Dealing with nightmares

Afterwards, I just didn’t sleep. I’d wake up in a cold sweat, all tensed up. My house mates told me they could hear what sounded like a muffled scream. I just couldn’t tell them.

It is relatively common for people who have been sexually abused in childhood to experience nightmares.

The trouble with nightmares is that they can be unsettling in and of themselves and be painful and unwelcome reminders of abuse and trauma that we would rather forget.  Below is some information about nightmares, along with some suggestions as to how you might deal with them. 

Effects of nightmares 

Nightmares can: 

  • Be vivid reminders and re-experiencing of traumatic events. They can replay things ‘exactly’ as they happened or involve only flashes and fragments of the past, or they can appear symbolic, where characters and events become distorted and amplified representations of the past with accompanying feelings, anxieties and fears. 
  • Evoke feelings associated with past abuse, feelings of loneliness, abandonment, distress, vulnerability, fear, anxiety, sadness, anger, guilt and shame. 
  • Produce real physical reactions, such as breathing difficulties, chest tightness, sweating, shaking, exhaustion and fatigue. 
  • Trigger unsettling thoughts and reminders of abuse.  
  • Interrupt established sleep routines, make someone fearful of going to sleep, of sleeping alone or with someone, affect overall quality of sleep, result in people self-medicating with drink and drugs in order to fall sleep or get through the night.   

Some of these impacts can persist throughout the day and have long term effects on overall wellbeing.  The trouble with nightmares is that they can appear out of nowhere, be hard to understand and if their content refers to sexual abuse can be difficult to talk about with others.   

Understandably, following nightmares men who have experienced abuse can become preoccupied with their content, trying to sort them out and make sense of them.  Prior to examining the nightmare content (as this can stir things up), it is worth first becoming familiar with some things you can do to manage nightmares.  

Consider talking with a health care professional 

If you are experiencing nightmares associated with sexual abuse, we do recommend you talk with a qualified and experienced health care professional who can assist you in managing nightmares and addressing the impacts of trauma.   

Things you can do to manage nightmares 

Nightmares happen and there are things you can do in the short term and long term to deal with them. Below are some ways of managing nightmares when they occur: 

Establish a good, regular, sleep routine 

  • Start to wind down an hour or so before bed time 
  • Go to bed and get up at the same or similar time each day   
  • Exercise in some small way every day  
  • Spend time during the day in natural light or outdoors  
  • Avoiding eating, caffeine or alcohol in the hours before bedtime 
  • Bath, shower, brush your teeth as part of established wind down routine 
  • Limit looking at electronic devices – having said this, we recognise that for some people calming apps, mindfulness or music can assist you to relax and can become part of a healthy sleeping routine.   
  • Make sure your bedroom is restful, create a quiet, calm space and ensure the bed and pillows are comfortable. 

If you are woken by a distressing dream or nightmare  

  • Reassure yourself that you are safe and that the traumatic event that you are remembering is NOT HAPPENING NOW. 
  • Ground yourself in the present as the adult you are now, with all of your resources. 
  • Breathe slowly and deeply. 
  • Be aware of and understand your body’s response as natural physiological reactions to a traumatic experience; try to slow these physical reactions by continuing to breathe deeply and slowly, try to see and imagine your muscles relaxing. 
  • Locate yourself in the present; check your present reality by looking around, touching things, standing up and stamping your feet, looking in the mirror or talking encouragingly to yourself. 
  • Confirm your physical safety – turn on the lights, walk around the house, check the locks if it will help re assure you.   
  • Become familiar with and make use of Grounding, Mindfulness and Relaxation Exercises that work for you.  For suggestions, see our web pages Grounding Exercises, Mindfulness Exercises, Relaxation Exercises. 
  • Have a drink of water. Wash your face or have a bath or shower. 
  • Re focus your mind: read a book or magazine, listen to calming and relaxing music. 
  • Talk with a partner, friend or relative who is supportive. 

What you can do if nightmares persist 

If the nightmare is of a general nature (not specifically related to childhood abuse) and in the morning, you can put aside the nightmare and concentrate on getting on and doing what it is important to you then do so.  

If, however, nightmares persist or becomes disruptive you might try the following exercise.   

  1. Pick an unpleasant dream/nightmare that is recurring, one that is not the most intense and not a direct replay or re-enactment of distressing event and write it down.  A journal can be good for this.    
  2. Write down what occurs in the nightmare, from the beginning, in as much detail as you feel comfortable writing down (you do not need to over describe upsetting content within the dream).  
  3. Write down the place, what is happening, who is there, what you are feeling. 
  4. Only in this telling of the dream you are the author and have power to change the ending so that it suits you.   
  5. Note what you are feeling in this revised version and edit the script so that you feel how you would like to feel at the end of the dream. 
  6. Remember it is your choice to do this and that you can stop writing, close the journal or thinking about the dream and do something else any time you want. 
  7. Now, take time to get to know this new preferred version of the dream, rehearse the revised dream it each night for about 5 minutes prior to going to sleep. 
  8. Once you have rehearsed the dream, perform a relaxation exercise.  One that you are familiar with and helps you to fall asleep peacefully. If you wake up, it can be useful to repeat this relaxation exercise, breathing deeply and slowly. 
  9. When you are satisfied that you have re-storied the unpleasant dream to suit you, you might choose to work on another nightmare that is slightly more intense than the last. 
  10. Always prioritise your wellbeing.  It is not recommended to work with more than 2 nightmares in one week.   

This is just one way of dealing with nightmares. If it isn’t working for you or if you find it is inviting of flashbacks during the day then stop.  

Some people have found it useful to write down the dreams and their reaction to them in a diary or a journal, as a way to get it out of their head.    

Dreams without meaning   

Nightmares that relate to past trauma are unusual, as the vast majority of dreams and many nightmares have no deeper meaning or require any action.  Although they may be connected in some small way to feelings or things we may have seen or heard during the day (maybe in person, in a video or something someone has told us) we can put them to one side and get on with our lives.  

Action in the present 

Because nightmares of past childhood abuse, are related to distressing real life events, they can persist, even if prior to going to sleep you re-author and re-story events, where you prevent and overpower the harmful person or gain some measure of justice.   

If you continue to be disturbed by nightmares or daytime reminders and memories of abuse, it is useful to talk with a qualified and experienced health care professional who is familiar with addressing the impacts of trauma.   

Acknowledgement: Adapted from information provided within Brisbane sexual assault service, information sheet – ‘Managing Nightmares’ and Krakow Hollifield et al, “Imagery Rehearsal Therapy for Chronic Nightmares in Sexual Assault Survivors with Posttraumatic Stress Disorder”. Journal of the American medical Association  Vol. 286 No 5, 1 August 2001 

DISCLAIMER: The information contained in this page is general in content and is not a substitute for professional advice.