Coping with Nightmares

Therapy can help reduce the frequency and intensity of nightmares in the long term as the source of the fear is processed and resolved. Unfortunately there may be times during treatment when nightmares actually worsen temporarily in response to old memories or feelings being stirred up.

Your nightmares may, in fact, provide important information about your past or how you experience the world. Consider writing down the details of your dream and sharing them with your therapist, if that feels safe to you.

Our goal here, though, is to help you effectively manage your nightmares so that you can recover more easily. We want to do this through two sets of strategies. The first is to reorient yourself when you wake up so that you feel grounded in the present. Second, we want to work on self-soothing behaviors that can reduce your fear in the moment.

If you have a partner or someone who sleeps with you frequently, involve them in this process. They may have helpful suggestions.

Try to imagine yourself using the below reorienting strategies:

  • Have a nightlight or flashlight by your bed so that you do not wake up in darkness.

  • Keep a bowl of water or damp paper towel by your bed so you can cool your face and focus your attention on that sensation.

  • Have a glass of water by your bed, again for cooling and to direct your attention to the sensation.

  • List your current address, telephone number, the current year, season, day of the week if you can recall it - any factual pieces of information that can connect you to the present.

  • Sit on the edge of the bed and direct your attention to the feeling of your feet against the floor. Notice how the floor supports you in this moment.

  • Walk over to a window and name every object you see.

  • Use each of your five senses, one at a time, to check in with yourself and your environment.

Not every strategy will be the best fit for you and that's ok. You only need one or two that fit your personal needs.

Now try to imagine using the below self-soothing strategies:

  • Have a soft blanket on your couch that you wrap around yourself or a pillow you can hug.

  • Use soothing scents in the form of essential oils, candles, or lotions.

  • Create an album on your phone of photographs that are meaningful or silly.

  • Create a music playlist, again it could be meaningful or silly depending on your preference.

  • Picture a box in your mind and put the nightmare in it. Lock it up, put it somewhere safe, and know you do not have to come back to it until you are with someone you trust and can then deal with what is inside.

  • Listen to a guided mindfulness recording, such as a progressive muscle relaxation or breathing exercise to relieve tension.

After you reviewing the re-orienting and soothing strategies, write down a few you will experiment with.

Picture yourself waking up from a nightmare. What will you need to have on hand? What can you prepare right now so that you have the best chance of feeling better after having a nightmare? Make that playlist, put that glass on your nightstand so you remember to fill it at night.

As often as you like during the day, imagine yourself waking up from a nightmare and effectively coping. Rehearsing this will make your coping second nature and give you a sense of control. You may not be able to change your past or the stressors currently impacting you. You can, though, find empowerment through decisively taking steps to help yourself moving forward.

If you have not already, check out my post about improving sleep quality to learn about ways to relax and reduce your anxiety before bed.

Feel free to reach out so we can further discuss ways to cope with your nightmares.