A Nightmare Doctor. Sounds like something out of a B-level horror movie, doesn't it? But this is an actual job for an actual doctor who exclusively focuses their life's study on nightmares.
When I was going through a Sleep Clinic appointment and getting a referral to cognitive behavioral therapy for insomnia (CBT-i) to address my all-my-life insomnia, the doctors said, almost offhandedly, "And if your nightmares are still waking you up, we can give you a referral to a nightmare doctor."
I said, "What?" And then, "Um—can I go ahead and get that referral now?" I was so intrigued by the notion of a psychologist who studies nightmares that I wanted to see them, regardless of if the CBT-i was successful.
I got my appointment. The staff told me that Dr. J. wasn't taking new patients currently, but they could take my name and information and give me a call when he was. I knew my nightmares and dreams are incredibly atypical and suspected, for a person who has dedicated his life to studying, "co-morbidities of trauma and persistent depression and nightmare reduction", that he would find mine fascinating. So I gave the staff my information and asked if I could also give them a few summaries of recent nightmares I've had for the doctor to look at.
The next day I got a call saying the doctor wanted to see me. Here is the meandering story of a handful of appointments with a nightmare doctor, unpacking several dreams, and reaching no satisfactory conclusions—as is the iconic nature of dreams.
The first meeting was full of Dr. J. telling me all the things we don't know about dreams and nightmares and sleep: which is basically almost everything. Apparently there's a strong lack of consensus on precisely why humans sleep in the way we do and what sleep does for us, and even more disagreements and lack of information regarding why we dream. In his entire life's work of focusing almost exclusively on dreams and nightmares, Dr. J. said he still doesn't know why things work the way they do; the best that scientists and doctors do right now is try a thing, see if it works, and if it does work, to continue using the thing, regardless that they're still lacking the why.
When it comes to tackling nightmares, there are lots of varying theories over why we have them: they may be our subconscious trying to draw our attention to areas that need it, they may be our brain/body rehearsing how to act in dangerous or stressful situations, they may be the body's and/or mind's response to trauma, they may be last night's bad pizza.
Dr. J. predominantly works with people who are experiencing regularly recurring nightmares or recurring scenes in different dreams: it's a lot easier to work with consistent themes, which made me an atypical candidate. It's unusual enough for people to remember their dreams on a consistent basis, let alone in any kind of detail. Most people, when they die in their dream, wake up in real life; and most experience their dream from a first-person viewpoint.
But my dreams are elaborate, lengthy, and I often remember most of them upon awakening. Sometimes when my character is killed, my consciousness assumes residence as a third-person narrator and watches the still-unfolding dream as a camera panning above the story. My POVs often switch between characters and from first- to third-person. I've had dreams that have accurately predicted future events, and I often lucid dream.
The medically distinguishing factor between a bad dream and a nightmare is intriguing: it's only considered a nightmare if you wake up. If you have a bad dream and wake up at a normal time the next morning and feel unpleasant, that's fine! A nightmare doctor doesn't care about those. He only cares about the ones that wake you up, so if you stay sleeping, that's considered a success. The goal through nightmare therapy is to shift all your dreams from the nightmare waking-you-up realm to the bad dream stay-sleeping realm.
This first appointment concluded with homework: I was to write down any dreams I remembered throughout the next couple weeks and begin incorporating body scans and mindful breathing into my falling-asleep routine. (Here are some resources from the MI Psychological Institute .) One of the other philosophies behind nightmare therapy is that addressing good sleep in general—especially in promoting a restful, peaceful mind-space before falling asleep—will help with nightmares in particular.
The next appointment, we dove into several of my dreams.
The first was a dream that's reoccurred for me every couple of years since childhood. I'm running (a constant theme in my dreams: always running from something) with other people through a large apocalyptic-style decrepit warehouse. We're in a Jurassic-Park style world; the things we're running from are dinosaurs. I bolt into a hallway with a comrade running beside me and we sprint for the open door of a giant garage at the end of the hallway just as a T-Rex rounds the corner behind us and the camera of my dream pans to show our two tiny figures desperately running with the T-Rex pounding the ground behind and catching up fast. Our colleagues begin shutting the mechanical door and it grinds down toward the ground; running full speed at the door, I drop to my side and slide under the door barely in time.
