Category: Dreams

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Nightmares and the nervous system: a new approach to treatment based on polyvagal theory

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At long last, my article that takes Porges’ polyvagal theory and the nervous system into account when considering the causes and treatment of nightmares, has been accepted for publication in the APA journal Dreaming. Although it could be many months before it is actually published, I am happy to share some of the main ideas and invite you to an online workshop on nightmare treatment based on this research. Those who sign up will receive an advance draft copy of the article, Solving the Nightmare Mystery: How Polyvagal Theory Updates our Understanding of the Aetiology and Treatment of Nightmares.

Here is the abstract: “Current theories about the aetiology of nightmares and mechanisms of action that account for their successful treatment have not yet taken the polyvagal theory (Porges, 2011) into consideration. While the polyvagal theory’s updated and multi-faceted view of the autonomic nervous system’s (ANS) response to threat has begun to transform the field of trauma treatment, most of these ideas have not yet been applied to nightmares and their treatment. This paper outlines how the theory may provide a missing link in understanding specific ways that trauma and adversity lead to chronic nightmares, and it offers a way to make sense of the heterogeneity of trauma-related symptoms and concomitant responses to nightmare treatments. A review of the literature demonstrates evidence of links between measures of ANS and physiological responses to nightmares. Content similarities between threat responses described by polyvagal theory and common nightmare themes provides an additional avenue for assessment and intervention. Theories of nightmare aetiology and treatment are evaluated with respect to polyvagal theory, and lastly, a proposed treatment protocol, Nightmare Relief, offers a polyvagal-informed, process-experiential approach to treating nightmares, with links to clinical examples.”

This sounds like quite a mouthful. In my upcoming seminar, I will present the most salient aspects of this material and focus mainly on introducing the Nightmare Relief protocol. I will be able to offer much more detail, clinical examples, demos and experiential practices than are covered in the academic paper. I would like those who take this workshop to be able to put these ideas into practice right away with clients who suffer from nightmares. Students of mine who have learned this way of working tell me it has stopped the nightmares of some of their clients.

What inspired me to spend the last couple of years on this enormous project? It stems from my experience as a trauma therapist, and many forces have converged to lead me to this focus on treating nightmares. In my 25 years working with posttraumatic stress injury and complex trauma, I have watched the practice of trauma treatment evolve, bringing more embodied practices and deep empathy into the work. I have enjoyed the move away from pathologizing stances toward a deeper understanding of the nervous system’s response to threat and ideas about how to help clients understand and befriend their bodies.

In the past few years, I completed a PhD with a focus on using focusing-oriented therapy, a gentle embodied approach to psychotherapy, for treating the nightmares of refugees. Encouraged by the results, I have continued to study nightmare treatment and was alarmed to discover two things: how few clinicians are versed in this important skill, and how imperative it is to treat nightmares. They are robustly linked to increased suicide risk, and associated not only with posttraumatic stress, but virtually all forms of mental health disturbance. The available treatments appear to work, but not necessarily for the most severe cases, and there is room to understand more about what works and why.

I have arrived at the idea that the nervous system is deeply implicated in nightmare suffering, and that using newer embodied trauma treatment methods that instill a sense of safety and connection are the starting points for treatment. I have incorporated what I learned in my doctoral research, and also what I have learned from existing evidence-based treatment to develop an individualized, embodied approach to treatment. This is described in my paper and upcoming workshop. I do hope you’ll join me.

Workshop: Nightmares and the Nervous System: How to treat disturbed dreaming
October 13, 9:30 to noon Pacific
LIVE online via Zoom, recording available to registrants
Cost: 140 (plus GST) = $147 USD

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Potential dangers (and benefits) of herbs that help you dream

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Clinical herbalist Sky Richarde says she is often asked about plants that can bolster your dream life by giving you more vivid or lucid dreams. However, few people are aware of the potential dangers of taking an herb without knowing about things like side effects and possible interactions with other medications.

“A lot of people have a misconception that just because it’s a plant, it’s very safe. It can be very safe for some people and can be very dangerous for others, especially for those who are taking medications or who already have other sleep disorders,” said Sky.

Sky is a student in my Embodied Experiential Dreamwork certification program and this presentation of her expertise was given at one of our final class meetings. (A new cohort begins this September). She has been working with medicinal plants all her life, and has also received formal training as a clinical herbalist, from Pacific Rim College in Victoria BC, where she now teaches several courses on herbal medicine.
Sky says that any herb can be helpful for promoting dream life if it is taken with that intention. Two of her favorites include lion’s mane (a fungi, not a plant) which increases mental clarity and can promote dream recall and lucid dreaming. She also likes holy basil or Tulsi, a pleasant tasting tea that can also help with certain sleep disorders and their physiological consequences. Herbs for sleep and dreaming are not a one-size-fits all but ideally are matched with what a person wants to achieve and take their unique sleep and dream life into consideration.

Sky warns against simply doing an internet search on dream-promoting herbs because side effects and dangers are rarely listed. Mugwort, for example, is often listed as an herb that can boost dream recall. However, most people burn mugwort in a room and allow the scent to promote dreaming rather than drinking this very bitter brew, which is not recommended if you suffer from acid reflux.

In general, Sky says an internet search on dream herbs typically yields a list of highly stimulating plants that are not conducive to sleep. Some can even induce psychosis. Blue Lotus Flower, for example, was used in Egyptian times, steeped in wine to induce euphoria. But some people have been inhaling it with vape pens and going into catatonic states that require hospitalization.

