Category: Course information

Posted in

Riding the Waves

By

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.

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!

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.

 

Posted in

Dreaming with our hearts as well as our minds

By

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

Posted in

Do Animals Dream?

By

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

Posted in

Does Your Child Have Nightmares?

By

When should you be concerned, and what should you do?

All of us can clearly recall at least one heart-pounding, fear-inducing nightmare from childhood that startled us out of our sleep. Whether it was a chasing dragon or a precipitous fall from a great height, it felt so real it left us shaken long after awakening. However, as adults we know that there isn’t a monster under our beds waiting to snatch us, even if we just dreamt about one. For children, nightmares can be confusing because they feel so very real. And as young children, the line between fantasy and reality is blurred,

Nightmares are completely normal phenomena, especially for children. They usually begin between age 2-4 and tail off by age 10-12. They are a developmental process and are a normal response to fear. They can be triggered by stressful events like starting school, family illness or conflict. In fact, nightmares can actually help process emotional events.

However, despite their potential to be helpful, nightmares do cause considerable distress and can disrupt sleep. So how can you help your child if they have frequent and distressing dreams?

  1. OFFER COMFORT AND SAFETY

Give them a hug, let them know they’re safe, that they’re not alone. Their nervous system is in a charged state. They need soothing to restore a sense of safety in their bodies.

  1. DON’T DISMISS DREAMS

Don’t try to talk them out of their experience or dismiss their dream using logic. In an attempt to offer comfort, don’t say, “It was just a dream, it’s not real” and expect that to be the end of it. Children experience their dreams as very real, and for certain, the intense feelings nightmares stir up are tangibly experienced.

  1. NORMALIZE TALKING ABOUT DREAMS

Ask your child about their nightmares. If they feel okay telling you about it, listen to the story of their dream. Sharing it with you will help take away some of the charge. It gives them a way to talk about their fears. There may be pressures they are facing that you have no idea about. Growing up is fraught with uncertainty and challenges that may seem inconsequential from an adult perspective.

Some children rarely articulate what’s scary for them, so we don’t get a chance to dispel needless worries or offer help. But their nightmares can do the talking for them in the form of metaphors and expressions of their main concerns.

Keep tabs on your child’s dream life, especially if it seems unusually dark and disturbing. If you make talking about dreams a normal part of the routine, you’ll know how often your child has nightmares and how distressing they are. You’ll be in a good position to know if professional help is warranted. And you will have gathered useful information to convey to a therapist about your child’s sleep.

  1. WHEN TO CONSIDER PROFESSIONAL HELP

Nightmares are considered chronic if they happen every week or more for at least 6 months. Fully 5% of children between the ages of 3-10 experience chronic nightmares, and for many, this is a normal developmental process. However, if chronic nightmares persist past about age 10, they are more likely to continue into adolescence and beyond. Age 9-11 is a critical juncture, a time to consider treatment if your child continues to have frequent, distressing nightmares.

Fortunately, effective treatment is available.

Imagery Rehearsal Therapy, (IRT) has been found to be effective in numerous controlled clinical trials in adult populations (ie with veterans and rape victims). This evidence has also been extended to children in a number of smaller studies that have shown it to reduce nightmare frequency, distress and general anxiety in children. Results were sustained 6-9 months post-treatment.

Imagery Rehearsal Therapy (IRT) is the most highly-recommended approach to nightmare treatment for any age group. Other protocols, like Exposure, Relaxation and Rescripting (ERRT) appear to work as well, but have simply not been studied as much. IRT is a non-invasive, cognitive behavioural approach that simply asks the dreamer to imagine and rehearse a new dream ending. This seeds a new story that often weaves its way into future dreams. One study showed that some children using IRT spontaneously became lucid after treatment and were able to alter their nightmares from right inside the dream.

  1. TRY DREAM THERAPY AT HOME

The original protocol for IRT suggests changing the dream in any way you want. However, for children, I recommend asking them the shift the dream in ways that help them feel better about the dream, ideally ways that bring a sense of hope and mastery.

To try your own version of this approach, first help your child feel safe and calm. Then ask them to recall their nightmare briefly, perhaps just up to the place where they might want something about the dream to change. Then ask them what they imagine could happen next in the dream to make the dream better. For example, ask what form of help, escape route, magic or superpower they might want to use. Let them know it’s their dream, and they can change it it any way they like.

For example, suppose your child dreams there is an evil monster under the bed, lurking and waiting for a limb to dangle over the edge so it can grab an arm or leg and drag them under. You could ask your child to imagine going back into their dream, to the part before it got scary. They could change the dream so what’s now under the bed is a favorite toy, perhaps a cuddly teddy bear that comes to life and takes them off to play in the clouds.

Or they might dream of a fire-breathing dragon chasing them. Often, it can really help to turn and face the dragon or monster, to really see it and perhaps ask what it wants. I did this with my daughter, reminding her of how I often sang Puff the Magic Dragon to her at bedtime. Her dream dragon became like Puff — lonely and in need of a friend. When playing with how to rescript nightmare, encourage children to give their imagination free rein, offer suggestions and keep it positive.

After rescripting, a further step in IRT is to rehearse the new dream ending, something children may need to be reminded to do. You can do a number of things to reinforce the new dream imagery for a child. You might suggest they draw a picture of it, imagine it again during the day, and/or tell you about it again as you tuck them in at bedtime.

What happens when we reimagine our nightmares or help our kids to do so? Sometimes the new dream ending becomes incorporated into future dreams, making them less frightening. Other times, people report a new ability to change their dreams from within. And sometimes the nightmare just stops coming. If the process doesn’t work the first time, try again, and play with different dreams as they come up. Do seek professional help if chronic nightmares persist or the process itself is upsetting (this is extremely rare). With the right support, and in time, your child will have fewer, less distressing nightmares. They may even come to cherish their dreams.