But the door halts before it touches the ground as giant claws slip under and grab it, and there's an agonizing moment of stillness before—in a burst of wood and metal splintering everywhere—the T-Rex breaks through the door and charges into the garage. And that's the moment where I wake up.
The second dream, again a recurring one, was where I was in a Nazi-era world, running and hiding with the Resistance and trying to get innocent people away, running with them to get them to a train station and away. When I got the last people there and was about to board myself, a comrade came up to me and told me they'd found that the bad guys had important information to the war effort on a flash drive in a house a couple miles away, and asked me to go with the team to retrieve it. We got in a jeep and drove through abandoned war-torn apocalyptic neighborhoods till we pulled up in front of the house. Covering each other, we entered the house. It was ransacked: debris everywhere, furniture broken and tossed around. We searched the house and finally I held up the flashdrive in triumph…and just then, a bad guy walked through the door.
In a moment of stillness and horror everyone met each other's eyes, and then my people stepped forward and grabbed him. "We need to kill him," they said. "No," I said, "we can just tie him up and leave him…" But my voice trailed off as we all had a horrible glimpse of the certain future where we left him alive, and he escaped and called the bad guys, who would stop the train that just left and kill everyone on board. The only way to keep them—and us—safe was to kill him.
I looked at him with tears breaking down my face, and then my consciousness separated from my body and split into two, one becoming an omniscient camera watching from the ceiling and the other remaining in the eyes of my character, because I couldn't bear to be in what was going to happen next. I watched as my character picked up a wine glass, shattered it against a bookshelf so it was a shiv, and then whirl and strike at the man as blood spattered across the room and my character's face and the camera viewpoints watching, and my consciousness couldn't handle the gory violence and faded the camera out, but not before I could see the man crashing to the floor. And then I woke up, shaken by the horrific violence.
This was a natural lead-in to Dream Rescripting: rescripting a part of the dream to address the overall theme without drastically changing the storyline itself.
To do Dream Rescripting, you need to consider big themes that occur throughout your dreams. This isn't something like "I'm scared about failing the test tomorrow," but more like, an overall fear of failure throughout your life. Nightmares about your partner breaking up with you might be an overarching fear of being alone or abandoned. So the overall theme is something more universal to humanity and occurring throughout your life: things like needing safety, fear of losing control, fear of trust, fear of intimacy, etc.
Then you take a dream: preferably one that occurs frequently, or one that's recently bothering you, and work on rescripting it. Rescripting means we don't try to change what the dream was doing. So you don't change that you're running from a T-Rex, but you script a vehicle into the garage where you can successfully escape. You don't change that you're searching for a flashdrive, but you script that the bad guy comes after you've gone, or you script that you tie him up instead of killing him. If you're running from a monster, maybe you script turning around to say, "I don't have to be afraid of you anymore." You can then turn and continue running, but you script in something to give yourself control and address the main theme.
Once you've rescripted a specific dream (ideally a recurring nightmare), you run the dream and the rescripted part of it through your head multiple times before you go to sleep, till—when you have the dream as you're sleeping—the rescripted version, instead of the original, is the one that plays out.
There's often a period, after being woken up from a dream, that I'll have a brief window of accessibility into being able to fall asleep and go right back into the same dream. I've used this in the past to try to figure out what happens; to change something so I don't die and wake up; to try and make the dream have a different ending. That's rescripting. While seeing the nightmare doctor, I woke up out of a nightmare where a loved one turned into a monster, and I could feel (as I lay panting in bed) that the dream was still there, for a few minutes, and I could reenter it if I wanted, and try to change it… But this time the dream was too terrifying for me to voluntarily re-enter, and so I waited till the last vestiges of the dream wisped away, and fell back asleep to a new, safer dream. Dr. J. said this was a good sign: that I was aware that I could rescript it, so even if I didn't do it, this was progress: and that there was nothing to be afraid of if I did choose to fall back asleep into that same dream.