Another plant, with the common name African dream root, was used by certain tribes to communicate with their ancestors. But it was taken as part of a ritual, and vomiting is expected. “A lot of these plants are often taken out of the context of their culture and people are using them recreationally without understanding their properties or potential interactions with other substances.”

In terms of potential drug interactions, Sky offers two examples: People might take St. John’s Wort for stimulating dreams, not realizing it can completely disrupt how their birth control medication works. Passion flower is not compatible with anti-depressant or anti-psychotic medication.

It is impossible to cover all of the possible benefits and dangers of dream-inducing herbs here. The main point is to treat plants as you would any other medicine or substance. Sky points out that you would not take another kind of drug without consulting a doctor and understanding its proper dosage and use, and if it has side effects. The same should be true for plants.

Sky recommends that if you’re wanting to explore the rich world of dreams with the assistance of plant allies, that the best course of action is to choose one plant to work with and research how it functions in the body, being sure to do a separate search for potential side effects and herb/drug interactions as well as herb/condition interactions, and try not to neglect learning about the cultural significance of the plants you want to use. Be fully informed before you consume any medicine.

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The dream text is not so sacred: Dreams as doorways to possibility

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“A dream is alive.” Eugene Gendlin wrote this in his book, Let Your Body Interpret Your Dreams to describe the ongoing, in-process nature of dreams and how much potential they possess because of this. He said dreams are ‘unfinished’ and therefore they represent a huge possibility space. Rather than dismiss what may at first feel like fragmentary nonsense, we can sink into our dreams experientially and flesh them out. This idea, that dreams are alive and rife with possibility, also means that they are fluid and responsive to our attention, rather than fixed. I see them as a doorway to the larger imaginal world of the dream, an opening to something larger.

In the early days of dream interpretation, a dream text was taken a little too seriously, as if it were sacred. I do have a deep respect for dreams. But when you think about what a curious mix of image, temporal anomaly, strangeness and confusion a dream is when you wake up…
and when you think of how much more comes (and how much more escapes) when you attempt to capture the dream in words as you write it down or tell someone about it…
and when you sense how much of the dream was not quite captured, how much more there was than you can recall… you realize the dream text you have written is not so sacred. Rather, it is a memory jogger, a leaping-off place into the world of the dream itself, which like a felt sense, contains so much more than you can actually say about it.

This is why I have adopted such an experiential approach to dreams. And why I like what Gendlin says about dreams needing ‘careful but irreverent handling.’ It’s okay to play with them and to engage with them. What feels unhelpful is to try to pin them down too soon, or to confine them to a particular meaning. That way of working with dreams can be a fun, intellectual exercise, but ultimately one that takes you further away from the dream itself. To borrow the words of another of my mentors, Dr. Stephen Aizenstat, a dream likes to be met in the way of the dream. The way of the dream is through imagination, play, creativity, and wonder.

This is the introduction I gave to my day-long pre-conference workshop at the Person-Centred and Experiential Psychotherapies world conference this month in Copenhagen. It was truly an honour to be among a new tribe of like-minded therapists and share my approach to dreams. It feels like another step forward in my mission to bring a modern, collaborative and experiential form of dreamwork more widely into clinical practice.

Why Work with Dreams?
Dreamwork (according to the research) is implicated in regulating our emotions – and one of the reasons sleep deprivation leaves us cranky and out of sorts is that we have missed out on the activity in REM allows for processing of our most salient emotional concerns. Dreams have been shown to help us work through grief and the impact of trauma while we sleep. They bring depth, meaning and creative solutions that may not be as available to our busy waking minds. With all input from the outside world shut out, and with our logical processing faculties dampened down, dreaming is a state conducive to associative play with images that depict our deepest concerns.

In therapy, they are a doorway to deeper conversations. They open up topics the dreamer may be hesitant to broach, but offer these in images and metaphor so the dreamer can process difficult topics with the help of mediating images. What I mean by this is that the images in our dreams can carry important pieces of process forward without the need to retell a traumatic story or go around the same pain- or problem-saturated circles. You don’t even have to know how the dream relates to the dreamer’s story. Such insights often drop in later, on their own. In the meantime, my best advice is to follow the dream itself, dive deep and trust it.

Dr. Leslie Ellis offers online dreamwork training programs to mental health professionals. Her flagship Embodied Experiential Dreamwork certification program begins in mid-September, and there are still a few spaces left.

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Dream Emotion: A key to unlock their meaning and purpose

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By Dr. Leslie Ellis

Emotion is key to understanding and working with dreams. Many theories of dreaming suggest that emotion is what generates dreams, and that one of the reasons for dreaming is to process feelings. Dream researcher Ernest Hartmann famously called dreams ‘picture-metaphors’ for the dreamer’s most prominent emotion. For example, he found that in the aftermath of trauma, people would often dream not of the trauma itself but of an image that depicted the magnitude of their feelings, a tidal wave for example.

One theory of the purpose of dream emotion is to tag specific events that are important to us so they can be woven into the web of associated memories, and therefore, available when we need to retrieve them. Memory reconsolidation is a helpful notion here. It is a big phrase for the way our memories are updated. Emotion is what tags the memory as important, and until we undergo some kind of process to integrate these emotional memories, they will stay alive and infiltrate our dreams.

As a psychotherapist, I have found that dreams also bring up unmetabolized feelings because they need to be experienced and processed before the body can let them go fully. We can do some this processing in our dreams, but if the same images or themes recur, then we may need to do some deliberate daytime processing as well. This is especially true of trauma and protracted grief – these feelings are big and take time to integrate, and they can be so overwhelming the related dreams become nightmares that wake the dreamer up. This is a hallmark symptom of posttraumatic stress injury.