 

Are you a parent concerned about the frequency and intensity of your child’s bad dreams? Should you be concerned?
Learn more about Nightmare Relief for Everyone designed by nightmare expert Dr. Leslie Ellis, this self-paced user-friendly and accessible online course covers the very latest in science and research about what nightmares are, and what they’re not. Leslie offers some simple steps you can take to get some relief from nightmares and other nocturnal disturbances – both for yourself and for others, including your children.

 

References

Fernandez, S., DeMarni Cromer, L., Borntrager, C., Swopes, R., Hanson, R. F., & Davis, J. L. (2013). A Case Series: Cognitive-Behavioral Treatment (Exposure, Relaxation, and Rescripting Therapy) of Trauma-Related Nightmares Experienced by Children. Clinical Case Studies, 12(1), 39–59. https://doi.org/10.1177/1534650112462623

Mélanie St-Onge, Pierre Mercier & Joseph De Koninck (2009) Imagery Rehearsal Therapy for Frequent Nightmares in Children, Behavioral Sleep Medicine, 7:2, 81-98, DOI: 10.1080/15402000902762360

Schredl, M., Fricke-Oerkermann, L., Mitschke, A., Wiater, A., & Lehmkuhl, G. (2009). Factors affecting nightmares in children: parents’ vs. children’s ratings. European child & adolescent psychiatry, 18(1), 20–25. https://doi.org/10.1007/s00787-008-0697-5

Schredl, M., Fricke-Oerkermann, L., Mitschke, A. et al. Longitudinal Study of Nightmares in Children: Stability and Effect of Emotional Symptoms. Child Psychiatry Hum Dev 40, 439–449 (2009). https://doi.org/10.1007/s10578-009-0136-y

Simard, V., & Nielsen, T. (2009). Adaptation of imagery rehearsal therapy for nightmares in children: A brief report. Psychotherapy: Theory, Research, Practice, Training, 46(4), 492–497. https://doi.org/10.1037/a0017945

Posted in
Posted in

Does Your Child Wake Up Screaming? How to understand and treat night terrors

By

I used to dread going to bed when we lived in my lovely heritage apartment in Vancouver. Every night, about two hours after falling asleep, I would be startled awake by the most blood-curdling, agonizing screaming from the woman next door. Her window faced ours, and she sounded as though she was being murdered in her sleep almost every night. I wondered why no one would wake her up or help her. I have since learned that this would not have done much good as she was having night terrors.

So many people I’ve spoken with about this have suffered the same thing with their children. Night terrors are fairly common in very young children, affecting 20-40% of children under age 3, and 3-14% of school age children, but just 2% of adults (APA 2013). In a typical episode, parents will put their child quietly to bed only to hear them thrashing and screaming in terror about three hours later. The kids were hard to fully wake up, disoriented and confused, often with little or no memory of the incident in the morning.

Night terrors are often mistaken for nightmares. At a recent talk I gave about nightmares, most of the questions were actually about night terrors – from desperate parents wanting to know if there was something they could do about them. I treat nightmares, not night terrors, but I did some investigation, and there are a few things to know and to do that can help. First and foremost, know that they are generally benign and kids usually grow out of them.

Who Has Night Terrors?

Before I get into some of the ways you can help your child with their night terrors, it helps to understand what they are, who has them and why. A thorough survey of the literature suggests that although the exact cause is not well understood, genetic, developmental, environmental, psychological and organic factors can all play a part.

Night terrors most common in early childhood. A longitudinal study (Petit et al., 2015) of 1,940 children from Quebec found that 34% of children aged 18 months experience night terrors, 13% at age 5, and 5% at age 13. A recent review (Leung et al., 2020) found the peak may be later, at age 5-7 years. Either way, sleep terrors typically start at a very young age and stop at adolescence. It’s rare that the condition continues into adulthood – although for some it can switch to sleepwalking.

Sleep terrors are more common under a number of conditions that can be controlled, at least to some degree, such as: sleep deprivation, going to bed with a full bladder, emotional stress, anxiety (including separation anxiety), bullying, a noisy sleeping environment and excessive alcohol or caffeine. Other factors associated with this parasomnia include: febrile illness (unexplained fever), ADHD, autism, epilepsy, sleep apnea and PTSD. Some medications, especially those that are sedative, can lead to night terrors because they increase the duration of non-REM, the deep sleep stage in which these episodes occur.

It bears repeating the while night terrors are very distressing and can disrupt sleep for both children and their parents, they are not considered dangerous. They warrant clinical attention only if they are severe enough to disrupt daytime functioning. If you are considering consulting a doctor, keep a sleep diary and track BEARS. Not the big furry animal, but the 5-item assessment tool for children with sleep problems (Owens & Dalzell, 2005):

  • B: bedtime issues
  • E: excessive daytime sleepiness
  • A: night awakenings
  • R: regularity and duration of sleep
  • S: snoring

What Are Night Terrors?

In a typical episode, the child will sit bolt upright or even jump out of bed, heart racing, screaming in terror. They may speak, but what they say will be confused and incoherent because although they appear to be awake, they are in a hybrid sleep-wake state. They will be difficult to wake fully because these episodes occur during very deep (slow-wave) sleep. It’s best not to wake them up during an episode, and typically they won’t recall a thing in the morning.

Night terrors are distinguished from nightmares because they happen in the first half of the night associated with the deeper (stage 3 and 4) of non-REM sleep, while nightmares mainly occur in the second half, and are associated more with REM sleep and dreaming. Nightmares are clearly recalled in vivid detail, and those who have them tend not to thrash around and scream.

Night terrors are much more common in children. When they continue into adulthood, they look a bit different. While two-thirds of children have no recollection after episodes of night terrors or sleepwalking, the same proportion of adults do recall at least one experience and remember their episodes about half the time (Castelnovo, et al., 2021). For adults, night terrors appear to be more of a dissociative experience, and can be accompanied by hallucinations.

