Kim Han-na, 32, whose name has been changed, suffered from nightmares for years. These are the dreams she described.
"I always have nightmares. I fall from somewhere, or someone torments me. Even in the dream I am gripped by fear. Sometimes a venomous snake appears and tries to harm me. I feel terror and a sense of crisis. I have to get away. There were times I had dreams like this around 7 a.m., just before waking up."
"Someone very close to me held a knife and tried to stab me."
"It was early this morning. I was about to head out to a new place, and a stranger cut off both my legs with a chainsaw."
Ernest Hartmann, a psychoanalyst and former president of the International Association for the Study of Dreams, said nightmares are the most useful dreams. Someone in deep distress from such dreams might think the idea makes no sense. But Hartmann meant that nightmares provide dream therapists with highly valuable information.
Kim came to me for counseling several years ago while struggling with psychological pain. After hearing about her dreams, I suspected she was in severe psychological distress. As the counseling progressed, the source of the nightmares emerged. She had fallen into deep depression under her father's harsh scolding and constant criticism.
Dream analysis can reveal why a person has nightmares. Kim was able to recognize the reason for her frequent nightmares — that her father's abuse had left her depressed and wanting to die. But interpretation alone does not readily produce changes in the body or in behavior.
Recent breakthroughs in neurophysiology have brought forward nightmare treatment techniques grounded in brain science. Here I want to briefly introduce Eugene Gendlin's focusing technique, a well-known approach to treating nightmares.
Focusing recreates the dreamer's nightmare in waking life so the person feels it directly in the body, drawing out change through a physical sensation called the felt sense. Kim's nightmare serves as an example.
Therapist: "Recall that dream again and describe it in the present tense."
Kim: "A venomous snake appears and tries to harm me. I run, but there is a cliff ahead. There is nowhere left to run. I feel terrified and hopeless."
Therapist: "Now take that feeling into your body. Where does the sensation come from — your throat, your chest, your legs?"
Kim: "It comes from my chest, around my heart, and it feels strange. Tense and tight."
Therapist: "Stay with that feeling for a moment. (After a pause) Does any realization come to you?"
Kim: "I am afraid and I want to avoid it. In trying to protect myself, I am fearing my father with my body as well."
Therapist: "If a realization comes about your wish to protect yourself, accept that change and welcome it. How does the feeling in your chest compare with the beginning?"
Kim: "I am less afraid than at first. And less tense."
Therapist: "What was happening in real life?"
Kim: "Whenever my father runs into me, he gets angry and scolds me, asking how old I am, when I am going to get a job, when I am going to get married. I am afraid of my father and I want to avoid him. Because I want to protect myself, I fear my father with my body as well."
Therapist: "Can you say what this dream means to you?"
Kim: "Even though my father criticizes me, I think he also wants things to go well for me. If he did not care, he would not say those things. From now on I should approach my father with a little more ease."
Therapist: "What could you do to use this dream as an opportunity for growth?"
Kim: "First I will persuade my mother, who supports me, and move for a while to a place where I can live on my own. There I will give myself some breathing room and look for what I truly want to do."
Apart from nightmares caused by emotional abuse, some people suffer nightmares stemming from severe traumatic experiences on the job. Soldiers exposed to danger to their lives, firefighters who risk death battling flames, police officers investigating homicides and correctional officers guarding inmates are particularly exposed to such risks.
The following is a dream of Michael, a pseudonym, a U.S. soldier who served in the Vietnam War.
"I was carrying out my duty, opening body bags one by one. ... Screams and the sound of helicopters filled everything. I was opening the bags one at a time, and inside the last bag was my own dead body. I woke up screaming."
Michael continued to suffer nightmares and was discharged from the military.
Continued suffering after a severe traumatic event, as in Michael's case, is called post-traumatic stress disorder, or PTSD. Michael would likely be diagnosed with nightmare disorder.
Nightmare disorder is a sleep disorder marked by repeated, extremely distressing dreams. Nightmares can bring severe distress, mood disturbance, fatigue and declines in memory and concentration. They can disrupt normal functioning at work or in social life, or create a fear of falling asleep itself. Nightmares tied to traumatic experience in particular can be linked to PTSD or raise the risk of suicide.
Theoretical analysis alone is not enough to use dreams as a therapeutic tool. Treatment effects can be expected when dream work functions as a tool that stimulates the patient's body and draws out change. Clare Johnson, a dream expert, said that painful dreams are an invitation to healing.