In my experience, the core of every dream is emotion — sometimes big emotion, sometimes underground feelings. They are in our dreams because they want to be integrated and transformed. Focusing creator Eugene Gendlin said that nothing can change until it is fully felt. This is why experiential dreamwork is so important, and why all modern dreamwork methods contain experiential elements. So when you are working with dreams, follow the feelings, and invite the dreamer to immerse in them, fully if possible, partially if necessary.

How do you find the emotional core of dream? Sometimes the dream is simply steeped in the feeling, and all you need to do is re-enter, revisit and engage with the dream images. Sometimes the feeling is hidden in a dream element or character. For example, in a dream I worked on where the landscape was dark and littered with corpses, the dreamer felt calm. In the dream, a nurse was able to bring one of the bodies back to life, and when I asked the dreamer to become the nurse, she started sobbing – the sadness in the dream was located in another dream character.

As you invite experiential exploration, visit all the corners of the dream, and hidden and contrary places. Watch for signs of striking an emotional chord, and when you do, slow down and invite the dreamer to drop in deeper. Ask into that felt sense: what did that just open up in you?

A good question from trauma work and focusing, to keep the emotion processing manageable: is this feeling mine alone or is it bigger than me? Some dreams can be about collective and/or intergenerational trauma. If so, it makes sense to enlist help from collective or ancestral sources – don’t go it alone.

Here is a trick I recently learned from expert dream tender Stephen Aisenstat: You can set up a dialogue where your helpful dream elements are the ones that turn and face the overwhelming emotions. This gives you, or the dreamer, a little bit of space to see what might otherwise be overwhelming from the vantage point of the observing self. This is a good way to help manage dream emotions that are too large or overwhelming to face alone. For example, a friend had a dream that included an image of Putin as a cold-eyed killer, and she needed to enlist the support of the archetypal mother to manage the terrifying image her dream had conjured up. She could imagine a face-off between the Great Mother and Putin so that much of the battle could take place outside of her, while she observed. This rendered the pain of the image much more manageable.

Dream emotions are not always so challenging, but they can be quite particular. It is as though our dreammaker wants to engender very particular feelings in us, and creates a scene filled with details that do just that, and just for us. This is what makes most dreams so very personal. Only the dreamer will react in a particular way to the strange collage of elements from past and present in their dream. Sinking into the emotions the dream evokes will carry the feeling forward to a new place, which is what the dream wants.

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What Can You Do About Your Nightmares? Ideas from a trauma expert

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There is a lot you can do, and some compelling reasons why you should take action to quell your nightmares, especially if you suffer from post-traumatic stress injury

Tom is awakened with a start by the sound of his own screams. Several nights a week in his dreams, he revisits the burning building, and hears terrified voices from inside, above the roar of the flames. The building has been deemed unsafe, he can only watch in frozen terror as the heavy beams start to fall and the building collapses. This is not an actual memory, but a condensation of all the times in his career as a firefighter that he arrived on the scene too late to save someone. Now, these memories haunt his dreams, and bring a deep sense of despair. What most people do not realize is that you do not need to simply suffer them; there is something you can do about nightmares.

Not all nightmares are a cause for concern

Nightmares plague almost all of us at different times in our lives. For the most part, this is not a problem, even though such dreams can be distressing. But if your nightmares cause significant distress, wreak havoc on sleep and adversely affect how you function during the day, it is really important to do something about your nightmares. About 5% of the general population and 30% of those with some form of mental illness fall into this category.

Researchers have established a clear link between nightmares and suicide, so if you have both suicidal thoughts and nightmares, you need to take action. Fortunately, what many people don’t realize is that there are many effective treatments for nightmares and they involve fairly simple steps. (If your therapist does not have training in nightmare treatment, some accessible online resources are listed below.)

Talking about your nightmares helps

Too few people talk about their nightmares; there is a tendency to think this wouldn’t help. Or that those you tell will judge you. Neither is true, and it really helps to talk about nightmares. Nadorff has studied nightmares extensively and concludes that “nightmares are a robust and modifiable predictor of increased suicidality and poor psychiatric outcomes” (2015, Journal of Clinical Sleep Medicine).

The good news is that nightmare treatment appears to work for many people. The research has raised many questions about what exactly is working and why, but it seems that almost anything that researchers have tried has the potential to make a difference. It may be that simply knowing nightmares can be treated opens the doorway to change.

Nightmare rescripting is the common denominator

There are many elements that have been incorporated into nightmare treatments. One of the most common is called nightmare rescripting. This is simply the process of coming up with a new ending to your nightmare. In the well-researched treatment modality called Imagery Rehearsal Therapy, people are asked to change their nightmare in any way they want, and then to imagine this new version a number of times before going to sleep. The research has shown this to be very helpful for many kinds of nightmare sufferers, from veterans to rape victims.

There are many variations on this treatment, and all appear to be helpful. I found in my practice that teaching clients to imagine a new ending to their nightmares is something they can do on their own, at home right when they wake up from a frightening dream. This gives them a constructive action to take, a way of calming down. They tell me it gives them a sense of control over their distressing dreams and takes away some of the fear of going to sleep. What is also good about such nightmare treatments is that they can not only help reduce nightmare frequency and distress, but they also reduce daytime symptoms of posttraumatic stress injury – things like flashbacks and a tendency to avoid situations that can trigger them. The other good news about most of the nightmare treatments studies is that treatment is quick, can make a difference in a session or two, and even if doesn’t help as much as you would like, the studies reported few if any adverse effects.

