Do you know someone who suffers from frequent nightmares? Chances are you do, especially if you work in the mental health professions, as two-thirds of psychiatric patients have clinically-significant nightmares. However, you may not be aware of just how many of your clients have this affliction because too few of us ask about nightmares and too few clients talk about them.

Why should you ask about nightmares? Because they are associated with a vast array of mental health issues, and are a red flag for suicide risk. They are a cardinal symptom of PTSD – up to 95% of those with PTSD have frequent nightmares. They are also associated with anxiety, depression, schizophrenia and trauma across the lifespan. They are also easily treatable.

A robust link to suicide risk. Few clinicians are aware of the well-researched and strong link between nightmares and suicide. One alarming study of 165 inpatients following a suicide attempt were found to be four times more likely to make a repeat attempt if they had frequent nightmares. This was after adjusting for anxiety, depression and other sleep disturbances. This is one of several studies establishing nightmares as a marker for suicide risk. (This course will offer an up-to-date summary of the relevant literature.)

In my 20 years as a trauma therapist, I have worked with perhaps hundred of nightmares. I also did my doctoral research on treating the PTSD-related nightmares of refugees who came to the Vancouver-based trauma clinic stating that nightmares were their main complaint. All of the people I have worked with experienced helpful changes in their nightmares, most after just one treatment. For some, their long-term recurring nightmares stopped altogether.

Avoiding talking about nightmares could be a clinical oversight

The sad fact is that most people who suffer from dangerous levels of nightmare distress do not get the help they need. Most are unaware that their nightmares are treatable, and even if they do bring their distressing dreams to a therapist, few clinicians know how to treat them. One study of 747 students found that as few as 11 percent reported their distressing level of nightmares to a mental health professional.

According to the researcher, Dr. Michael Nadorff, “Nightmares are a robust and modifiable predictor of increased suicidality and poor psychiatric outcomes, yet nightmare screening and treatment remain rare.”

Treatment for nightmares is simple and effective

There is some good news here. Nightmare treatment in a psychotherapy context is well-researched, evidence-based, simple and quick to administer. Roughly two-thirds of nightmares sufferers experience immediate relief – reduced nightmare frequency and distress, and clinically-significant reductions in PTSD symptoms. In the many studies I surveyed in preparing this course, I found few, if any adverse effects reported by participants. For most, treatment really helped, and for those who needed further support, the process did no harm.

There are complexities involved in treating trauma and nightmares, but as a helpful first step, reducing nightmares makes the pathway to healing easier. Those I interviewed post-treatment reported a greater sense of control over their nightmares, a sense of hope and immense gratitude at being able to go to sleep without fear.

In this course you will learn the basics of the best methods for treating nightmares, and then we will look further into ways to help those more complex cases that may require additional help. I have developed a process called Nightmare Relief that incorporates the results of my research, the best-tested practices currently known, and the new ways of treating trauma based on our current understanding of the nervous system’s response to threat. Demonstrations and clinical examples will be included, so you can both offer immediate relief and longer-term support for those whose nightmare are more chronic.