Feb 162013

nightmares250We have all had nightmares. Almost everyone gets them once in a while; adults as well as children however, people suffering with BPD report them in abundance and to a degree that they become negative, life impacting events. Just the thought of another night disturbed by a hair curling nightmare is enough to cause dread of going to sleep. A quick Google search using “nightmares in Borderline Personality Disorder” will verify this fact.

Stressful things that happen during the day can turn dreams into nightmares. Nightmares may be a way to relieve the pressures of the day. Could it be that people with BPD have such a high level of stress and anxiety that this population would be plagued by nightmares?

A simple solution is to decrease the stress and anxiety in life, which is way easier to say than to do.

There is much more to sleep disturbances within the BPD population than nightmares however, presenting some solutions when awakening from nightmares is the goal of this article. If you suffer from nightmares only you have the ability to do something about them. Reading the tips below is the easy part, actually trying one or two is the difficult part, especially when you’re tired and feeling like camel dung but what have you got to lose?

Some effective tips for anyone dealing with nightmares are:
  • Use relaxation strategies pre-bedtime to decrease the fear and anxiety associated with the “anticipation” of nightmares/inability to sleep.
  • When you wake from the nightmare, sit up and put your feet on the floor.
  • If awoken by a nightmare, turn on a light in the room and move to a different part of the room or bed.
  • Get out of bed if you can’t fall back asleep and read or do some form of self-soothing or relaxing activity.
  • Immediately remember the nightmare, BUT, change the ending. Create an ending of empowerment, magical event, even physically impossible or downright fun.
  • Get an ice-pack or ice water (after nightmare) and use for at least ten minutes to decrease arousal level that interferes with getting back to sleep.
  • Use grounding materials to be mindful of present i.e. cat purring, worry rock.
Grounding exercises when awakened from a nightmare:
  1. Turn on the light
  2. Name 5 things you see, 5 things you hear, 5 things you feel
  3. Name 4 things you see, 4 things you hear, 4 things you feel
  4. Name 3 things you see, 3 things you hear, 3 things you feel
  5. Name 2 things you see, 2 things you hear, 2 things you feel
  6. Name 1 thing you see, 1 thing you hear, 1 thing you feel

Note – The same things may be repeated each time but notice and name each thing.

Imagery re-scripting rehearsal
  • Write down a new dream that you would like to have and then practice the new dream (making it as dreamlike as possible) twice a day for 3 minutes.
  • Any intrusive/negative images should be stopped immediately – not rehearsed.
Breathing Exercise:
  • Breathing in, saying to yourself, “Mindfully breathing….”
  • Breathing out, saying, “Letting go of distressing images…”
  • Repeat this for 10 minutes or more, especially when going to sleep.
Bedtime Script:
  • I may awaken in the night feeling ___________ (name of anticipated feeling, usually fear), and will be sensing in my body _____________ (describe 3 or more bodily sensations) because I will be remembering ______________(“title” of trauma – no details).
  • At the same time, I will look around, where I am now _______________(current location) in _________________(current year, date) and I will see _______________________(describe some of the things that are present in current location around bed and room), so I will know ____________________(“title” of trauma) is not happening now/anymore.