What to do when you wake up from a nightmare

When you are jolted out of sleep by a nightmare, your body will likely be quite amped up. So take a few minutes to let your heart rate and breathing slow down. Remind yourself gently that this was just a dream, and that it is not happening now, real as it may have seemed a few moments ago. Take a few long, deep breaths, extending the exhale to calm your nervous system. Calm your emotions by picturing in detail one of your favorite places or imagining someone you love deeply and amplifying the feelings you have about them. Look around the room for something comforting and to remind yourself you are safe in your bedroom, not back in the dream.

Once you feel calmer and better, go back to your nightmare images, just the very last part of the dream that woke you up, and allow the dream to play forward from there in any way you want. It does not have to come to a tidy resolution, although it might. Just let the dream play forward to find a better stopping place. Keep your breath slow and regular. What most people find is that this simple practice changes the dream for the better and gives the dreamer a greater sense of control and safety.

Nightmare changes can indicate trauma recovery

When I have treated patients with nightmares in a similar way to what is described above, I found that all of them experienced some kinds of changes in their dream life. Sometimes the nightmares stop altogether, but more commonly, they begin to change and start to look more like normal dreams – they are a bit stranger, more a of mix of past and present, and less of a direct replay of a trauma memory. This is an indication that the process of healing has begun.

When a traumatic event has not been metabolized, it can come back in the form of recurrent dreams that either represent or replicate the actual trauma event. The more the dreams of the trauma begin to weave in elements from current life, the closer the dreamer is to having integrated their trauma. The nightmares may not stop right away, but if they shift and start to feel more like normal dreams rather than repeated replays, this is a good sign.

Resist the urge to avoid treating nightmares

Both therapists and those who suffer from nightmares might be tempted to back away from conversations about their alarming content. But if you are suffering from the same kinds of terrifying dreams most nights, it is a mistake to think not talking about it will help in some way. It does not. Talking about it helps, even when the subject matter is intense.

Philosopher Eugene Gendlin said it this way: “What is true is already so. Owning up to it doesn’t make it worse. Not being open about it doesn’t make it go away… People can stand what is true for they are already enduring it.”

Current research has shown that even with the most unbearable trauma, such as those who were inmates of Auschwitz, it is better for survivors to talk about their dreams than try to bury them. A Polish researcher, Wojciech Owczarski, studied 500 dreams of 127 former inmates and found that only 10 percent are still suffering from recurrent dreams that replicate their trauma. He found that all the dreams had “therapeutic potential” either on their own or with the help of a therapist.

To wrap up, there are many reasons to talk about your nightmares, to rescript them, and to seek treatment if they cause you significant distress. These challenging dreams can be seen as your own body’s attempt to integrate the trauma you have suffered, but to realize this helpful effect, you must work with the dreams rather than avoiding them.

 

As a small gift to those who suffer from nightmares, I have made a free 7-minute self help video, dedicated to first responders and front-line workers. For those clinicians who want more information on treating nightmares, consider taking my online course: Nightmare Treatment Imperative.

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Dreaming in Times of Collective Crisis: A nocturnal perspective on Ukraine

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Recently I dreamt I was standing on a rocky, mountainous ridge, the stone an iron colour, like dust mixed with blood. I am looking for a way down, and all the options seem treacherous. Suddenly, the ground begins to split under my feet, a massive slice of it neatly dropping away. It feels as if this has destabilized everything around me, as if the earth’s crust has suddenly lost its integrity. I am left in a state of expectant waiting-for-disaster and not sure what form this will take. To me this dream clearly speaks to the devastation I feel as I watch, with the rest of the world, as the horrifying events of the Russian invasion of Ukraine unfold.

Like the recent global coronavirus pandemic, the war in Ukraine is an event that affects us all. It has destabilized the world and divided countries along ideological lines, which has the frightening potential of leading to a much larger war. The pandemic clearly infiltrated the world’s dreams, increasing dream recall and disturbed dreaming, and introducing themes related to health, loss of freedom, invisible threats and death. A number of studies have documented this global phenomenon, lending support for the continuity hypothesis that suggests that waking-life concerns find their way into our dreams. The same holds true for the way war now unfolding is infiltrating our collective dreaming.

In a recent and poignant session with one of my dream classes, I wanted to take a moment to acknowledge the harrowing events in Ukraine. I shared my dream and the personal nature of the war for me. Half my ancestry is a mix of Ukrainian, Russian and Polish. The borders have changed so much in the areas where my mother’s family originated that the same area was at times Russian, Ukrainian or Polish. The epicenter, according to my ’23 and Me’ ancestry test, is at Lviv, now part of Ukraine, part of the area that is being systematically reduced to rubble.

My dream of the ground splitting under my feet feels like a direct response and an apt metaphor for what is happening in Ukraine. This war feels very close to home, destabilizing and so much bigger than me. Others in the dream group, and in other dream circles I tend, have been reporting similar themes: dreams of invasion, of violence and displacement.

One poignant example was a recent dream offered by Theresa, her in-laws having immigrated over 50 years ago from what is now the Ukraine, Germans fleeing from the Russians. Recounting the dream, she said, “I am at my mother’s house. Looking out from the second-floor deck (of my current home), I see the new neighbour with his teenage sons looking towards me. They have torn down the fence and stripped my mother’s backyard of all its’ bushes and flowers. One tree remains, an apple, with only the trunk left standing. Now I find myself in my mother’s basement, the neighbour there with his boys, though younger in age. The room is wild, toys spread chaotically everywhere. I ask the one boy to clean up his mess and he defiantly refuses. I go upstairs to ask his father, the neighbour, and my husband, for help. By the time we return to the room, the toys are cleaned up and the other children confirm the young defiant one has helped…”

Many in the group could relate to the themes of invasion, destruction and utter disrespect of boundaries in the dream. There was a collective sense of grief, sadness and frustration expressed. However, the dreamer is given the last word in this dream process and Theresa said she ultimately saw this dream as one of reconciliation, the coming together of warring parts that have entered the foundation of her mother’s home; an invitation to have all take part in the commitment to a better way.

