108 Dealing with troubled sleep and nightmares
TO THE TRAINER
PART II: THE TRAINING
Dealing with troubled sleep and nightmares
Aim. To learn what can be done to help survivors deal with bad dreams and nightmares.
Many theories seek to explain the function of dreaming. A number consider that dreams are a way of processing events of the day; they carry some information about what a person did or dealt with. Though it is hard to investigate dreams, some research on the effects of sleep deprivation has showed that people deprived of sleep are likely to develop psychoses. This strengthens the theory that dream sleep helps to process information.
During dream sleep, a person is not physically able to move his or her body. This is called dream paralysis. In deep sleep, by contrast, we are able to move. When trauma survivors wake up from a nightmare, dream paralysis can trigger trauma reactions, because the nightmare replays the trauma and their paralysis reminds them of being trapped in a helpless state during the traumatic event. When this happens, a survivor can enter a frozen state, connected to our passive defence system, which is both extremely frightening and makes it harder still for her to end the paralysis.
It is important to be aware that, in many cultures, a person who has nightmares is believed to be cursed by evil spirits. Suggesting that dreams are ways to process events in our lives can give survivors the courage to work on improving their sleep and may lessen the impact of nightmares.
Survivors need to discover what helps them. By asking a survivor what her room looks like and whom she sleeps with, a helper can identify and list effective reminders of safety and anchors to the present. If a survivor cannot read, helpers can make a list of symbols, or practise until the survivor knows what to do by heart.
Alert the participants that they need to be aware of cultural differences. In some cultures women are comfortable having objects close to their bed that remind them they are safe and anchor them in the present. In other societies, such behaviour may be strange and might be associated with curses, voodoo or evil spirits. Find out what is acceptable and appropriate in the local culture.
DISCUSSION
Discussion. Dealing with nightmares: good reminders.
Rehearse the different forms of support that are available to survivors who have nightmares. Add suggestions to the list on the flip chart.
Find out if the participants’ communities have access to light.
Remind the participants that they can prepare lists for the survivors they work with, as the helper did for the Butterfly Woman.