What you can do about night terrors

While none of the suggestions below work all the time, there are a number of things you can try to reduce or even eliminate night terrors. Excellent sleep hygiene (such as regular bedtimes; limiting screen time, no food and drink before bed, especially sugar and caffeine; dark, cool quiet bedroom; and wind-down rituals like story time) can all help reduce night terrors. Parents can also do their best to limit stresses on kids who have night terrors – things like bullying and separation anxiety might be addressed. Interestingly, psychological factors are found to be mostly associated with night terrors in teens and adults, but not children.

Wake-up treatment. One treatment that has met with some success is to wake a person up about half an hour before they would typically have an episode. If you do this for two weeks, it can break the cycle and stop it from recurring. In some cases, however, the episodes simply start occurring later in the night.

Co-sleeping. One interesting paper (Boyden, Pott & Starks, 2018) suggests that sleeping with your child stops night terrors, especially with very young children. The authors say that evolution did not design humans to sleep alone when very young and that “night terrors are the result of an environmental mismatch between evolved behaviour and the modern cultural practice of solitary sleeping.” This solution has not been empirically tested, but anecdotally, it appears to work for many.

The bottom line is that while night terrors can seem extreme, they are usually benign and your child will experience them less and less over time. There are a number of things you can try, such as good sleep hygiene, limiting stress, waking them prior to an episode and co-sleeping. To all those exhausted parents reading this, I hope it has been of some help.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Davey, M. (2009). Kids that go bump in the night. Australian Family Physician, 30, 290- 294.

Ekambaram, V., & Maski, K. (2017). Non- rapid eye movement arousal parasomnias in children. Pediatric Annals, 46, e327-e331. doi:10.3928/19382359-20170814-01

Golbin, A.Z., Guseva, V.E., & Shepovalnikov, A.N. (2013). Unusual behaviors in sleep as “compensatory” reactions aimed at normalizing the sleep–wake cycle. Human Physiology, 39, 635-641. doi:10.1134/ S0362119713060042

Ivanenko, A., & Johnson, K.P. (2016). Sleep disorders. In M.K. Dulcan (Ed.), Dulcan’s textbook of child and adolescent psychiatry (2nd ed.). Arlington, VA: American Psychiatric Publishing.

Laberge, L., Tremblay, R.E., Vitaro, F., & Montplaisir, J. (2000). Development of parasomnias from childhood to early adoles- cence. Pediatrics, 106, 67-74. doi:10.1542/ peds.106.1.67

Leung, A. K. C., Leung, A. A. M., Wong, A. H. C., & Lun Hon, K. (2020). Sleep terrors: an updated review. Current Pediatric Reviews, 16(3), 176-182.

Murphy, P.J., Frei, M.G., & Papolos, D. (2014). Alterations in skin temperature and sleep in the fear of harm phenotype of pediatric bi- polar disorder. Journal of Clinical Medicine, 3, 959-971. doi:10.3390/jcm3030959

Nguyen, B.H., Pérusse, D., Paquet, J., Petit, D., Boivin, M., Tremblay, R.E., & Montplaisir, J. (2008). Sleep terrors in children: A prospective study of twins. Pediatrics, 122, e1164- e1167. doi:10.1542/peds.2008-1303

Petit, D., Pennestri, M.H., Paquet, J., Desautels, A., Zadra, A., Vitaro, F.,…Montplaisir, J. (2015). Childhood sleepwalking and sleep terrors: A longitudinal study of prevalence and familial aggregation. JAMA Pediatrics, 169, 653-658. doi:10.1001/ jamapediatrics.2015.127

Salazar, F., Baird, G., Chandler, S., Tseng, E., O’Sullivan, T., Howlin, P.,…Simonoff, E. (2015). Co-occurring psychiatric disorders in preschool and elementary school-aged chil- dren with autism spectrum disorder. Journal of Autism and Developmental Disorder, 45, 2283- 2294. doi:10.1007/s10803-015-2361-5

Silvestri, R., Gagliano, A., Aricò, I., Calarese, T., Cedro, C., Bruni, O.,…Bramanti, P. (2009). Sleep disorders in children with attention- deficit/hyperactivity disorder (ADHD) re- corded overnight by video-polysomnography. Sleep Medicine, 10, 1132-1138. doi:10.1016/ j.sleep.2009.04.003

Wolke, D., & Lereya, S.T. (2014). Bullying and parasomnias: A longitudinal cohort study. Pediatrics, 134, e1040-e1048. doi:10.1542/ peds.2014-1295

Are you a parent concerned about the frequency and intensity of your child’s bad dreams? Should you be concerned?
Learn more about Nightmare Relief for Everyone designed by nightmare expert Dr. Leslie Ellis, this self-paced user-friendly and accessible online course covers the very latest in science and research about what nightmares are, and what they’re not. Leslie offers some simple steps you can take to get some relief from nightmares and other nocturnal disturbances – both for yourself and for others, including your children.

Posted in
Posted in

Nightmare-Suicide Link Extends to Adolescents

By

Read on to find out how you can help!

If you know or work with a deeply troubled teen, you might consider asking them about their dreams. If they report frequent disturbing dreams or nightmares, they are at a greater risk for suicide. The link between adult suicide and nightmare frequency has been well established, and a new study extends this correlation to young adolescents. The good news is that nightmares are treatable, and some very simple steps can make a meaningful difference.

In a recent study based in Montreal, Canada, Aline Gauchat and colleagues studied both the dreams and suicidal ideation of 170 children when they were 12 and again at age 13. Disturbed dreaming tends to lessen with age and did so in this sample. At the same time, the rate of suicidal ideation increased, and analysis of the data showed that the adolsecents who had suicidal ideation had significantly more disturbing and recurring dreams.