Recounting the dream brought deep and surprising emotion for the dreamer. Theresa said that her dream invited process at the collective as well as personal level, speaking to the situation in the Ukraine, and her life. She recognized the dream was showing her the power of our own ‘sacred motherland’ and at another level, the strength of the archetypal divine feminine to stand loving and firm while holding chaos and destruction. She felt the dream was hopeful in that her call for help was answered by the two adult men, as well as the children. One apple tree was left standing, the potential for regrowth still present. (The biblical symbolism of the garden of Eden is not lost on us.)

When I had my dream of the ground splitting, or when someone brings a dream of invasion and destruction, I wonder, as I am wont to ask, what is helpful about such dreams?

For the dream groups I am hosting, discussing dreams in times of crisis gives us a venue to feel and express our concerns and the deep emotion that has been stimulated by world events. We can hold each other in our grief and sorrow. Many of us have been given an image or a metaphor for our deep unexpressed feelings. This does not solve the larger problems, but it does make us feel less alone with them and it prompts action, in whatever ways we can offer help.

That world events can infiltrate our dreams makes sense because intense emotion is the fodder of dreams. World crises are changing our dreams collectively, demonstrating how we are all in this together. Information travels fast, and no longer do massive humanitarian crises take place in secret. My hope is the increasingly collective nature of world events can begin to sow the seeds of peace.

Near the close of the dream group, one member, through her tears, spoke in response to Theresa’ dream, “The devastation image was so immediate and resonant of Ukraine, and then Theresa brought such compassion to it. If we are going to dream our mutual dream of the human race forward, this is what will lead us.”

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Nightmares and the Nervous System: A new way to understand and treat nightmares

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In the world of trauma therapy, a paradigm shift has been taking place over the past decade or so, a marked shift toward embodied and somatic approaches to the understanding and healing of trauma. The polyvagal theory by Dr. Stephen Porges has led clinicians to consider that much of what was previously viewed as pathological behaviour can be seen as adaptive responses that our client’s autonomic nervous systems (ANS) have initiated as a means of protection and survival. This hopeful and non-shaming approach has changed the way trauma therapy is practiced for so many… yet the paradigm shift has not found its way into the treatment of nightmares. I feel that it’s high time for this to change because nightmares deserve clinical attention. They are a cardinal symptom of post-traumatic stress injury, and associated with complex trauma, anxiety, depression and many other mental health challenges. They have been strongly correlated with increased suicide risk.

I have been doing my best to help more clinical attention to nightmares and opportunities for training. I have spent the past several years developing a theory and treatment protocol for nightmares that takes the polyvagal theory into account. This work is the basis of a major article (now under review) and two online courses on nightmares, one for clinicians and one for the general public. I am consistently sending the message that nightmares are urgent messages from the body, attempts at trauma recovery and at getting the dreamer’s attention so they can attend to underlying sense of threat that haunts their nights. Nightmares are treatable, yet so often they are not treated. And in the   most serious cases, where they may lead to greater suicide risk, I believe treatment is imperative.

 

Nightmares reflect a nervous system that doesn’t feel safe

One of the most freeing aspects of Porges’ theory is the idea of ‘neuroception’, which is the internal sensing process which happens automatically, outside of conscious awareness, as our bodies pick up cues of threat and safety from the environment and react accordingly. The theory states that our autonomic responses happen in a specific order – first with activation to fight or flee from danger, and second with immobility or shutdown when fight or flight are not possible or advisable. Shutdown in the face of an overpowering aggressor may in fact be the wisest choice, though it is completely out of conscious control. Knowing this has helped rape survivors, for example, understand why they went limp and didn’t fight back, an action their own body deemed would put them in even greater danger. This knowledge reduces their sense of shame.

 

Nightmare content reflects the autonomic nervous system

Something interesting I noticed in working with nightmares over time is that the content of these dreams often reflects the various states ascribed to nervous system responses. The vast majority of fear-based nightmares depict scenes of being chased or running away (flight), of being faced with agression (fight) or of a sense of frozen hopelessness and inability to move (immobility). It is as though our dream content is describing our autonomic state. The beauty of this is that it is not static, but can shift and change in response to cues from the environment.

Porges has stated, quite simply, that when in comes to trauma and resulting ANS reactions, “safety is the treatment.” I have found that with frightening dreams, if you can instil a sense of safety in the dreamer, either within the dream itself, or after that fact in working with the dream material, it can shift even long-term recurrent nightmares, sometimes permanently. Too often I have seen that nightmare sufferers feel like victims of the terrifying dreams, thinking there is nothing they can do, making them fear sleep itself, which is ideally a balm and a time for deep rest and recovery.

 

Not all nightmares are the same

One thing that the polyvagal theory has helped me to understand is that there are two distinct responses to trauma and adversity – one is highly activated and the other is more dissociative. The pathway to safety and recovery from these two states is different, yet most nightmare treatments are applied as if they are all the same. When a person’s body reflects collapse or immobility, what the polyvagal theory states is that they are very far from being able to engage with someone who is trying to soothe or help them because they have turned inward and their social engagement system is shut down. Porges says the path back from this state is longer and more complicated and needs to pass back through the activated state most of us associate with trauma.

