Trauma-Related Nightmares
Many people who have experienced trauma struggle with recurring nightmares about the event(s). During a nightmare, the same horrifying storyline repeats itself over and over, and the dreamer is awakened suddenly. These nighttime occurrences can last for years and even decades after the traumatic event(s). Because of the intense and terrible emotion you experience during a nightmare—fear, horror, shame, disgust, grief, rage—people with nightmares often fear going to sleep, and avoid sleep, or may try avoiding reminders of the nightmare during the day, pushing it out of their mind if it’s triggered. While these responses are completely understandable, they unfortunately tend to increase the likelihood of having future nightmares... Because both anxiety and sleep deprivation actually increase the chance of having more nightmares, a self-fulfilling prophecy unfolds and the cycle continues. A person has more nightmares, fears nightmares even more, avoids sleep, and ends up having more nightmares, and on and on.
If you struggle with trauma-related nightmares, relief is possible.
Treating PTSD nightmares can also support trauma healing
Not only is it possible to treat trauma-related nightmares, but treating nightmares may also accelerate the trauma healing process itself. This is consistent with research suggesting that dreams help us process emotional experiences we have during the day, storing those experiences as representations in our long-term memory and reducing the emotional intensity associated with our past experiences.
The problem with a trauma-related nightmare is that the processing gets interrupted too early because of the intensity of the emotions experienced in the dream. The dreamer essentially wakes up before the “story” can be resolved to reveal an important truth—that whatever horror was experienced is over now and you did get through it.
This may be part of why traumatic memories feel as intense as the traumatic event itself— because interruptions in trauma-memory processing (like waking up from a nightmare) do not allow memories of the trauma to be stored like memories of other events in life.
Evidence-based treatment, such as Exposure, Relaxation, and Rescription Therapy (ERRT) can help reduce the intensity and frequency of trauma-related nightmares (see below for info about ERRT).
Exposure, Relaxation, and Rescription Therapy (ERRT) for Trauma-Related Nightmares
If you struggle with recurring nightmares about a traumatic experience, Exposure-Relaxation and Rescripting Therapy (ERRT) can help. ERRT is a brief evidence-based intervention to reduce the frequency and intensity of trauma-related nightmares. This treatment can be used as a stand-alone treatment or as an adjunctive intervention.
ERRT is a therapy that involves practicing specific techniques to modify the narrative of your nightmare storyline in such a way that the dream itself changes, allowing the emotional experience associated with the dream to change, and resolution to occur. ERRT has been found to reduce the frequency of having nightmares, and has also been shown to reduce the emotional intensity of nightmares, as well.
The length of ERRT can vary. ERRT is usually ten sessions (45 minutes) or five sessions (90 minutes). This therapy involves daily/nightly practice assignments between sessions.