This is another piece of mounting evidence that when working with those with a potential risk of suicide (for example those with depression, borderline personality or a history of complex trauma) you should ask about nightmares as part of the screening process.

 

Why we should ask about nightmares

Dr. Michael Nadorff, who has conducted several studies linking nightmares and suicide, noted with dismay that in the past 50 years, we have not become any better at predicting suicide. Paying attention to dreams, in particular the frequency of disturbing dreams and nightmares, is one way to help determine who is most at risk.

The other important thing to note with respect to the nightmare-suicide link is that effective nightmare treatments are available. In his talk on nightmares at the recent (June, 2021) conference for the International Association for the Study of Dreams, Nadorff noted that of those with dangerously troubling dreams, only one person in ten might report this to a mental health professional. There are a couple of reasons for this: those with frequent nightmares don’t always realize that such dreaming is not typical. And very few people are aware that nightmares can be treated. People also hesitate to talk about their nightmares for fear of being judged for the dark images that haunt their sleep.

However, talking about nightmares, and getting treatment can have positive effects that extend beyond the simple reduction in the frequency and distress caused by disturbing dreams. In general, symptoms of depression and trauma dissipate, and although this has not been specifically studied, it is fair to suggest the risk of suicide drops significantly as well.

Instilling Hope

When asked what he thought made nightmare sufferers more likely to consider taking their own life, Nadorff said he thinks a lack of hope is a major contributing factor. For frequent nightmare sufferers, even sleep is not a refuge from their tortured thoughts. Those contemplating suicide report deep loneliness and a sense that they are a burden to those closest to them. He suggests intensive support for those whose risk of suicude is high, stressing that the periods of high risk are time-limited.

Treating the nightmares of those contemplating suicide is also something Nadorff recommends, though this idea has not taken hold very widely, at least not yet. But Imagery Rehearsal Therapy (IRT), lucid dreaming, and several other nightmare treatment protocols demonstrate that it can be fairly quick and easy to reduce nightmares and their related distress. In my survey of the nightmare literature, I have found that virtually all methods researchers tried seemed to help, and adverse effects seemed absent.

The common denominators in nightmare treatment include instilling hope by teaching those with nightmares that they are treatable and it is entirely possible to change their dream life for the better. The other key elements of treatment are to write, rescript or re-imagine a new ending to their nightmare, ideally one that gives them a sense of mastery over the challenge presented in their dreams. They can, for example, develop a superpower that enables them to escape or overpower their attacker. In my experience, the more richly imagined this new dream ending is, the more power it has to change subsequent dreams. If it sounds too simple, don’t be fooled… it can really be that easy to make a meaningful difference, possibly even save a life.

 

Some further resources:

Help for nightmare sufferers (free PDF) CLICK HERE

A short focused course on nightmare treatment for clinicians CLICK HERE

Are you a parent concerned about the frequency and intensity of your child’s bad dreams? Should you be concerned?
Learn more about Nightmare Relief for Everyone designed by nightmare expert Dr. Leslie Ellis, this self-paced user-friendly and accessible online course covers the very latest in science and research about what nightmares are, and what they’re not. Leslie offers some simple steps you can take to get some relief from nightmares and other nocturnal disturbances – both for yourself and for others, including your children.

 

References

Gauchat, A., Zadra, A., El Hourani, M., Parent, S., Renaud, J., Tremblay, R. E., and Seguin, J. R. (2021). Association Between Recurrent Dreams, Disturbing Dreams, and Suicidal Ideation in Adolescents. Dreaming 31(1), 32-43.

Nadorff, M. (2021). Invited talk for the International Association for the Study of Dreams (IASD) Online Conference, June 13-17, 2021.

Posted in

Can Your Apple Watch Stop Your Nightmares?

By

For more than 30 years, retired combat Marine veteran Tim Bahr would have his sleep interrupted by a dozen or so nightmares every night. He clearly recalls the morning of August 5, 2017 because that was the first time in decades that he woke up from a full night of sleep and could not recall a single nightmare. Bahr was testing an early version of NightWare and has become a strong advocate for this new nightmare treatment.

Nightware, is a ‘breakthrough’ system that uses an Apple watch and iPhone to help reduce nightmares and their related distress. As you begin to have a nightmare, a gentle vibration from the watch wakes the wearer just enough to change the dream state, allowing the person to sleep on more peacefully. Bahr said the sleep data shows he is still having nightmares but the device ‘breaks’ them before they get to the most intense places, so he is blissfully unaware of them. He also says this does not replace therapy but it does enable him to work through his PTSD with a well-rested body and a clear mind. “I now wake up without that fog.”

Granted FDA approval in November 2020, Nightware is now available on a limited basis by prescription to those who suffer from nightmare disorder or nightmares related to post-traumatic stress disorder (PTSD). This is new order of nightmare treatment was granted ‘breakthrough device’ designation that allowed it to fast-track through the FDA approval process.

Recurrent, realistic nightmares that replicate traumatic events are a cardinal feature of PTSD. They cause considerable distress and impair sleep, and for many, these distressing dreams do not simply go away with time. There have been several effective nightmare treatments developed that involve some variant of nightmare rescripting – in which the dreamer invents and rehearses a new ending to their nightmare. Imagery Rehearsal Therapy (IRT) has the most supportive evidence, and many other, similar psychotherapy-based interventions have been developed over the past 20 years. Medications are often prescribed as well, most often Prasozin, but it was recently downgraded because in a recent study, it did not perform better than placebo. However, NightWare is a new and different kind of treatment that can augment other ways of helping reduce nightmare suffering.

The beauty of Nightware is that this wearable device poses minimal risk and has no side effects. When we have a nightmare, our body reacts as though the terrifying event is really happening – so our heart rate increases, our breath becomes rapid, and we can tend to thrash around a lot more. The Apple watch can detect heart rate and movement. Over the first week or so of wearing the device, the patented Nightware software creates a personalized sleep profile to enable it to detect when a person is likely to be having a nightmare. It will then send a signal to create a gentle vibration in the watch, enough to cause a shift in the dream state, but not enough to wake the wearer up… or if the signal is too strong and does wake the wearer, the watch will adjust the signal and make it softer.