In either case, instilling a sense of safety and then of connection will help shift the dreamer’s state, and often, the memory of this stays with them when they next encounter the fear response within their dreams. This is why the popular nightmare treatment method of ‘rescripting’ or rewriting the content of one’s dreams can be so powerful. When we revise our dream narratives, we can add empowerment, help from others, a new way of seeing the situation that renders it less threatening… or anything that feels right to the dreamer.

In my work with dreams and nightmares, I always ask the dreamer to find and then embody any aspects of the dream they find helpful – and to imagine the dream forward to include such elements if the dream itself contains no such sources of support. When they experience a sense of power, of safety and of company in the face of their haunting dreams, these dreamers often hold on to it, and the potential for a helpful shift is available to them next time they have a similar dream. This brings hope and change to places that felt frozen in place, the beginning of a new and more empowering relationship to one’s embodied dreams.

 

Do you know someone who suffers from frequent nightmares? Or are you a parent concerned about the frequency and intensity of your child’s bad dreams?
Learn why treating nightmares is both essential and surprisingly simple in these two online course about nightmare relief.
Nightmare Treatment Imperative – The complete course for Clinicians
Nightmare Relief for Everyone –  A little course designed to help everyone
Learn how to treat nightmares with evidence-based methods!

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Riding the Waves

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A shift in dreaming patterns from the first to second wave of the COVID-19 pandemic

A year and a half ago, as the full scope of the pandemic that was descending on us became apparent, there was a global increase in severe stress, worry, fear and uncertainty. Reports of heightened dream recall and dream vividness were also on the rise, with many experiencing nightmare-like depictions of their greatest pandemic fears realized. This was a time of great upheaval and dysphoria, or, as Harvard professor and dream researcher Dierdre Barrett put it, “an extraordinary time in the history of dreaming.” Global dreaming trends can give us crucial insight not only into our collective mental state, but into how times of crises are reflected in our dream lives.

In Wuhan, a study of 100 nurses working on the front lines found almost half were experiencing nightmares (Tu et al., 2020) and an online survey of 811 individuals reporting dream content found 55% had pandemic-related dream content (Pesonen et al., 2020). As the first wave of the pandemic subsided, dream reports began to decrease. Many reported a “return to baseline” in both dream recall and emotionality (Scarpelli et al., 2021). But we all know this isn’t where the story ends.

Enter the delta variant, causing more infections and spreading more rapidly than its predecessor, plunging many countries into a second wave. So what happened to our collective dream lives during the second wave? Researchers are now sharing their answers.

In the spring of 2020, Scarpelli and colleagues released a web survey to “collect socio-demographic information, psychological and sleep measures, and dream variables” from participants in Italy. Then the second wave hit Italy in October of 2020, giving Scarpelli and colleagues the unique ability to conduct a longitudinal within-subjects study of oneiric activity in different stages of the pandemic.

The researchers released a second survey to the participants of the previous survey, designed to investigate dream changes during the second wave compared to the first wave of the pandemic, and 611 participants responded. They asked about dream recall frequency, nightmare frequency, lucid dream frequency, emotional intensity and nightmare distress. Interestingly, all variables, both quantitative and subjective, were lower in the second wave, yet the emotional tone of the dream content was more negative. Essentially, people are remembering their dreams less, apparently dreaming less, yet the dreams they do have are more negatively toned.

The Scarpelli study was not the only one that who found this. Conte and colleagues (2021) showed that “reported dream emotional tone became significantly more negative both in total lockdown and partial lockdown (second wave) compared to previous periods.” In addition, they found that waking mood was much more negative and fearful during the second wave. Since pandemic dreaming has largely been supporting the ‘continuity hypothesis’ that our dreams reflect waking life concerns, this suggests an over dip in mood and increase in fear which may reflect the fact that by now, most of us believed we would have put COVID-19 behind us. Instead, it seems increasingly unpredictable and lasting, and many people are losing patience and hope.

Each wave in each country hits the residents differently, and everybody rides the waves in their own fashion. Yet, after the devastating effects of the first wave in Italy, it is not difficult to imagine how facing a second wave could elicit negatively toned dreams in Italian residents. A German study by Moradian and colleagues found that during the second wave, participants had more depressive symptoms and exhibited less safety behaviours (such as handwashing and mask wearing), which they believed was evidence of  “pandemic fatigue.” Another study by Kimhi and colleagues found that facing a second wave, participants had reduced resilience. After the shock of the initial wave, it appears that people are facing the second wave with a more resigned and negatively toned attitude, and this is what second-wave dream content reflects – less intensity but increased negativity.

With the dissemination of effective vaccines, it appears the waves of new infection have subsided from tsunami scale to a much more manageable level, especially among vaccinated populations. But vaccine availability and uptake is variable, and the waves continue to roll out in an unpredictable fashion, making this challenging time a kind of ongoing global experiment. The initial shock of the pandemic elicited such a strong shift in our collective dream lives that it spurred the publication of dozens of studies looking into dreams. Hopefully as the degree of disruption subsides, our shared interest in dreams will remain.

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References

Kimhi, S.; Eshel, Y.; Marciano, H.; Adini, B. (2020). A Renewed Outbreak of the COVID−19 Pandemic: A Longitudinal Study of Distress, Resilience, and Subjective Well-Being. Int. J. Environ. Res. Public Health, 17, 7743.

Moradian, S., Bäuerle, A., Schweda, A., Musche, V., Kohler, H., Fink, M., Weismüller, B., Benecke, A. V., Dörrie, N., Skoda, E. M., & Teufel, M. (2021). Differences and similarities between the impact of the first and the second COVID-19-lockdown on mental health and safety behaviour in Germany. Journal of public health (Oxford, England), fdab037. Advance online publication.

