COMMON QUESTIONS ABOUT NIGHTMARES
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What is a nightmare?
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A nightmare is a very distressing dream which usually forces at least partial
awakening. The dreamer may feel any number of disturbing emotions in a
nightmare, such as anger, guilt, sadness or depression, but the most common
feelings are fear and anxiety. Nightmare themes may vary widely from person
to person and from time to time for any one person. Probably the most common
theme is being chased. Adults are commonly chased by an unknown male figure
whereas children are commonly chased by an animal or some fantasy figure.
Who has nightmares?
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Just about everyone has them at one time or another. The majority of children
have nightmares between the ages of three or four and seven or eight. These
nightmares appear to be a part of normal development, and do not generally
signal unusual problems. Nightmares are less common in adults, though studies
have shown that they too may have nightmares from time to time. About 5-lO%
have nightmares once a month or more frequently.
What causes nightmares?
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There are a number of possibilities. Some nightmares can be caused by certain
drugs or medications, or by rapid withdrawal from them, or by physical
conditions such as illness and fever. The nightmares of early childhood
likely reflect the struggle to learn to deal with normal childhood fears
and problems. Many people experience nightmares after they have suffered
a traumatic event, such as surgery, the loss of a loved one, an assault
or a severe accident. The nightmares of combat veterans fall into this
category. The content of these nightmares is typically directly related
to the traumatic event and the nightmares often occur over and over. Other
people experience nightmares when they are undergoing stress in their waking
lives, such as difficulty or change on the job or with a loved one, moving,
pregnancy, financial concerns, etc. Finally, some people experience frequent
nightmares that seem unrelated to their waking lives. These people tend
to be more creative, sensitive, trusting and emotional than average.
What can be done about nightmares?
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It really depends on the source of the nightmare. To rule out drugs, medications
or illness as a cause, discussion with a physician is recommended. It is
useful to encourage young children to discuss their nightmares with their
parents or other adults, but they generally do not need treatment. If a
child is suffering from recurrent or very disturbing nightmares, the aid
of a therapist may be required. The therapist may have the child draw the
nightmare, talk with the frightening characters, or fantasize changes in
the nightmare, in order help the child feel safer and less frightened .
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The nightmares which repeat a traumatic event reflect a normal psychic
healing process, and will diminish in frequency and intensity if recovery
is progressing. If after several weeks no change is noted, consultation
with a therapist is advisable.
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Adults' nightmares offer the same opportunity as other dreams for self-exploration
and understanding. With practice, the dreamer can often learn to decode
the visual and symbolic language of the dream and to see relationships
between the dream and waking life. The nightmare by nature is distressing,
however, and the dreamer may need to reduce the distress before looking
more closely at the meaning of the dream. Some techniques for reducing
the distress of the nightmare include writing it down, drawing or painting
it, talking in fantasy to the characters, imaging a more pleasant ending,
or simply reciting it over several times. The more relaxed the dreamer
can be while using these techniques the better. A number of good books
are available for learning how to understand dreams. Alternately, the dreamer
may wish to ask a therapist for assistance.
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Sometimes nightmares are related to intense stress or emotional conflict
that is best dealt with in consultation with a therapist. One should not
hesitate to consult a therapist when in doubt.
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It may be surprising to learn that many people are not really disturbed
by their nightmares, even though the experiences themselves are distressing.
Research has shown that about half of people who have quite frequent nightmares
regard them as fascinating and creative acts of their minds, and either
view them as very interesting or dismiss them as "just dreams". This illustrates
the fact that one's attitude toward nightmares is quite important.
What about night terrors?
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Night terrors are something quite different. Nightmares tend to occur after
several hours of sleep, screaming or moving about is very uncommon, the
dream is usually elaborate and intense, and the dreamer realizes soon after
wakening that he or she has had a dream. Night terrors, on the other hand,
occur during the first hour or two of sleep, loud screaming and thrashing
about are common, the sleeper is hard to awaken and usually remembers no
more than an overwhelming feeling or a single scene, if anything. Nightmares
and night terrors arise from different physiological stages of sleep. Children
who have night terrors also may have a tendency to sleepwalk and/or urinate
in bed. The causes of night terrors are not well understood. Children usually
stop having them by puberty. They may be associated with stress in adults.
A consultation with a physician may be useful if the night terrors are
frequent or especially disturbing.
Copyright 1991 Association for the Study of Dreams
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