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Friends and Friendliness: Could They Be the Clue in Psychiatric Patients’ Dreams?

G. William Domhoff

May 1, 2015 DOI: 10.4324/9781315761640-12 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Theoretical or philosophical paper
Interventions Desensitization techniques Imagery rehearsal therapy (IRT) Exposure therapy
Key points The chapter argues that sleep medicine and psychiatry diverge on whether chronic nightmares are an independent disorder or a secondary symptom, and reports that direct treatments such as desensitization techniques and imagery rehearsal therapy markedly decrease nightmare frequency and distress-symptom severity, including anxiety and posttraumatic stress symptoms.

Abstract

Sleep medicine specialists view the problem of chronic nightmare disorder as an independent sleep disorder. When patients seek treatment for chronic nightmares, a direct intervention may be offered regardless of the putative causes. In contrast, sleep medicine does not view nightmares exclusively as a symptomatic feature of a primary disorder, whereas the psychiatric community and its nosology have long maintained that nightmares are best understood as a secondary phenomenon for which treatment need only be directed at the inciting disorder. This chapter presents a direct nightmare treatment with either desensitization techniques or imagery rehearsal therapy (IRT) markedly decreasing chronic nightmare frequency as well as distress-symptom severity, notably anxiety and posttraumatic stress symptoms. At the locations where IRT was in more frequent use, individual practitioners described the approach of offering a patient a starting point with either IRT for nightmares or exposure therapy for Posttraumatic Stress Disorder (PTSD).

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