Pesonen, A.-K., Lipsanen, J., Halonen, R., Elovainio, M., Sandman, N., Mäkelä, J.-M., Antila, M., Béchard, D., Ollila, H. M., & Kuula, L. (2020). Pandemic dreams: Network analysis of dream content during the covid-19 lockdown. Frontiers in Psychology, 11.

Tu, Z. H., He, J. W., & Zhou, N. (2020). Sleep quality and mood symptoms in conscripted frontline nurse in Wuhan, China during COVID-19 outbreak: A cross-sectional study. Medicine, 99(26), e20769.

 

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Dreaming with our hearts as well as our minds

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New research uncovers a brain-body network that creates our dreams

So much of the research into how and why we dream has focused on the brain rather than the body… with the possible exception of nightmares where physiological fear responses are clearly a part of the experience. My sense of dreaming has always been that it is deeply embodied, and dynamically responsive to both our thoughts and emotions in an intricate dance. This may indeed be the case as a team of Italian researchers propose activation of the brain-heart axis is a trigger for dreaming.

New research led by Mimmi Nardelli has uncovered what I have always suspected was there: a body-mind link that drives dreaming, a bi-directional link where the body affects our dreams, and our dreams affect our bodies. The research team at the University of Pisa performed a comprehensive analysis of physiological signals during dream-rich REM sleep with nine healthy dreamers tracking brain and nervous system dynamics associated with dream recall. They also looked at causal directions not just correlations. They concluded that “bodily changes play a crucial and causative role in conscious dream experience during REM sleep.”

Much of the physiological dream research conducted to date has focused on neural correlates of dreaming, but this study also examines its relationship with the central and autonomic nervous system using measures of heart rate variability and blood pressure, along with EEG (brain) signals. Heart rate variability is a reliable measure of the state of the autonomic nervous system, which governs the body’s responses to cues of threat and safety. Blood pressure can also indicate levels of sympathetic activation.

The authors of the study noted that previous studies of nervous system correlates focused on discriminating sleep stages – for example, several studies investigating heart rate variability dynamics found a shift from vagal to sympathetic activity during REM. According to the Polyvagal Theory developed by Stephen Porges, this would indicate a shift from a sense of safety to one in which the body mounts a response to threat. This study goes beyond study of sleep stages to uncover new information about the relationship between dreams and the body.

During the experiment, researchers woke participants up during REM sleep and asked about their dreams – did they recall one, and was it positive or negative? They captured physiological data from the minutes prior to awakening and compared instances of dream recall with those where no dream was recalled.

Dreams and emotions linked

Previous studies have shown that in dreaming, the right hemisphere of the brain, more associated with visuo-spatial functiong and non-conscious emotional perception, is more active during dreaming, while activity in the left frontal hemisphere, associated more with logic and executive functioning, decreases. These finding were supported in this study. With respect to heart rate variability, when a dream was recalled,  an overall increase in sympathetic activity, and parallel decrease in vagal activity, was observed. The authors speculate that these findings indicate emotional arousal during dreaming.

In their study of changes in the nervous system over time in relation to dreaming, the authors found evidence to support a long-standing ‘activation-synthesis’ theory by Hobson and McCarley (1977) that dreaming arises from sensorimotor information relayed from the brain stem to the cerebral cortex. The current study suggest this is only half true. They found a bi-directional influence – a dynamic interchange from body to brain and brain to body.

The researchers wrote: “Results from the heart-to-brain interaction analysis suggest that the interactions between CNS and ANS associated with dreaming experience are bidirectional and exhibit dynamic changes.” They are quick to point out the results are preliminary because the sample size was small and low in statistical power. However, the study points to something I have come to believe about dreams: that their images are a picture of our embodied emotional state that impacts us deeply – and that we can also impact our dreams and how they unfold. They respond to us and we to them.

 

References

Hobson, J. A. & McCarley, R. W. (1977). The brain as a dream state generator: an activation-synthesis hypothesis of the dream process, The American journal of psychiatry.

Nardelli, M., Catrambone, V., Grandi, G., Banfi, T. (2021). Activation of brain-heart axis during REM sleep: a trigger for dreaming. American Journal of Physiology – Regulatory, Integrative and Comparative Physiology. https://doi.org/abs/10.1152/ajpregu.00306.2020

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Do Animals Dream?

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Three kinds of evidence to suggest they do!

Everything that makes us what we are, from the structure of our limbs down to the arrangement of our cells has been selected to give us an advantage over thousands of years of evolution. So, by this logic, dreams must increase our chances of survival in some way. The nocturnal movies we experience every night can be funny, terrifying, at times enlightening, at times just plain nonsensical. Yet they do appear to serve a purpose beyond mere entertainment, terror, or confusion. Dream researchers are uncovering their crucial role in memory consolidation, fear extinction, and emotional regulation. Yet this begs the question, where in the branches of the evolutionary tree does dreaming start?

If you have a pet, I’m sure you’ve seen them shifting their paws and growling while asleep, as if chasing a squirrel in their dreams. Believing a dog – or any mammal for that matter – can dream does seem plausible. But what about birds? Or octopuses? The great dilemma of animal dreaming lies in the fact that they are unable to communicate verbally to actually tell us about their dreams. But does this mean that the study of animal dreaming is truly inaccessible to science?

A recent article (Malinowski, Scheel, and McCloskey, 2021) explores this very concept. The authors propose three different non-verbal lenses through which we could study animal dreaming, including dream-enacting behaviours, neural correlates of dreaming, and replay of newly acquired memories. Let’s dive in!

