Betty W. Phillips, Ph.D., Psychology
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Dreams and Nightmares; Changing Unwanted Dreams, Parts I and II



DREAMS AND NIGHTMARES


Last month's column dealt with the importance of healthy sleep, and this column will bring you additional information about a vital component of sleep: dreams. While there is more to learn about the function of dreams, it is thought that dreams are important to physical and mental health. Almost everyone dreams in "REM" sleep, although the dreamer may not remember the dreams. Dreams occur with specific brain waves and images/thoughts different from the normal waking state, so the dream state is usually thought of as a product of the "subconscious" mind. Images from the present and past are combined in ways experienced as illogical, and the dreamer is usually unable to move so that the dreams are not converted to motion. As described in my articles on sleep, the conscious mind needs to be "turned off" for sleep and dreams to occur.

While children experience short dream states, adult-type dreaming does not begin to occur until 11-13 years of age. Dreamers usually dream four to six times per night in REM sleep and dreams may also occur during non-REM sleep in the morning prior to awakening. Studies of dreams show several parts of the brain are involved in dreams, the limbic brain/amygdala which controls the vigilance/fear system and cortical brain areas related to visual association to produce imagery.

Some dream books suggest that dreams may be prophetic. Little research supports pure prophecy aside from the dreams which are formed from an individual's speculation during waking states about future events. Other books supply you with lists of dream symbols which often have little research backing. Dreams tend to be idiosyncratic or individual. Most dream "cookbooks" are not useful aside from the fact that some types of dreams contain common cultural or linguistic symbols. For example, dreams about fly or falling occur with some frequency, with flying high usually reflecting positive content and falling down usually reflecting negative content. In order to ascertain the "meaning" of your dreams, you will need to associate to the prominent elements in the dream to try to find what they symbolize or represent to you.

Some theorists speculate that dreams have a problem-solving function, although there is little research support for this theory. In my opinion, problem-solving is mostly a logical and rational function best performed by the conscious mind. Some people believe that dreams provide access to creativity. While this is sometimes true, creative imagery can also be accessed during meditative states of the conscious mind (theta brain waves), and dreams produce creative solutions much less frequently than these meditative states.

Dreams do have value in reflecting unsolved individual preoccupations or problems. Studies of dreamers demonstrate that dreams often do have repetitive themes which are individually generated. Probably related to the origin of dreams in the lower brain, the feeling tone of many dreams is negative, often reflecting emotional preoccupations and unsolved problems. The dreams unfold as dramas in which the dreamer acts out various scenarios often revolving around repeated basic personal issues. Some dream content is obvious, other parts of the dream are symbolic or metaphorical, while some components of the dream appear randomly related to present or past experiences. Past experiences reflected in dreams sometimes express current conflicts with similar emotions and dynamics. Repetitive dreams, then, may reflect unsolved personal issues which could profitably become a focus for problem solving during the waking state with or without a therapist or life coach.

Recurrent bad dreams, nightmares or trauma nightmares are usually extremely stressful to the dreamer and disrupt quality sleep. While general mental health therapy is helpful in working through issues related to specific dreams, individually designed therapy for a sleep or nightmare disorder is usually indicated. Dreamers find that, even after trauma symptoms subside, the nightmare may take on a "life of its own" and/or may recur after a new life stress. Most of these distressing dreams originate in life problems or traumatic events, although some individuals prone to bad dreams are temperamentally hypersensitive to ordinary life stresses, producing these negative dreams.

Research has shown that relaxation and imagery techniques can be used to help the individual develop new skills which can then be used to change negative dream themes. The individual learns relaxation and positive imagery skills, then learns to re-script the distressing dream into a positive scenario and practices the new dream until it begins to replace the nightmare. These techniques can also be used to change dreams which are unacceptable but not traumatic, such as anxiety dreams about losing a purse, being unprepared for exams or appearing unclothed in public.


DREAM THERAPY: CHANGING UNWANTED DREAMS AND NIGHTMARES

Last month's article discussed the psychology of dreams, and this article will provide information about techniques to change distressing dreams into more tolerable or even positive dreams. The article will overview techniques to change nightmares and trauma dreams as well ordinary stress dreams. Additional information available on the web site will discuss how these techniques can be used with children.

Psychotherapy is useful in dealing with life problems which cause nightmares and in fact is essential in dealing with stress disorders engendered by life-threatening trauma. However, nightmares may continue as a learned habit even after therapy has dealt with the life problems. Repetitive nightmares can re-traumatize the dreamer and even cause a sleep disorder characterized by poor quality sleep and hyper-arousal which can persist during the waking state. In this case, specific dream therapy techniques are useful.