NightWare was tested in 30-day clinical trial with 70 patients who were randomly assigned with the working app, or a placebo app that did not create vibrations. Both groups reported improved sleep quality, but those with the Nightware app reported greater benefit. A larger controlled clinical trial is under way in several Department of Veterans Affairs hospital sites. According to NightWare CEO Grady Hannah, the company was founded specifically to support the physical, mental and emotional health of veterans and active duty service members.

There are some caveats. The FDA suggests that Nightware should be used in conjunction with other treatments and under the supervision of a professional. And it’s not recommended for those who tend to sleepwalk, or become violent or act out their dreams because the device may increase this undesirable activity (called REM Behaviour Disorder). It also recommended only for those 22 years of age or older. Nightware is available by prescription only, and is currently limited to veteran and military individuals. To find out more about it, you can do go the company web site at nightware.com.

 

Dr. Leslie Ellis is an author, researcher and therapist who specializes in PTSD nightmare treatment. If you are interested in learning more about nightmares and their treatment, check out my Short Focused Course on Nightmare Treatment. Or go HERE for a free PDF for clients on ‘What You Can Do About Your Nightmares.’

Posted in

Sleep deprived? You may be getting more sleep than you think!

By

We’ve all experienced nights like this: where we toss and turn and worry and plan, and when morning comes, it feels as if we have barely slept at all. The truth is you may actually be getting a lot more sleep than you realize. New research suggests there can be a big difference between your real and perceived duration and quality of sleep. A group of Swiss researchers recently found that when we are in our deepest sleep, we tend to perceive the opposite.

In the recent experiment at the Center for Investigation and Research on Sleep and University Hospital in Switzerland, researchers recruited 20 good sleepers and 10 with severe sleep misperception (also called paradoxical insomnia). In the sleep lab, they woke the participants up a collective total 787 times, at different sleep stages, to inquire about their perception of the quality of their sleep. Sleep stages were measured by high-density EEG. Our brain waves clearly show when we are in the deepest non-rapid eye movement (MREM) or ‘slow-wave’ sleep, and when we enter lighter, dream-rich REM sleep, or any of the stages in between.

One of the biggest surprises in this research by Stephan, Castaldi and Sicari (2021) is that we tend to perceive the opposite of what is true. They said, “Surprisingly, in good sleepers, sleep was subjectively lightest in the first two hours of NREM sleep, generally considered the ‘deepest’ sleep, and deepest in rapid eye movement (REM) sleep. Both the good sleepers and the sleep misperceptors felt they were sleeping deeply when they reported “dream-like features of conscious experiences… These findings challenge the widely held notion that ‘deep’ (slow wave) sleep best accounts for feeling soundly asleep.”

Anecdotally, this observation is supported by sleep medicine practitioners. At a sleep conference, I recall listening to a sleep doctor talk about a particular patient who checked into the clinic because he suffered from terrible insomnia. They set him up in the sleep lab, connected him to the EEG equipment to record his sleep duration and quality. In the morning, the lab staff were able to report to him that he had a full 8 hours of normal, restful sleep. The speaker said he happened to overhear a phone conversation the man had with his wife that morning. The man said, come get me, the doctors here don’t know what they’re talking about. In his perception, he had once again barely slept at all.

In the Swiss study, researchers wanted to know if this kind of sleep misperception was similar in nature (though clearly not in degree) to that of good sleepers. They found that both groups perceived they were awake more often during the first two hours of sleep, when we drop into our deepest sleep of the night, and again in the last hour before waking. Predictably, the misperceptors felt awake more often than good sleepers. The researchers also found that the ‘wake-like’ neurophysiological processes that typify NREM infiltrated REM more often for paradoxical insomniacs, possibly accounting for their misperceptions.

In terms of sleep perception, the only difference between the two groups was that misperceptors reported more thought-like experiences than good sleepers. Overall, the more dream-like experiences perceived, the greater the sense of having experienced a good sleep. This gives a clue about how you might treat paradoxical insomnia, and insomnia in general – stop thinking so much about whether or not you are sleeping, or worrying about how well you are sleeping. Instead, allow your mind to wander and to dream. Get a sleep meditation app like Insight Timer and find your favorite voice to fall asleep to. I notice when I listen to the same yoga nidra recording over and over, I lose big chunks of it to sleep, something I would not even realize if I didn’t know the sequence so well.

It may also really help to change your expectations about what sleep should be like, especially as you age. A continuous sleep, in which you lay your head down at night and are conscious of nothing until you wake up in the morning, can indeed be a rare event for many people – for example women experiencing menopause, and the elderly. Those who adapt best to this learn to accept periods of wakefulness as part of the norm. It may help to know that in these periods we perceive as wakeful, we may in fact be getting a lot more sleep than we think.

 

Posted in
Posted in

Embodied Experiential Dreamwork Certification Program

By

Experiential Dreamwork Certification Program

Join us for an amazing journey that will bring about insight and growth, both personally and professionally.

Now taking applications for FALL cohort 2022. Reserve your spot now!

This program is a deep dive into the world of dreams, and a clear path to learning how to engage yourself and guide others in embodied experiential dreamwork practices. Upon completion of this program, you will be able to confidently engage with your own dreams and the dreams of others, both one-on-one and in groups. And you will be able to help those who suffer from trauma-related nightmares to not only reduce nightmare frequency and distress, but also PTSD symptoms. This course is a companion to Dr. Leslie Ellis’ recent book, A Clinician’s Guide to Dream Therapy but goes beyond the material in the book to include personal and group dreamwork, and co-creative dreamwork.

