings tend to express themselves in more intense dreaming. Rather than see this a problem, I suggest making the dreams allies in the recovery process, an aid to emotion processing. Encourage your clients to befriend the dreams, listen to them, welcome them, and in turn they will become friendlier, clearer and more helpful.

 

Are Using Dreams Helpful or Dangerous?

There is some conflicting evidence about whether dreams of using promote or prevent relapse, a great fear amongst those on that path to recovery. In keeping with the many theories of dreaming as a simulation, Kelly & Greene suggest using dreams may be a way of rehearsing situations that might tempt one to relapse, increasing awareness and motivation to stay sober. However, dreams of using can also increase cravings because they return the dreamer to a lived experience they may be missing.

Johnson, who works with the ‘using’ dreams of those in her practice, suggests some helpful practices for others who work with the dreams of those in recovery from addiction. She said it’s helpful to tell clients that using dreams are normal and highly prevalent, and they do not indicate potential relapse or that anything is going wrong. In fact, discussing the dreams can help the client struggling to adapt to abstinence by providing images that aid in processing the spectrum of emotions associated with the recovery process.

 

Kelly, J. F., & Claire Greene, M. (2019). The reality of drinking and drug using dreams: A study of the prevalence, predictors, and decay with time in recovery in a national sample of U.S. adults. Journal of substance abuse treatment, 96, 12–17. https://doi.org/10.1016/j.jsat.2018.10.005

Millios, R. (2016). Dreams in Recovery: “Using” and Relapse Dreams – What Do They Mean? American Addiction Centers. https://recovery.org/pro/articles/dreams-in-recovery-using-and-relapse-dreams-what-do-they-mean/

Winhall, J., & Porges, S. W. (2022). Revolutionizing Addiction Treatment with The Felt Sense Polyvagal Model. International Body Psychotherapy Journal, 21(1).

Posted in
Posted in

Dream to remember, dream to forget, dream to feel better…

By

Dreaming after an emotional experience might help us feel better in the morning

Although dreaming has been implicated in the consolidation of memories, it seems we also dream to forget. In a similar way that sleep has been shown to clean our brains of clutter, a recent study supports the notion that dreaming helps us rid our minds of non-essential memories so we can focus on what is important to us, but only if we remember our dreams.

Zhang and colleagues (2024) recently completed a study that supports an active role for dreaming in reducing next-day reactivity associated with emotional memories. Their research also suggests there is a mechanism in which dreams enhance salient emotional experiences at the expense of less relevant, or neutral memories. In short, dreaming helps us remember and process what’s important to us, and to forget what is not. But again, only if we recall our dreams.

This is an interesting feature of the study – the results only applied to those who recall dreams. We know that just because we don’t recall dreams in the morning, this does not mean we did not dream during the night. Most of our dreams are forgotten; it has been suggested that dreams do their job even when we don’t recall them. However, this study demonstrates an important role for dreams that we remember upon waking – a possibly a reason it’s worth cultivating greater dream recall.

According to the authors: “This study asks why we dream. Building on prior work demonstrating a link between sleep and the processing of emotional memories, we examine whether dreaming alters overnight memory and emotional reactivity on an emotional picture task. We found that participants who reported dreaming exhibited an emotional memory trade-off, prioritizing retention of negative images over neutral memories, a pattern that was absent in those who did not recall their dreams. Moreover, dreaming was associated with decreased emotional reactivity to negative memories the following day, with reduced reactivity tied to more positive dream content. We provide the first empirical support for dreaming’s active involvement in sleep-dependent emotional memory processing, suggesting that dreaming after an emotional experience might help us feel better in the morning.”

This article juxtaposes the continuity hypothesis of dreaming with that of dreaming as emotional regulation. “The Emotion Regulation theory of dreaming is different from the Continuity theory of dreaming as it proposes that dreams lead to a functional change in emotion regulation during waking.” The authors note a dichotomy in the prevalent theories about dreaming – those who consider dreaming a passive activity ascribe to the continuity of dream affect before, during and after dreaming. Those who ascribe to Emotion Regulation or Simulation theories suggest dreaming plays an active role in changing one’s experience (albeit by different mechanisms: Emotion Regulation by downregulating negative emotions, and Simulation Theory by preparing for future experiences).

The current study is an attempt to test whether dreams actively support the transformation of emotional reactivity by measuring changes after a night of sleep in both those who report dreams and those who do not recall any dreams. If the dream recallers have decreased reactivity the morning after dreaming, this would support the sleep-to-forget, sleep-to-remember (SFSR) hypothesis. SFSR is supported by previous studies which show that REM sleep preferentially preserves emotional memories over neutral ones.

However, the authors note that results of research into the effect of REM sleep on emotional reactivity are decidedly mixed – some studies show increased regulation, others, increased arousal. In surveying existing literature, the authors reached the conclusion that “dreaming might play a role in both the memory consolidation and the emotional regulation aspects of emotional memory processing.”

To test the change in next-day emotional reactivity after memorable dreaming, 125 women were studied, in a mix of sleep lab and at-home settings. The authors were able to replicate prior reports of an emotional memory trade-off in which sleep preferentially enhances consolidation of negative versus neutral memories. They suggest their study “highlights the critical role of dreaming in emotional memory processing during sleep.”

The study also supported prior research showing that emotional reactivity to previous experiences decreases after a night of sleep, but again, this effect was only present in those who remembered their dreams. In participants who did not recall dreams, no significant differences were found between negative and neutral memory performance. This interesting distinction was flagged as “remarkable” and an important topic for future research.

 

Zhang J, Pena A, Delano N, Sattari N, Shuster AE, Baker FC, Simon K, Mednick SC. Evidence of an active role of dreaming in emotional memory processing shows that we dream to forget. Sci Rep. 2024 Apr 15;14(1):8722. doi: 10.1038/s41598-024-58170-z. PMID: 38622204; PMCID: PMC11018802.