Abstract Index Conference Index

ABSTRACT

Type: Paper (introduction) 25-30 minutes

Title: The Nightmare: A part of normal healing, a symptom of another conditions, or a condition requiring treatment.

Author: Ernest Hartmann MD

Summary: This paper will define a nightmare, differentiate it from Night Terror and other phenomena. Often a NM is not a condition requiring treatment. There are times when the NM may be a normal part of a reaction to stress and trauma and part of normal healing. At other times the NM can be a symptom, for instance of a developing psychosis, or of a reaction to certain medications; in these situations treatment i s needed but not for the NM as such.

Learning: 1) Learn the definition of a NM and related phenomena.
2)Learn about multiple causes for NMs.
3) Learn when a NM requires treatment.

ABSTRACT:

A NM is usually defined as a dream which awakens the sleeper.
The definition has problems, but s generally accepted.

The NM can be differentiated from the Night Terror, and usually can be distinguished from other phenomena such as Hypnagogic Hallucinations.

The NM cannot be differentiated from a dream. The NM is a dream. There is no clear dividing line between a dream, a frightening dream, and a NM.

NMs are common, in adults and especially in children. Discuss data.

A NM can be considered a normal part of child development at ages 4-6.

Likewise the NM is normal in adults who have just experienced trauma or great stress. Discuss the progression of dreams after trauma. Perhaps functional, "healing."

The NM is especially common in persons with "thin boundaries." Discuss the personality dimension related to boundaries.

IN all the above situations the NM can be considered normal.

At other times NMs can be a symptom of another condition which may require treatment. For instance a young college student complains of increasing NMs, then insomnia, then withdraws from people, becoming suspicious of them. Here NMs may be an early symptom of a psychosis.

A middle-aged man with some heart disease, hypertension, etc., suddenly develops severe NMs, disturbing him every night. Usually this can be traced to having recently started a new medication, for instance a beta-blocker for hypertension.

IN these situations treatment is needed, but not treatment for the NM per se.

All these things need to be considered before one assumes that a person complaining of NMs requires treatment aimed at the NMs.

All the above situations involve NMs as normal phenomena