For some, nightmares are like short scary films: their images startle but the effects last no more than a few minutes upon waking. For others, however, these dreams are regular terrors, causing frequent agony and transforming the act of sleep into something that should be feared. Particularly for those suffering from some form of post-traumatic stress disorder (PTSD), bad dreams are full of images and impressions they’ve spent their daytime lives trying to forget.
Recurring nightmares may seem inescapable, but not all is lost. Tools and tricks are available to ward off bad dreams — and even eradicate those that have plagued sufferers for years. One of the most common tactics is referred to as a nightmare script. A psychological cheat sheet of sorts, nightmare scripts enable people to rewrite their nocturnal narratives in such a way that they cease to cause fear. Using the technique, what once terrified can be transformed into a garden-variety reverie of the dreamer’s own choosing.
The technique, also called scripting or dream mastery, is a type of image rehearsal therapy implemented when subjects are awake. It was developed in the early 2000’s by a team headed up by leading nightmare researcher Dr. Barry Krakow, founder of the PTSD Sleep Clinic at the Maimonides Sleep Arts and Sciences Center. A typical scripting session practiced by sleep specialists typically includes four sessions of group treatment and between one and ten individual sessions, though three and five sessions are usually effective. It is mostly used for those whose nightmares are born of trauma and studies show that 70 to 80 percent of nightmare sufferers who try it get significant relief.
Here’s how it works: A doctor will ask patients to imagine the nightmare in question and then alter a terrifying aspect of it. For instance, a patient reliving a battlefield scenario could imagine that soldiers are holding candy canes instead of guns. Or imagine that the soldiers are the size of fleas.
“I teach nightmare sufferers to take a nightmare and then change it any way they wish so that it is either neutral or positive and not scary anymore,” says Dr. Shelby Harris, director of the Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center at Montefiore Medical Center in New York. Harris’ patients can change a tiny bit or the entire nightmare. “I then have them picture the changed dream—not the nightmare—in their mind's eye for five minutes daily.”
If the sufferer doesn’t have a particular outcome in mind, a psychologist can make suggestions, like shrinking the dream attacker to the size of an insect, or replacing fire with bubbles. Other options include being rescued or rescuing themselves.
Put simply, a nightmare is a bad dream that brings out strong feelings of fear, terror, distress, or anxiety. They can be just one way our brain has of dealing with the stresses and fears of everyday life. One or more terrifying dreams over a short period of time may be caused by a major life event, such as the loss of a loved one or a traumatic event, or increased stress at home or work. But recurrent nightmares could be a sign of a breathing disorder in sleep (sleep apnea), PTSD, or more severe anxiety disorders or depression.
“For PTSD suffered, nightmares are dream reenactments of trauma,” says Dr. Deirdre Barrett, a psychologist at Harvard Medical School and an expert on the connection between trauma and nightmares. “They go a little bit further than simple nightmares. They seem like waking life, but are distorted in some way.” In such dreams, sufferers are experiencing real, traumatic events over and over. And these experiences are not just happening during the REM stage when most of us dream. “It happens at any stage of sleep,” she says.
“They are pretty much the same as waking flashbacks,” Barrett adds, saying that psychoanalyzing such awful encounters is futile. “There’s no point in interpreting the meaning behind a dream about rape or a fire.”
The scripts one chooses can be magical or realistic, consist of small or large changes. And regardless of the specifics, the process works to vanquish the nightmares. The likely reason is because the strong intent of the waking mind to reimagine the dream is remembered by the dreaming mind. Researchers, however, aren’t certain.
“We do know that it creates changes in the brain when someone practices imagery rehearsal with focused mental practice, but the actual mechanism of action is still unknown,” says Harris.
But they are sure of its efficacy: Though few of those who use this technique actually report having the specific dream they imagined while awake, they still see dramatic improvement in the form of fewer or no more nightmares. For PTSD sufferers, the results even transcend alleviating nightmares: daytime terrors stop, as well.
“In dreams, the nervous system is active,” says Barrett. “For PTSD sufferers, the nightmares re-entrench the traumatic events over and over. Every night it’s like they’re in battle physiologically. It reinforces and refreshes the experience.
“The mastery dream has the opposite effect,” says Barrett. “Sufferers have fewer daytime symptoms like flashbacks.”
While therapy sessions are often for those suffering from nightmares the root of which lies in deep psychological scarring, the process can be implemented by anyone plagued by bad dreams.
Plagued by nightmares? Try it yourself: At some point during the day, re-imagine your nightmare, then visualize it changing to something benign or silly. Are you constantly chased by a faceless man with a machete? During the day, visualize him holding a dripping ice cream cone. (It’s similar to what this hero did by editing garlic bread into “The Force Awakens”. Kind of takes the teeth away, right?)
Set aside a few minutes each day to imagine the altered version of the nightmare. Repeat the exercise again before falling asleep. It’s such a simple process, but its effects effects should take hold within a few nights.