Individuals with nightmare disorders are often fatalistic about the possibility of change, but research results confer hope and a positive expectation that change is possible. Even if the distressed dreamer begins this process with skepticism, progress in learning relaxation and positive imagery skills provides an incentive to continue. The technique involves learning skills to change the dream from disturbing to positive. This appears counterintuitive, since most people want to avoid the content of the bad dream by "counting sheep" or some other distraction based technique. This, however, is very difficult because bad dreams are usually very vivid and hard to dispel.

Changing nightmares and trauma dreams includes learning and practicing new skills. Essential to the process is learning to relax. Various techniques, tapes, music and supplements are available to promote relaxation. The hemi-sync tapes or CDs described in the last articles can be very useful in learning relaxation. Medication can provide assistance in difficult cases and then can be phased out as new skills are learned.

The next step is learning methods to inhibit intrusive negative imagery and promote positive imagery. Frightening images and thoughts can be opposed with simple "stop" techniques or strategies for "grounding" in the present. After these techniques are learned and practiced they can be used to counter the negative images from trauma dreams. Positive imagery techniques include developing and practicing thoughts/images of "special places" which are beautiful, safe and comfortable.

After the individual practices these imagery skills, ideally daily for short periods of time, the next step is learning to change dream scenarios into more positive and productive dramas. The individual is encouraged to change the dream story in any way that seems right to them, starting with practice on their less intense bad dreams. After success with these dreams the individual will be able to apply this new skill to nightmare or trauma dreams. Practice during the day is also necessary to learn the skills involved in re-scripting dreams. The middle and end of the dream should be changed to make it more positive or acceptable. Because bad dreams are repetitive it is best to write down the new dream script and practice it for short periods of time daily so it becomes a learned habit stronger than the old dream. The new favorable outcome can be reality or fantasy based. For example, if the dream is of a tornado, the new dream could be that the weatherman announces there are no tornadoes in the area and the dreamer looks outside to see the sun shining. A fantasy response could be that the dreamer becomes a superperson who fights the tornado and flings it back into the sky while crowds cheer.

A similar technique can be used for mildly unpleasant or uncomfortable dreams without having to spend as much time learning relaxation and imagery skills. Pick a positive ending to a disturbing dream, write it down and then practice the new ending while you are awake. For example: a dream of losing a purse. Women will identify with the fear of losing their keys, money and credit cards. The dream can be re-scripted to the ending that the purse was not lost but just put behind the chair. The dreamer should then find the purse behind the chair, happy that it's not lost. Usually the dream will switch automatically to the new script if the new ending has been practiced. If not, the dreamer should program her mind to wake up and consciously switch the dream to the new ending, allowing her to fall back into more peaceful sleep.


CHANGING DREAMS, PART II: CHILDREN AND ADULTS

This article contains supplementary information to the previous article on dream therapy. Readers have requested information as to how to apply this technique with children. Other readers have requested additional information about learning relaxation and imagery skills.

This technique is very useful for children, since children usually enjoy positive fantasy. Children who are sensitive, anxious or have experienced trauma often have trouble sleeping and sometimes experience nightmares. Teaching children relaxation and positive imagery will be helpful to their overall personality development in addition to helping with nighttime disturbances. Special tapes or CDs have been created for children to help them relax and enter into positive imagery states. The tapes and/or CDs are available in both regular and hemi-sync formats.

Parents can help their own children learn these techniques or they can request the assistance of a therapist. To begin, the parent or therapist should tell the child about this special power to change bad dreams, explaining that everyone can learn to do this. It's best to teach this skill during the daytime, making a game with the child and thinking up dreams to change. Explain that the child can learn to stop a bad dream and "switch" the bad dream to a good dream. Explain that every dream has a story in it and that children can learn to change the story anyway they want. It's best to help the children imagine the new dream story in specific colors to help immerse them in the fantasy. For example, most children usually dream about monsters. You could start by asking the child to imagine that big monster, saying, "What does the monster look like? How big? What color? Red eyes? Big teeth?" Then ask the child to imagine shrinking the monster with this special mind power so that the monster shrinks down to a spot on the floor. The child will usually want to step on the monster spot. A funny outcome would be to change the monster to a chicken, then you can demonstrate how the chicken would run around the room clucking and flapping its wings. (One child was enchanted with this outcome and promptly sent the monster-turned-chicken to Kentucky Fried Chicken.) Another favorite outcome is that the child becomes a superperson able to fight the monster or throw it over the mountain. Ask the child to pick the colors of the superperson cape and suit.

