Why do we have nightmares? There are only theories. They may be our subconscious’ way of helping us confront scary situations in a safe place. They may also be an internal therapist of sorts, letting us work through complex emotions. What we know for sure is that, for kids, nightmares and bad dreams are more common and, often more, terrifying. But there is a way for parents to help their kids defeat bad dreams and nightmares. It’s all a matter of changing the script.
Nightmares are more terrifying for children because they have a hard time distinguishing reality from dreams and therefore are more likely to feel like nightmares truly happened. They are more common for young children and because a child’s mental sleep-wake switch is still under development, nightmares cause them to wake more often from unsettling dreams, says Dr. Abhinav Singh, M.D., the Medical Director for the Indiana Sleep Center. What’s more, nightmares can be exacerbated by changes to sleep routines due to general life-changes, traumatic experiences that bring on stress, anxiety, or other such emotions.
It wouldn’t be a surprise then for children to be experiencing an uptick in nightmares right now. The coronavirus has altered everyone’s routines.
Importantly, a child who wakes terrified from a nightmare should be comforted. Most medical establishments, including The Mayo Clinic, recommend that parents stay with the child for a brief period following the nightmare, and continually reassure them that they are safe. Empathy is important, too, so parents should be sure to explain that they understand that a child’s dreams do seem really scary, while also enforcing the fact that nightmares are not real. Leaving the bedroom door open, and using a night light can both be helpful techniques when nightmares start
What Is Image Rehearsal Therapy for Nightmares?
If a child experiences a constant recurring nightmare or bad dream, there is another trick parents can deploy: Image Rehearsal Therapy (IRT). IRT is a type of cognitive behavioral therapy that works by asking nightmare-sufferers to write down the dream, re-script its narrative, and then rehearse the new narrative of the dream during the day to cement it in their subconscious.
“Image Rehearsal Therapy is essentially recalling the nightmare, writing it down, and then changing things in it — changing the storyline, changing the ending — so that the next time the nightmare happens, it ends on a happier note,” says Dr. Singh. The American Society of Sleep Medicine recognizes IRT as a treatment for nightmares. And Dr. Singh, who uses the therapy to help children in his clinic, speaks of its efficacy. “With time, it does work,” he says. “It has the best effectiveness as far as behavioral therapy.”
IRT consists of a simple three-step process. Here’s how it works.
- Write Down the Nightmare
- Rewrite the Nightmare, But Change Elements
- Study and Rehearse the New Narrative for 10-20 Minutes Per Day.
The object of the therapy, per Dr. Singh, is to convince a nightmare sufferer to that they can regain control of the narrative and create a new version that remains in their subconscious. “Basically, you’re trying to refute the original premise of that nightmare,” he says. “You’re super-imposing the thought on it. And that can slowly erode what the sequence of the recurring event is to what you have been putting in in the script.”
How to Use IRT to Vanquish Children’s Nightmares
So, how can parents use IRT to help children suffering from nightmares?
Okay. Let’s say a child is suffering from a recurring nightmare where a giant squid is attacking them. The first step is, the next day, to have the child write down the dream as specifically as possible. What color is the squid? What did the water around it look like? This may be tough for a child, but it’s a positive exercise.
Once the narrative has been created, it’s time to rescript it. So, the terrifying element of the dream is that the squid attacks your child. Okay, well, in this new narrative, perhaps the squid isn’t attacking them, but saying “Tag!” or “You’re it!” This would mean that, instead of being an enemy, the squid is a friend that’s been wanting to play a game this entire time. But go deeper: should the squid be wearing a hat? Great. What color hat? What kind of hat? Maybe the squid is on a movie set and playing a role in the next SpongeBob movie. The more details, the better.
Once the new narrative is set and the dream’s edges have been sanded down, it’s time to rehearse it. Have a child reread the narrative a few times a day. Better yet, have them also draw a squid with a funny hat who wants to play tag. The idea is to bombard them with new stimuli and create a new narrative onto which they’ll latch.
“If I’m this child’s sleep doctor I’m going to find out what they like, and I’m going to help him write a script and practice it,” says Dr. Singh. “And I’m going to have the kid read the script to me. I’d say ‘Okay, tell me. Now narrate the story we just wrote.’ And they will because they’re involved with it.’ I’d ask for more details. Add some happy sounds. Build a movie around it, maybe. You want more and more detail. Because the kid now has a storyline and you’re just implanting more stimuli into this.”
An important point here, as we’re dealing with the subconscious, is to let your child guide the discussion. You know how in Inception, the dream-hacking team explains that you can’t just plant an idea in someone’s head because they’ll know it wasn’t theirs to begin with? Same concept.
To that end, Dr. Singh says that parents need to avoid the temptation of making too many suggestions. “Huddle up beforehand and make sure you do not to do the creative work. Let them come up with it. Hold back. Let there be some silence,” he says. “The child might be thinking about how terrible it’s been, as this squid has been attacking them for the last three months. But let them think about it. Let them create the story.”
Once they have the story, they should rehearse it once a day for 10-20 minutes at a time so it becomes a part of their daily lives. Ideally, this exercise will change the dream entirely so the nightmare is no longer a nightmare, just a dream that doesn’t wake them. It’s vanquished. All that remains is the promise of sleep.