Dream Behaviours

Dream-enacting behaviours describe the sleeper physically re-enacting a dream behaviour. When we sleep, our bodies are in a state of paralysis. Our partners should be grateful for this as it keeps us from thrashing them as we fight a dreamed enemy! While we don’t enact the bigger movements in our dreams, our bodies do have detectable physiological responses that directly correlate to dream content. For example, LaBerge (1986) found that smooth eye movements during sleep correlate with visually tracking something in a dream, and that dreamed-of sexual activity can lead to orgasms! In essence, our bodies respond to our dream content.

Individuals who report themselves as “non-dreamers” have been observed exhibiting dream-enacting behaviour, indicating that they do dream, but without recall. They classify themselves as non-dreamers because they cannot make verbal reports of dreaming, yet behavioural evidence indicates they do, in fact, dream. The inability to describe a dreaming experience, therefore, cannot be sufficient evidence that an individual does not dream. By this logic, we cannot classify animals as “non-dreamers” simply because they cannot tell us of their dreams.

In 1979 Michel Jouvet conducted a series of experiments on cats in which he “turned off” the part of the cat’s brain responsible for sleep paralysis. He observed that during REM sleep, the cats would begin to display dream-enacting behaviours. They would move as if stalking prey, play or begin to groom themselves. Their eyes remain closed and they did not respond to any visual stimulus, their movements appeared to be entirely oneiric. The movements would stop when the cats returned to slow-wave (or non-REM) sleep. Medeiros and colleagues (2021) have also observed octopuses exhibiting dream-enacting behaviours. They found that during sleep, octopuses would vary ventilation rates, move their arms and change their body patterns in ways unrelated to their surrounding environments. If you’ve seen My Octopus Teacher, you would not find it hard to believe octopuses have sufficient consciousness to experience dreaming.

Neural correlates denote dreaming

Tracking neural correlates of dreaming is another non-verbal way through which we could detect animal dreaming. When we dream, there is heightened activity in certain areas of the brain. Using this, we can detect when someone is dreaming. However, the study of neural correlates of dreaming goes beyond simply knowing someone is experiencing a dream, it can give us an idea of dream content. Activation of different areas of the brain coincides with dream content. For example, Siclari and colleagues (2017) found that a different area will be activated for facial recognition than for walking or running in a dream. These findings could have the potential for us to not only study animal dreaming but to determine the contents of animal dreams. However, the technology is not quite there yet, but I look forward to seeing future developments of this technology.

Evidence of new learning

One of the main functions of dreaming is the consolidation of newly acquired memories. A specific neural pattern will fire when forming a new memory, then will replay during sleep. This has not only been shown in humans but in rats as well. Dupret and colleagues (2010) placed rats into a new environment and measured the “place-related firing” of neurons. While the rats were asleep, they observed similar neuron firing. Rats that had this neural replay process disrupted had impaired memory of the environment, indicating that neural replay is essential in forming new memories.

However, dreams are rarely exact replays of memories our brains are consolidating. The memories get warped and woven into other dream content, so in observing replays we would not expect to see the exact neural pattern repeated, but a slightly altered one. Gupta and colleagues (2010) discovered this changing neural pattern in rats. They found that the neural pattern played not just forwards, but backwards as well. They also observed the pattern changing in novel ways, indicating active learning.

Though animals may not be able to discuss their dream lives with us, there are many promising ways to study animal dreaming. As we unravel the evolutionary drivers behind dreams, we may continue to discover different avenues for the non-verbal study of dreams. Given all the evidence just discussed, I am inclined to believe that when my pup’s busy paws mimic running in her sleep, she truly is chasing her dream squirrel, and maybe even catching it for once.

References

Gupta, A. S., Meer, M. A., Touretzky, D. S., & Redish, A. D. (2010). Hippocampal Replay Is Not a Simple Function of Experience. Neuron, 65(5), 695-705. doi:10.1016/j.neuron.2010.01.034

Jouvet, M. (1979). What does a cat dream about? Trends in Neurosciences, 2, 280-282. doi:10.1016/0166-2236(79)90110-3

LaBerge, S., Greenleaf, W., & Kedzierski, B. (1983). Physiological responses to dreamed sexual activity during lucid REM sleep. Psychophysiology, 20, 454-455.

Laberge, S. (1986). Lucid dreaming: Psychophysiological studies of consciousness during REM sleep. Sleep and Cognition., 109-126. doi:10.1037/10499-008

Malinowski, J., Scheel, D., & Mccloskey, M. (2021). Do animals dream? Consciousness and Cognition, 95. doi:10.1016/j.concog.2021.103214

Medeiros, S. L., Paiva, M. M., Lopes, P. H., Blanco, W., Lima, F. D., Oliveira, J. B., . . . Ribeiro, S. (2021). Cyclic alternation of quiet and active sleep states in the octopus. IScience, 24(4), 102223. doi:10.1016/j.isci.2021.102223

Medeiros, S. L., Paiva, M. M., Lopes, P. H., Blanco, W., Lima, F. D., Oliveira, J. B., . . . Ribeiro, S. (2021). Cyclic alternation of quiet and active sleep states in the octopus. IScience, 24(4), 102223. doi:10.1016/j.isci.2021.102223

Siclari, F., Baird, B., Perogamvros, L., Bernardi, G., Larocque, J. J., Riedner, B., . . . Tononi, G. (2017). The neural correlates of dreaming. Nature Neuroscience, 20(6), 872-878. doi:10.1038/nn.4545