TIMING OF ONLINE LIVE CLASSES:

There will be 10 2.5-hour live group Q/A and dreamwork practice/demo sessions.
Time: 9:30 AM to NOON PACIFIC on the third Wednesday of each month, starting in September. Sessions will be recorded and available to view at any time, but in-class attendance is strongly encouraged.

Instructor: Dr. Leslie Ellis

Dr. Ellis is a world expert in the clinical use of dreams, with a specialty in working with PTSD nightmares. She has a PhD in Clinical Psychology from the Chicago School of Professional Psychology and a Masters in Counselling Psychology from Pacifica Graduate Institute. She is vice president of The International Focusing Institute and has more than 20 years’ experience in clinical practice. She has taught a focusing certification program to therapists for more than 10 years, and is now offering online instruction in dreamwork to therapists and anyone interested in cultivating inner life through dreamwork, focusing and active imagination. She is the author of A Clinician’s Guide to Dream Therapy (Routledge, 2019), as well as numerous papers and book chapters on focusing and embodied, experiential dreamwork. She has also taught and delivered talks worldwide, including a recent keynote for the International Association for the Study of Dreams.

Who should attend?

This course is aimed at mental health professionals and students working toward psychotherapy, counselling, social work or coaching certification, as well as those with a strong interest in dreams and dreamwork. It is also of interest to spiritual directors and those intending to lead dream groups. This program is intended as an adjunct to the practice you already have, and it is up to each student to practice dreamwork within the scope of your own skills and training base. It is also not a substitute for therapy, although working with dreams is often therapeutic. If you have any questions about whether this program is for you, feel free to ask.

CEUs. A total of 50 CE credits are offered for this program from the Canadian Counselling Association.

 

Online Instruction includes the following courses:

Working with your OWN dreams

Dreamwork Demystified, the clinical use of dreams, parts 1 and 2

Working with Nightmares

 

Interactive instruction and practice

Monthly dream group meeting

Live demos and Q/A sessions

Practice partnership to exchange dream sessions

Online discussions, and bonus articles, videos and demos on topics of interest to the group

 

Assignments

Dream journal (for yourself)

Records of dream practice session, and questions and insights that arise

Option to present a case study, video, paper, artwork on an aspect of working with dreams

 

Reading

Ellis, Leslie. (2019) A Clinician’s Guide to Dream Therapy: Implementing Simple and Effective Dreamwork. New York & London: Routledge.

Gendlin, E. T. (1986). Let Your Body Interpret Your Dreams. Wilmette, IL: Chiron Publications.

Gendlin, E. T. (1978/1981). Focusing. New York, NY: Bantam Books

 

Suggested Reading

Bosnak, R. (1998). A little course in dreams. Boston & London: Shambala.

Malinowski, J. (2021). The psychology of dreaming, London & New York: Routledge.

Bulkeley, K. (2017). An Introduction to the Psychology of Dreaming. Santa Barbara, CA: Praeger.

Specific additional reading will be assigned or suggested as the course progresses.

 

PRICING

To purchase the individual components of this program would cost more than $2500 USD. We are offering the complete program for $1750 USD or $2100 Cdn. There is an option to pay monthly, in instalments of $175 USD or $210 CAD (includes GST). A deposit of $175USD or $210 CDN is required to secure your spot – this is not included in the total or monthly fee and is non-refundable. Please send deposit and registration info (see below) to leslie@drleslieellis.com via paypal or e-transfer.

Contact information: Dr. Leslie Ellis, email leslie@drleslieellis.com.  Web: www.drleslieellis.com

 

What current students of the course are saying:

  • “Personally and professionally helpful” 
  • Leslie is incredibly knowledgeable and always has lots to offer. I have found this course to be greatly helpful to me, both personally and professionally. This course is equipping me with the tools to work with a wide variety of clients on a much deeper level. Moreover, I have found it to be personally helpful as it has provided me with a platform to further engage with myself.
  • “Captivated my curiosity” It is with immense pleasure that I share with you my experience of this Experiential Dreamwork Certification Program that has captivated my curiosity and attention each and every day. I have been working with my dreams for over 30 years and have recorded 30 dream journals; however, this course has moved me so much farther in understanding my dream life that is so precious to me.
  • “Multi-layered and integrative” This program is multi-layered and I am learning so many new skills. I have been in this course approximately 3 months and have already learned so much, including: how to work with nightmares; how to work with my dreams on my own; how to participate in dream groups;  how to find the life force found in my dreams;  how to work with lucid dreams; and how to discover my blind spots when sharing my dreams. Most of all, I have gained skill in integrating Focusing while processing my dreams so that I can experience my dream more fully, embody useful elements of the dream and move the dream and myself forward.
  • “Skilled and knowledgeable facilitation” Dr. Ellis is a very skilled facilitator and psychotherapist and is exceptionally knowledgeable about the vastness of dream work.  She has written a cutting-edge dream book, A Clinician’s Guide to Dream Therapy: Implementing Simple and Effective Dreamwork that complements her online course, virtual classroom and group dream work.  I feel very fortunate to be studying with her.
  • “Fresh and fascinating” For me, this course is a fresh approach to the dream world. Beyond attempts for analysis and interpretation, it offers the opportunity to re-live our dreams and to receive all the gifts they bring.  For me, it was surprising to learn that nightmares can also carry helpful elements and how there are ways to find them and listen to them. Throughout this journey, Leslie is a very warm and supportive teacher and the educational process of the course enables us to quickly bond as a team. I believe it is a fascinating experience for every dreamer.
  • “From having nightmares to loving dreams again” 
    As a mental health professional, I’ve found the techniques I learned in this course to be incredibly effective in reducing my client’s nightmare frequency and severity. But it’s not only for clinicians. Anyone can take it and help themselves have a better dream life, and better connection with their dreams. I’ve come to see how much dreams can bring help and resolution to a bunch of different aspects of one’s life. So that’s something I’ve really taken away. I just like loving dreams again.The course came at a time where I was having really, really frequent nightmares that were just terrifying. And they were happening maybe every 10 days. After our one-on-one session, it just went away and never had it again. That was that was really, really helpful. I couldn’t find a solution before that.
  • “An Amazing Journey.” It’s been an amazing journey. I’ve always been passionate about dreams and with this approach I definitely feel a shift in how I work with dreams. There is such power for healing when we really attune to bodily sensations, when enter dreams in an experiential way. I find it very, very powerful. The finding of the helpful life force in the dream is a new technique for me and it’s really amazing. I find it that dreaming a dream forward gives that quality of more. My clients are really happy with the process as well. I can see it helping them move forward in their lives.
  • “Excellent.” 
    This dream course was excellent and if I could, I would do it all over again. I learned far more than I could ever articulate, and I now have a focusing-oriented template for supporting my clients with their dreams.