In the rescripting process, we develop a sensitivity to and appreciation of themes, to the point where we can understand the themes that haunt us and eventually rescript all our nightmares with these common themes in mind.
A way to understand our themes—which are based in our fears—is to interpret each aspect of a dream as representing various parts of ourselves. I had a dream where I was protecting a small blond child from a monster that revealed itself as the Babadook. In this dream interpretation, what part of me is the helpless child? What part of me is the sacrificial protector? What part of me is the vicious monster?
Dr. J assured me that we're really scared of—our nightmares—are just our own thoughts. And there's nothing inside our own heads that we have to be scared of.
…Except I don't agree with that. In Robin McKinley's Sunshine, a fantasy world filled with vampires and monsters, the heroine Sunshine says, "Isn't it…silly…how upsetting just…thinking can be?" Her gentle mentor replies, "It's not silly at all. The insides of our minds are the scariest things there are." Sunshine thinks: "Scarier than vampires? Well. That was what she'd said, wasn't it?"
I find it bizarre and perhaps counterproductive that waking up is universally considered the thing to avoid by nightmare doctors, regardless of other factors. Lucid dreaming—realizing that I'm dreaming in the dream itself—and using that to get myself out of nightmares was a defense mechanism I actively developed years ago to deal with my nightmares. But now Dr. J was saying that this is the opposite of what we want to do: that we want to maintain sleep at all costs.
And I find myself disagreeing with this too. One of the most horrifying nightmares I've ever had involved me hiding at a crowded party from demons that disguised themselves as people, and after several adrenaline-packed hours, they filtered out onto the balcony where I stood. Slowly I turned toward them, and they smiled, showing teeth that were not-quite-human, and said, "We have you now." I looked around, but everyone at the party was continuing to drink their wine and eat their hors d'oeuvres, and somehow I knew if I made a scene, it wouldn't be them coming to my rescue: it would turn into a slaughter.
I looked back at the demons, smiling in human faces, and then had a blinding realization: I laughed, shook my head, and said, "This is a dream. You can't touch me." My consciousness heard this and began waking up and my dream self reached up to the sky to be pulled out of the dream and into the waking world in my bed—
And the demon nearest me stepped forward and grasped my wrist, and its fingers dug into my skin in the waking world, and I was pulled out of the beginning-to-wake-up space and yanked right back into my dream-body, trapped in the dream. I looked from the fingers bruising my arm, panting in fear, back to the demon-human, and murmured, "No. No. You're just a dream. You…can't…touch me. I can wake up. You're just a dream."
The demon-human laughed at me, and said again, "We have you now." The cameras filming the dream panned around in a whirl and I was screaming and the world was whirling and roaring and I woke up gasping for breath, still feeling fingers gripping my wrist.
Being able to wake myself up out of nightmares too traumatic to remain in had for years been a saving grace, and the one time it didn't work, it was the worst nightmare of all.
If nightmares are partially a result of trauma we've experienced (this is one of the more commonly accepted possible interpretations to nightmares), we might not be emotionally ready to deal with some of the stuff they dredge up for us. So counting it as a win if we can just stay asleep…That seems too narrow a view for me, especially if we're dealing with trauma dreams.
There's no nice and tidy conclusion to this nightmare doctor story. I only went several times before my insurance rolled over and it got too pricey to go again. And—although I found the scientific and medical theories on nightmares and bad dreams fascinating and enlightening—I also found myself disagreeing with some of their conclusions and methods.
But working with dream rescripting, being more observant of universal themes, and seeing each part of the dream as representative of something within me has elucidated better interpretations and understandings of my dreams…and hey. It's pretty cool to say you've been to the Nightmare Doctor.