After the child picks his or her favorite outcome for the new dream, it is helpful to reinforce the new dream story by drawing or role-playing. You should encourage the child to draw the new dream in as much color and detail as possible. Then you can role play the new dream story with the child so the child practices switching to the new dream ending. Explain that after you have practice the new dream during the daytime, the bad dream may automatically switch to the new dream at night. However, if the new dream does not start automatically, tell the child to wake up during the night and "switch" the bad dream to the new good dream. If these steps don't work, tell your child to call you to come to the child's bedroom to help make the switch and talk the child through the new dream. Often children can then be left in their bedrooms without having to actually seek solace into the parent bed. The American Psychological Association Magination Press (www.maginationpress.com) sells a childrens book about the process entitled Jessica and the Wolf.

The rest of this article provides additional information to adults suffering from bad dreams and nightmares who wish to learn this new technique but have experienced some difficulty with the process. People who suffer from nightmares often have difficulty learning to relax because they experience chronic stress and tension both in their bodies and in their mind states. As background, it is helpful to know that the relaxation response is mediated by the parasympathetic nervous system which helps the body calm down and let go of tension. The sympathetic nervous system is the mechanism which regulates our activating and stress response system. The sympathetic nervous system prepares our body for "fight or flight" to deal with the dangers in our environment. Since modern-day man is not confronted by a tiger at the cave door, the fight or flight response is rarely useful. Your heart rate, breathing rate muscle tension, metabolism and blood pressure all increase quickly to enable you to respond to an external threat. Individuals experiencing chronic stress often suffer from prolonged activation of this response. Therefore, any interventions to break this cycle and increase the relaxation response will be helpful in decreasing physical and mental stress. Changes in breathing, release of muscle tension and increase in positive imagery will induce relaxation and short-circuit the stress response. Therefore, learning slow abdominal breathing is one approach to promoting relaxation. Methods to learn to release muscle tension and feel like a "rag doll" will also facilitate the body slowing down and relaxing. Often these methods are combined with positive imagery techniques as a multimodal way to inhibit the stress response. You can learn to practice diaphragm or abdominal breathing sitting or lying down, slowly counting with each deep breath, perhaps stopping at the top of the breath to help decelerate the heart rate. Thoughts are usually of feeling peace, warm, safe and heavy, often repeated as a mantra while breathing slowly and deeply and relaxing tight areas of the body. Peaceful music often promotes relaxation. Special tapes or CDs are available to teach or promote these relaxation responses.

Since nightmares consist of negative imagery, learning positive imagery is an important skill to promote relaxation and second to counter the effects of the negative dream images. It is often helpful to construct an image of a special place or places where you feel happy and safe. The special place can be anywhere as long as it is private, secure, comfortable and peaceful for you. A special place may often be the beach, but can be any beautiful outdoor environment or a cozy room. Involve all of your senses in your imagination: sight, hearing, smell, touch and taste. For example, see a green forest with bright blue sky and white clouds, hear the sounds of wind in the trees and bird calls, smell the pine needles, touch the warm grass, drink from a mountain spring. Use positive affirmations such as, "I can relax anytime I want. I am in harmony with life. All the tension is flowing from my body. Peace is within me." Practice these positive images several times a day, including at night while lying in bed. If you're having difficulty visualizing or concentrating on these positive images, you can write a script and record your journey to your special place on the tape, then play the tape to reinforce your imagery. Background music is a positive addition to the tape. Some people like to add an "inner guide" to the positive imagery as an imaginary person or animal to clarify and instruct you in your journey through your special place.

Some people find it difficult to manage intrusive or recurrent negative images which get in the way of relaxation and positive imagination. There are several techniques which can be helpful in managing unpleasant images. A simple "stop" response may inhibit and interfere with a negative thought or feeling. Say "stop" to yourself, visualize a big red stop sign and notice that the negative image is gone. You can use a "breathing response," breathing in and exhaling the image away. "Grounding" is a very useful response to rid yourself of fearful images. Grounding involves immersing yourself in the sensory details of your current environment, opening your eyes, noting in detail what you see, feet on floor, feeling your chair and floor and realizing that you are safe in your present environment. "Choosing" can be used as when you simply acknowledge the presence of a negative image, then choose to shift to a preferred positive image. "Recording" can be used to write down negative images, then close them up in a book and put them away.

This process of imagery reversal can be used for all kinds of dreams, even those which are poorly remembered or changing. Even if only a small part of a nightmare is remembered, this can be enough to script a new positive dream. If you suffer from multiple and changing nightmares, you can often construct a positive dream ending which can be practiced and used to change many different bad dreams. Although you may find it unpleasant to consider nightmares, they only have to be recalled once to change the script. When the new positive dream is practiced, the old nightmare scene does not have to be remembered.

I hope that this article has provided enough information for you to begin the process of changing your nightmares or those of your children. Therapists may have experience in assisting clients in learning these new skills, and I of course am available to consult with you and to help you learn these dream therapy techniques.