internal.gif (3063 bytes)   HOW TO DEAL WITH PTSD NIGHTMARES

Recurring nightmares are common symptoms of Post- Traumatic Stress Disorder. When those individuals who suffer from post-traumatic stress disorder fall asleep, they often experience the exact replica of the traumatic event in a nightmare. One of the most common and successful models for working with groups after a traumatic event or experience is through the Critical Incident Debriefing Model created by Mitchell and Everly. This is a seven-stage process designed to help minimize the effects of the traumatic incident on the individual. Many of the ideas of the Critical Incident Debriefing Model were used to then create the Traumatic Dream Defusing Process (TDDP) for working with post-traumatic dreams. The purpose of this model is to help decrease the intrusive impact of the traumatic memory in the dream. Using the TDDP model has shown to also have success to help increase healing from symptoms of PTSD. The seven stages of the Traumatic Dream Defusing Process are outlined below:

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PHASE 1- INTRODUCTION: Asking the survivor about their current sleep patterns and assessing whether or not they have been experiencing posttraumatic dreams. Suggest to patient that working with the nightmares can help defuse some of the memory from the trauma. Also, find out about sleeping environment.

PHASE 2- FACT: Ask the patient about the facts of the traumatic event or experience. The goal is trying to find out the content of the nightmares that the patient is suffering from. Have the patient start at the beginning of the nightmare and go through moment by moment of what is experienced. Talking about the event out loud is very important to understand all parts of the traumatic experience.

PHASE 3- THOUGHT: During this phase you want to find out the individual’s thoughts while experiencing the nightmare. Ask what kinds of emotions were experienced while the nightmare was taking place. Many times the individual will talk about survivor guilt during the phase in which they are confused about making it through a disaster when others were killed.

PHASE 4- REACTION: This part of the session is used for processing the emotions about the traumatic event and accompanying nightmare. Many times the emotions experienced in a traumatic nightmare are the worst part and the recurring nightmares make these intense emotions occur over and over to the individual. In this phase one wants to ask the patient what their feelings are throughout the nightmare.

PHASE 5- SYMPTOM/SENSORY: In this phase the goal is to get the patient in touch with body memories or sensations that they may be experiencing during their traumatic nightmare. In addition, the purpose is to find out how the traumatic experience plays a role in their body in the nightmare so they can then understand and destroy these particular sensations.

PHASE 6- RE-PLAY: In this phase the patient will re-play the nightmare by writing it will a sense of strength and control. Techniques include listing the thoughts, feelings, sensations, facts and emotions. Then the patient will discuss how they feel the nightmare needs to change in order to feel safer.

PHASE 7- TEACHING: In this phase the goal is to teach the patient that the traumatic nightmares are a normal way to work through the memories of the traumatic event. Also, a goal is to be supportive and encourage the patient to continually talk and discuss their emotions to kick the nightmares. The more times the traumatic nightmare is told through writing, drawing and discussing, the quicker the defusing of the nightmares will take place.


Who Gets PTSD?     How Are PTSD Nightmares Different?     Reoccurences of PTSD Nightmare

Treatment for PTSD NIghtmares      Diagnostic Statistical Manual (DSM-IV) PTSD