Tired of waking up in a pool of sweat, your heart racing and your mind overwhelmed with terror? What if you could take control of your dreams and “tame” your nightmares? Sleep science says you can do just that with Lucid Dreaming Therapy.
Lucid dreaming is an altered state of consciousness, during which you are aware that you are dreaming. LD has been considered a prized avenue of learning among oneironauts. It is also a potent therapeutic tool.
In this piece, we take a look at lucid dreaming therapy for the treatment of nightmare disorder. More precisely:
- What are nightmares? What types of nightmares are there?
- Your treatment options for nightmare disorder.
- How Lucid Dreaming Therapy works in practice.
- The Limitations of Lucid Dreaming Therapy.
- The scientific background of LDT.
How Does Science Define Nightmares? What Types of Nightmares are There?
According to the International Classification of Sleep Disorders, a dream/sleep problem has to satisfy a minimum number of criteria to be considered a nightmare disorder.
These criteria are:
- Dreams have to occur repeatedly. Sufferers need to remember such dreams well, and the dreams have to be highly dysphoric. They need to contain perceived threats to the dreamer’s bodily integrity, survival, and/or security.
- A nightmare sufferer becomes highly alert immediately after awakening from such a dream.
- The dreams and the sleep disorder resulting from them have to cause the sufferer significant distress, socially, occupationally, or in some other essential aspect of life.
The distress angle may be somewhat subjective. The ICSD has therefore provided a few criteria to help patients identify the condition. If you suffer from one or more of the following issues, you are experiencing significant nightmare-induced distress.
- Anxiety, depression.
- Fear of going to bed, in anticipation of the likely nightmare experience that awaits.
- Problems concentrating.
- Memory problems.
- Persistent fatigue. Lack of energy.
- Trouble initiating and handling social interaction.
- Fear of the dark.
- Sleepiness during the day.
Nightmares can be of several types. Some are milder and do not require treatment. Others are persistent and recurring. This is the category that affects the quality of life, requiring treatment.
- Idiopathic nightmares are randomly occurring sleep disturbances. As such, they are little more than one-off nuisances.
- Comorbid nightmares are coupled with a condition, which is usually responsible for their presence. Such conditions can be PTSD (Post-traumatic Stress Disorder), substance abuse, schizophrenia, etc.
What Options Do You Have for the Treatment of Nightmare Disorder?
Nightmare disorder sufferers can turn to scores of treatment options to alleviate their condition. The Journal of Clinical Sleep Medicine has defined two main treatment avenues.
- The pharmacologic option category includes various drugs. The JCSM, in a June 15, 2018 literature review, has declared some drugs “recommended” for nightmare disorder treatment. It has defined a couple of other categories of medicines that “may be used” for treatment and that are “not recommended.”
- The same publication has also analyzed an array of behavioral and psychological treatment options. Within this category, it has yet again defined “recommended,” “may be used,” and “not recommended” sub-categories.
- In the “recommended” category, Image Rehearsal Therapy (IRT) has taken the top spot. This is interesting because Lucid Dreaming Therapy (LDT) is a variant of IRT.
What is IRT?
IRT is a cognitive behavioral therapy method, which consists of modifying the image content of a nightmare, thus turning it into a benign dream. Those who embark on this type of treatment rehearse the modified dream scenario several times a day. This way, they condition their brains to bend the nightmare into a benign dream, when it happens. Despite its seemingly far-fetched nature, the technique is surprisingly effective.
LDT takes this concept and runs with it. Lucid dreaming allows the dreamer to retain consciousness while in a dream. Some lucid dreamers can even bend the dream content to their will. The only problem with lucid dreaming is that it is a rather difficult cognitive state to achieve. You cannot just will yourself to become lucid when dreaming.
How Does Lucid Dreaming Therapy Work in Practice?
Lucid dreaming enthusiasts will tell you that you can learn to trigger lucid dreaming episodes. We have dissected several such methods on the pages of this website as well.
No. It is not easy to achieve lucidity in a dream. Yes. You can learn to do it. Lucid dreaming therapy for the treatment of nightmare disorder is a multi-step process.
The first step is to convince patients that this is not some far-fetched, occult approach. They can indeed learn to control their dreams. There is plenty of scientific evidence available in this regard.
During this stage of the treatment, the therapist/coordinator introduces various LD induction techniques to participants. The first results might come extremely early. Some patients respond after a single session. In other cases, it may take six weeks for results to show.
Once nightmare sufferers gain control over their dreams, their situation improves drastically. The sense of control derived from LDT endows them with in-dream fearlessness. Even if they continue to have nightmares, these bad dreams will never be as distressing as before.
According to a 2006 study by Spoormaker V. I. and van den Bout J., once patients learn to control their dreams, their frequency of nightmares automatically decreases.
Facing the primary threat in a nightmare is a popular way to address this sleep disorder among lucid dreamers. If, for instance, an entity chases you in your nightmare, stop, face it, and ask it what it wants from you. In many cases, the threat reveals itself to be a familiar source of waking-life stress of the dreamer.
The second step of LDT aims to explore the conscious psyche of the nightmare sufferer. It seeks answers regarding the source(s) of nightmares.
Turning LDT into long-term psychotherapy makes sense for several reasons. As mentioned, lucid dreaming can be much more than a quick solution for nightmares. Through it, the oneironaut gains an unequaled peek into his/her psyche. Eventually, it may even sort out the very issues which lead to the appearance of nightmares.
The biggest hurdle to effective LDT therapy is the difficulty of achieving a lucid in-dream state. Some people may have serious difficulties in this regard. Others may see their efforts hampered by preconceptions and skepticism. Attaining quick results should always be the therapist’s objective. It motivates the patient to stick with the program and to pursue further objectives.
