Rewrite the script of his nightmares

Having anxiety-provoking dreams regularly, once a week for several months, is not trivial. If this has consequences on your daily life, it is a pathology that can be treated very well.

Nightmares, everyone has had them at one time or another. It is not so severe, except when it becomes pathological. Sleep specialists consider it a disease when it occurs at least once a week for more than 6 months, with an impact on quality of life.

“Nightmare sickness” is considered a sleep disorder by the International Classification of Sleep Disorders (ICSD-3) (1) and a disorder likely to cause distress and impairment of daily functioning by the Diagnostic and Statistical Manual mental disorders, from the American Psychiatric Association (DSM-5).

Negative emotions are not metabolized

The "nightmare" wakes up after a long sequence of complicated and highly anxiety-provoking or terrifying dreams. The scenario depicts an imminent physical or psychological danger (the subject is pursued, attacked, he is going to die…) which can, in certain cases, be linked to a trauma or to a very painful life event that causes suffering. “One of the functions of sleep is to metabolize negative emotions during dreaming.

When these sensations are too strong, it does not work and the alarm clock interrupts the “digestion” in progress. However, we would have to go to the end of the nightmare to digest it and not repeat it, ”explains Isabelle Arnulf, head of the sleep pathologies department at the Pitié-Salpêtrière Hospital (Paris) and researcher at the Institut of the brain. “It is perfectly normal and important to have nightmares from time to time or after a traumatic event, to turn the page on our emotional experiences,” says Benjamin Putois, clinical psychologist, author of the Nightmare Healing Manual (Les Arènes editions).

But here it is: if the sleeper who wakes up from his bad dream quickly regains his senses, he retains a feeling of fear or anxiety which prevents him from falling back to sleep and can even cause insomnia. The aftermath of nightmares is very painful. The person is tired, feels depressed, anxious with trouble concentrating, and has difficulty focusing their attention. It is all the less necessary to minimize the problem that it is possible to treat.

Recreate mental images

Still underdeveloped in France, mental imagery rehearsal therapy (RIM) can reduce the frequency of nightmares and the associated distress by approximately 70% (2). Derived from behavioral and cognitive therapies (CBT), this approach, developed in the United States in the 1990s, is the only one to have obtained grade A recommendations (the highest) from American learned societies. RIM is a very simple method, prescribed by sleep specialists, which can also be applied without medical recourse.

It is based, in fact, on everyone's ability to create their mental images and to become the screenwriter of their dreams. The idea is to rework the scenario of his nightmares, which takes between half an hour and an hour, then to review this scenario every evening for 5 minutes. The results are obtained in 3 to 4 months. In practice, you have to write down your nightmares in the morning and give them a title in the form of a keyword (accident, drowning, mourning, ravine, etc.) is a good start to divert them.

Then group them by theme and rank them from the least distressing to the most frightening. You will “work” one nightmare from this “blacklist” per week. To modify the scenario, put yourself in the shoes of a director and replace all the scenes, the characters, and the negative elements with their opposite, to radically change the atmosphere. A feeling of oppression can thus become a feeling of freedom, sadness can be transformed into joy...

This work of creativity takes practice and takes time in the beginning. Visualization exercises to be done every day are valuable for developing the necessary imagination. Once the contents of your nightmares have been cleaned up, imagine a new film that will be their positive version. Close your eyes, breathe deeply and calmly, and visualize the nightmare, then the positive dream you had of it. Repeat the scenario for 5 minutes, once a day for a week. Repeat with the next nightmare, until you re-script everyone on your blacklist.