‘Embodied Experiential Dreamwork Program ‘made me a better clinician’

I recently had a conversation with one of the recent graduates my year-long dreamwork program – looking for feedback and ways to talk about the program to prospective students. If you are considering the program, Shauna’s experience may help you decide if this is a fit for you.

Read full conversation HERE.

 

To reserve your spot: A completed registration form and deposit of $175 USD  or $210 CAD (includes GST) is required (PayPal or e-transfer to leslie@drleslieellis.com). Deposit is nonrefundable. Once the program has started, refunds will be prorated and will not include the current month.

Registration form: Please email the following information to leslie@drleslieellis.com

1. Name, email address, mailing address.

2. Education and training

3. A very brief statement about your experience with dreamwork (none required) and your reasons for taking this course.

4. Your preferred payment method: $175USD deposit, and monthly instalments ($175USD x 11 months), or save $175 with payment in full ($1750 USD plus deposit).

Other currencies. Canadians are welcome to pay in Cdn funds: $210 deposit, and monthly x 11, or in full at $2100, plus deposit. For those in countries with large currency differentials, further discounts are available.

FAQs

What if I don’t recall any dreams — can I still benefit from the program and learn to work with dreams?

The short answer is yes, you can do dreamwork even if you don’t recall dreams. But you will likely find that you recall more dreams as you pay more attention to them. I have written a blog post with some ideas about how to recall dreams. And I also teach some ways to cultivate waking dreams, and these can be used for practice in the course in the same way you would work with night dreams. This also works for clients who don’t recall dreams.

Is the class time-intensive? How much time outside of class is required?

At minimum, you need to attend the monthly 2-hour class, or watch the recording if you are not able to attend in person — though it is highly encouraged to attend in person as often as possible. Outside of class time, you will have a dreamwork partner and are encouraged to work with each other’s dreams at least once a month. There are a couple of short books that are required reading. And there are several online courses you can consume at your leisure.

I have a suggested time-line of reading and coursework, but because my students are all adult learners and busy professionals, I want everyone to consume the material at their own pace, and to enjoy the process. Of course, the more time you put in, the more you will get from the course material, but I leave that up to each individual.

Are there scholarships available?

I do offer a discount in specific cases — mainly for those who reside in countries where the currency differential would render the tuition out of reach. There are a limited number of discounted spaces, and candidates will be considered in a case by case basis.

Is the course eligible for CEUs?

The course has been approved for 50 CE credits by the Canadian Counselling Association. These may not apply in your jurisdiction however.

Can I take this course if I am not a mental health professional who works with clients?

While this course is aimed at those who want to use dreamwork in clinical practice, it is open to all with a strong interest in working with dreams — their own, or the dreams of others. It may appeal to spiritual directors, coaches and anyone with a deep interest in exploring the fascination world of dreams.

Besides the group meeting each month will we (the students) have an ongoing dream group that meets more regularly?

The monthly meeting will be a 2.5 hour session that will typically begin with a brief Q/A. Then we will talk about a specific dream practice, topic or theory, I will demonstrate the dreamwork method with a class member or two, and then break you into smaller groups to try it out. Then we debrief the experience. There may be sessions where we stay together as a large group to learn and experience dream group process.

In addition, I will create a dreamwork exercise based on each month’s learnings for you to try with your small group — you will be assigned to a dyad or triad to meet over the year between classes to practice what we are learning together. There will also be an option for the small groups, or the whole group to continue meeting after the year is over.

Will there be assignments to support the certification?

There is one assignment to present on any aspect of dreamwork that intrigues you, and the format for this is very open. Most students have offered a short presentation (10-15 minutes) or led a class exercise/discussion. You can also write, film or record what you want to share. But these are not formally assessed. if you attend classes, engage in the dreamwork practices assigned, do the reading and courses that are part of the program, you will qualify for certification. If you would like to record a dreamwork session for feedback and a more formal assessment, that is an option.

Would this course be recognised by the IASD in its guidelines for ethical dreamwork certification?

Yes, this course will be recognized by the IASD as it follows the ethical dreamwork certification guidelines closely.

Is this course a stand alone course or are there other levels of qualification?

This course is a stand-alone course. There is a related course offering on how to understand and treat nightmares that I would recommend for all of those doing clinical dreamwork. And graduates can continue is a quarterly dream circle for those who have completed the program. If there is enough interest, ad advanced dreamwork certificate may be offered in the future.

If you have any questions that are not answered here, let me know.  THANK YOU!

Home Contact

 

Posted in
Posted in

REM Rebound: Managing intensification of dreaming when sleep deprivation or substance use stops

By

When you end a period of sleep deprivation or substance use, your dreams return, sometimes with a vengeance. Dr. Leslie Ellis explains how to understand and manage REM rebound.

While the global pandemic has been identified as a big factor in the recent increase and intensification of dreaming, a phenomenon called REM rebound may be the mechanism at work in some cases. REM sleep is so important that following a period of REM deprivation, our bodies will automatically make up for what it has missed. REM rebound is characterised by intense dreaming and a structural shift in the normal sleep cycle.