Those who find it difficult to induce LD can resort to several techniques beyond the most common/popular ones. Applying external sensory stimulation during the REM stage of sleep is one such technique.
There are a few substances (like galantamine) that can also help with LD induction. Some of these solutions do promote nightmares, however, so they should not be used, unless recommended by a specialist.
Changing the dream content without achieving lucidity is also an option. According to a 1990 study by Brylowski A., published in the Psychiatric Journal of the University of Ottawa, even if patients fail to achieve in-dream lucidity, the lucidity-focused exercises they do while awake, help them wake up when a nightmare commences.
Some specialists, among them the “father” of lucid dream theory, Stephen LaBerge, do not see this approach as an ideal one. Instead of allowing the patient to face his/her fears, just waking up becomes another way to run from the nightmare.
In his book Lucid Dreaming: A Concise Guide to Awakening in Your Dreams and in Your Life, LaBerge argues that nightmares are “dreams gone wrong.” Their original intent was healing, which is revealed by becoming lucid within the dream. We miss the whole point if we wake ourselves up. Rather, he suggests to face the bad dream and that “staying with the nightmare and accepting its challenge, as lucidity makes possible, allows us to resolve the dream problem in a fashion that leaves us healthier than before.”
Still other authors, like Stumbrys T. and Erlacher D., in a 2017 study have pointed out that trying to make dream figures disappear may enhance their threatening nature. When one looks at a dream figure with confidence and courage within the dream, this figure tends to shed its threatening nature.
In many cases, however, would-be lucid dreamers will still wake up as a direct result of having achieved lucidity.
This discussion makes it clear that Lucid Dream Therapy has its limitations when tackling nightmare disorder.
How Do You Confront a Nightmare?
If you manage to achieve lucidity in a nightmare, here is what you can do to confront the entity terrorizing you.
If you are having a dream in which an unknown entity chases you, stop. Bear in mind that the fact that you can control your dream makes you all-powerful in that instance. Assume a confident and bold attitude. Ask your pursuer: “Who are you?” “Why are you chasing me?” At this point, your nightmare is defeated, regardless of how the entity responds to you.
If you are having a falling nightmare, let go of your fear as soon as you become lucid. Understand that nothing bad can happen to you. Instead of dreading the fall, try to enjoy it. You may turn the dream into a floating/flying experience.
The Limitations of Lucid Dream Therapy for Nightmare Disorder
As impressive a weapon as in-dream lucidity is against nightmares, it is not the be-all-end-all solution to the problem. In some cases, lucidity may result in enhancing the nightmare, instead of emptying it of threats.
According to a May 2000 study, published in the Journal of Abnormal Psychology, by Zadra A. and Donderi D. C., researchers have recorded cases where lucidity amplified the terrifying nature of nightmares. Cases have been reported, where lucid dreamers found themselves unable to control dream content or to wake up. Thus, they had no choice but to observe with a lucid mind as the nightmare unfolded before them.
According to a 1991 Lucidity Letter by Scott G. Sparrow, LDT is a dangerous approach to treating nightmare disorders. Sparrow explains that those with nightmare problems are especially vulnerable to lucid nightmares. Dopamine and community support have been found to help in reducing lucid nightmares.
There is little consensus among researchers concerning the extra-potent nature of lucid nightmares. In a 2018 study, Stumbrys T. found no difference in the distress levels of lucid nightmares and regular ones.
The difficulty of lucid dream induction is yet another limitation for LDT. Some people find it quite impossible to achieve lucidity, even after months and years of lucidity-focused exercise. Those most likely to achieve lucidity are people suffering from narcolepsy.
A 2015 study by Rak M., Beitinger P., and others established that some narcolepsy sufferers successfully used their lucid dreams to combat nightmares. Researchers concluded that lucid dreaming was an efficient way for narcoleptics to deal with nightmare disorder.
The Scientific Background of Lucid Dream Therapy
The position paper on the treatment of nightmares in adults, of the Clinical Journal of Sleep Medicine, has identified two randomized studies and a case series report on the use of Lucid Dreaming Therapy.
The results of the first randomized trial were published by Spoormaker V. I., and van den Bout J., in 2006. 23 test subjects took part in the trial, which evaluated the frequency of nightmares in a 12-week period. Participants used self-reporting. The conclusion of the study saw a statistically significant drop in nightmare frequency as a response to LDT.
A second study took aim at Gestalt Therapy and LDT. This January 2015 exercise by B. Holzinger, G. Klosch, and B. Saletu divided 32 participants into two groups. The first group received Gestalt therapy. Gestalt is a psychotherapy method focused on the interpretation of present circumstances without any preconceptions stemming from previous experiences.
The second group used Gestalt combined with LDT. Both methods proved equally effective in reducing nightmare frequency.
The case series report by Zadra A. L. and Pihl R. O., followed five test subjects receiving either LDT alone or LDT in combination with progressive deep muscle relaxation and guided imagery. The results after a year of treatment were amazing. Except for a single participant, all patients stopped having nightmares. Even the exempt person reported a significant reduction of nightmare frequency.
The efficacy of LDT in the treatment of nightmare disorder is real and impressive. The therapy can be used in combination with other behavioral and psychological treatment options such as:
- Image rehearsal therapy.
- Cognitive-behavioral therapy.
- Eye movement desensitization.
- Exposure, relaxation, and rescripting therapy.
- Progressive deep muscle relaxation.
- Self-exposure therapy.
- Sleep dynamic therapy.
I find it interesting (but not surprising) that two of the most common sleep disorders can be successfully treated with awareness: Insomnia with mindfulness-based therapy and nightmares with lucid dreaming therapy.