Guided visualisation helps reduce nightmares

As children, we all probably experienced what we would call nightmares at some point, perhaps about the boogie man or some other monster that lived under our bed or in the closet.

When I was a child, I often had bad dreams and I found myself in bed at night repeating to myself in my head the mantra “I’m going to have a dream”. Now as a qualified hypnotherapist, I can see that what I was doing was very solution focused and I was in fact performing self-hypnosis! By focusing on what I wanted, rather than what I didn’t want, meant that I didn’t get anxious about going to bed and having bad dreams and so found it easier to get off to sleep, but it also seemed to reduce the frequency of them.

Now these nightmares that we experience as children are different to those experienced by someone who has been through a trauma such as war veterans or rape victims, but either way the same techniques can be used to help change how these bad dreams affect us in our waking life and also reduce the severity and frequency of them.

We make use of the REM (Rapid Eye Movement) stage of sleep, where we commonly have dreams and/or nightmares, to process our day and other unresolved issues. "We take our problems to sleep and we work through them during the night," says Rosalind Cartwright, Professor of Neuroscience at Rush University Medical Center. Our worries and concerns are processed and moved from the primitive part of the brain, where they are an emotional memory, to the intellectual part of the brain where they become a narrative memory. What this means is that the emotion has been stripped from the memory and you have a better control over it – you can think about it when you want to rather than it randomly popping up in your head when you don’t want it to. You can still recall that it wasn’t a pleasant experience but it no longer triggers the same emotional response as it once did and you are able to rationalise what happened.

But nightmares interrupt this process. Often, nightmares will wake us up before the emotion or issue is resolved, so it remains in the primitive part of the brain and causes the nightmare to repeat again in the future, which may explain why we have recurring dreams.

When we have a high level of stress hormones in the brain, the hippocampus, which is responsible for memories among other things, cannot perform its job as well as it should and cannot process the memories and unresolved issues effectively, causing nightmares and also flashbacks in those who have suffered a trauma. Because these memories and other issues have not been processed properly, they do not go away and continue to be a source of anxiety and stress. Guided visualisation not only helps to reframe these nightmares and flashbacks but helps to reduce your anxiety and stress levels and gets the brain producing serotonin more effectively boosting your mood. Once your anxiety and stress levels have been reduced, the brain can start to process the memories and the flashbacks and nightmares will disappear.

Dr Shelby Freedman Harris, director of the Behavioral Sleep Medicine Program at Montefiore Medical Center uses guided visualisation with her patients to assist with their debilitating nightmares. Patients use guided visualisation to transform their nightmare into a more positive context and have it become a different dream. By training the mind during the day using guided visualisation, the nightmare becomes less debilitating for them.

One of Dr. Harris’ patients had recurring nightmares of being surrounded by sharks and she reframed the nightmare by imagining they were dolphins instead. Another patient who had nightmares of being chased reframed the pursuer into chocolate and ate him. The latter example just shows that what you visualise doesn’t have to be in the realms of reality – be creative; making it as entertaining and funny as you like.

We can often feel out of control when suffering from regular nightmares, but using this technique helps give you control over your nightmares rather than them having control over you.

A similar guided visualisation was used in a study of 168 women who had been the victims of rape and were experiencing recurring nightmares.(1) The study showed that the women who had used guided visualisation, or Imagery-Rehearsal Therapy (IMR), to reframe their nightmares, had fewer nightmares and of less intensity compared to the control group. The study concluded that “Imagery Rehearsal Therapy is a brief, well-tolerated treatment that appears to decrease chronic nightmares, improve sleep quality, and decrease PTSD symptom severity.”

Guided Visualisation has also been successfully used with children with night terrors and war veterans from Iraq and Afghanistan, to help reduce nightmares.

I use guided visualisation with my hypnotherapy clients to reduce their stress and anxiety levels, help them to focus on how they want things to be, and help put them back in control of their thoughts, feelings and behaviours.

REM sleep, the stage of sleep in which we commonly dream, has been found to help ease painful memories and you can read more about this in a previous blog post – REM Sleep Helps Process Negative Thoughts and Memories

Find out more about how hypnotherapy can help with Insomnia

References:

(1) Krakow B, Hollifield M, Johnston L, et al. Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder a randomized controlled trial. JAMA. 2001;286(5):537-545.