Sleep rhythm will return to normal once we have made up our REM sleep debt. This can take days or weeks depending on why, how long and how severely the sleep cycle has been disrupted. There is much in the literature about how to manage sleep problems associated with REM rebound, but very little in the way of help with what to do about all those troublesome dreams. Read on for some simple suggestions from a clinical dream and nightmare expert.

 

What is REM rebound?

First, we need a basic understanding of rapid-eye-movement (REM) sleep. This is the sleep stage most associated with dreaming. In a typical night, we have 4-5 REM sleep periods that gradually increase in length over the course of the night. In total, we spend about 90 minutes or more in REM sleep during a typical 8-hour night of sleep, with most of our REM concentrated toward morning. If we become deprived of REM, our bodies will drop into REM immediately upon falling asleep instead of moving through the progressively-deepening cycles of non-REM sleep that typically start our night. This is REM rebound, a natural increase in REM to make up for what was missed, often due to sleep deprivation or the kind of stress that leads to restless, broken sleep.

There is considerable research to support the notion that REM sleep and dreaming help to regulate emotional reactivity and to reframe negative experiences. REM sleep affects hormonal balance and sleep homeostasis. To return to the normal, restorative sleep patterns so important to all aspects of our health, we may need to go through a period of intense dreaming to allow our sleep rhythm to reset itself. My suggestion is to befriend this process. A first step is to understand that even our most frightening nightmares are trying to help us by balancing our emotional state and taking the charge out of challenging past and current life situations. We can work with them, not against them. More on this later.

 

Substance Use and REM Rebound

The most common cause of REM rebound is sleep deprivation, especially very early awakening that cuts off the second half of our sleep. REM rebound also happens when a person stops taking a substance that suppresses REM sleep. These include many commonly-used substances like antidepressants, alcohol, cannabis and benzodiazepines. Paradoxically, many of these substances are used to promote sleep – and while they can help you fall asleep, they disrupt normal sleep architecture, ultimately making the situation worse. (Newer sleep aids like zolpidem do not cause this problem.)

Sleep is critical to our emotional and physical health. Insufficient or poor-quality sleep is associated with poor emotional regulation, diminished ability to consolidate memory, a higher risk of psychiatric illnesses (depression, anxiety, PTSD), obesity, heart disease and stroke as well as increased risk of workplace and vehicle accidents. Clearly, getting a good night’s sleep is critical to all aspects of our health. Getting sufficient REM is intrinsic to this process.

The best way to overcome REM rebound is simple, yet it can also be a challenge for those with chronic difficulty sleeping well. You simply need to get enough good-quality sleep to make up the REM that your body requires. There are plenty of resources available on good sleep hygiene: things like a calming bedtime routine, limiting screen time, caffeine and alcohol before bed, and getting enough exercise are well documented and can help.

However, for some people, the intensely disturbing flood of dream imagery following the cessation of substance use can make it tempting to go back to taking the antidepressant medication or addictive substance they want to stop using. For those in this category, part of the answer is to befriend your dreams, especially those that have returned with great intensity following a period of silence. If you have intense, frequent and disturbing nightmares during the REM rebound period, making friends with these dreams may seem like an impossible task, but it’s not. Few people realize that nightmares are both treatable, and in many ways, also helpful in the emotional recovery process.

 

Changing Your Relationship With Your Dreams

Dreams and nightmares have been shown to temper emotional intensity. Studies suggest that when we dream about a disturbing scenario, we generally feel better about it than we did before. The big problem with nightmares is that they can be so intense, they wake the dreamer up, so they disrupt sleep rather than helping. A simple solution is to imagine the dream forward; just let it continue from where it left off until you get to a place that feels like more of a resolution. It doesn’t even have to be a triumphant solution, just one that carries the dream forward.

In my experience, this simple process can effectively stop or change a nightmare immediately. It can also take a few tries, and in some cases might require professional help. If you have PTSD or a history of trauma, a professional trained in working with nightmares can make the difference. There are many studies on a version of this method called Imagery Rehearsal Therapy (IRT) that show it often helps, and when it doesn’t, it causes no adverse effects. In other words, it’s worth a try.

In general, getting to know more about your dream world and what it’s trying to tell you will set you up for a more positive relationship with your dreams. I have written extensively about this, and will post a list of resources in the references below. My main message, having worked for decades with the dreams of those recovering from trauma and addiction, is that your dreams are trying to help you, not hurt you. Dream lovers welcome the flood of nocturnal images that characterize a REM rebound. If you are someone who has stopped the use of a REM-suppressant substance, for whatever reason, be prepared for the dreams that will come to you, and find a way to welcome them. Also know that the condition is temporary and if you can stay the course, your normal sleep rhythm will return.

 

Dr. Leslie Ellis is the author of A Clinician’s Guide to Dream Therapy, and an expert in dreamwork and nightmare treatment. Her web site (www.drleslieellis.com) contains many resources about how to work with dreams and nightmares.

 

Resources:

There Are No Bad Dreams – a Ted-like talk about nightmares.

Nightmare relief, free PDF: What you can do about nightmares

For clinicians: A Short Focused Course on Nightmare Treatment

Live Oct. 13 (and recorded) Live workshop on Nightmares and the Nervous System

Blog post: Whether and how to work with traumatic nightmares

Blog post: Whether and how to work with traumatic nightmares

 

Selected references for this article:

Ellis, L. (2019). A clinician’s guide to dream therapy: Implementing simple and effective dreamwork. New York: Routledge.

Feriante J, Singh S. (2020). REM Rebound Effect. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560713/

Krakow, B. and Zadra, A. (2006). Clinical management of chronic nightmares: Imagery Rehearsal Therapy. Behavioural Sleep Medicine, 4(1), 45-70.