Eliminating nightmares in young children

Nightmares (distressing dreams which lead to at least partial awakening) are common in children ages three to eight. At times, after waking up in terror, dreamers of any age can, for a short period, have problems distinguishing their nightmare from reality. This is particularly true of children, the nightmare seems real and continues to scare them even when they are fully awake. As a child grows older, nightmares tend to diminish in frequency, however this is not always the case, 5-10% of adults have nightmares at least once a month. Nightmares can be caused by a number of things, including illness, medication or drugs. Particularly in children, nightmares reflect a struggle to understand and deal with fear and problems. Nightmares can be the real or symbolic re-enactment of a traumatic incident and are the most defining symptom of a post traumatic stress disorder. (Pagel; 2006)

Night terrors are dreams in which the dreamer startles awake, filled with feelings of extreme panic and terror: night terror take place during a different stage of sleep than do nightmares. The dreamer typically cannot remember the content of a night terror, although the fear and panic can last for some time after they awake. The flashbacks associated with post traumatic stress disorder can come in the form of a night terror. When nightmares and night terrors are When flashbacks to a traumatic incident or incidents, present as nightmares and night terrors, they typically cause the dreamer to experience intense fear and panic. This can lead to sleep deprivation when this type of dream results in a fear of falling asleep and dreaming.

Nightmares and night terrors are a common symptom of undisclosed traumatic incidents which have occurred or are on-going in the life of a child or adolescent. When a child or adolescent continually experiences nightmares and/or night terrors , the possibility of undisclosed trauma in their life (such as abuse or bullying) should be considered and explored. This exploration should take into account that children are often traumatized by events that would not be so to adults. (such as a shy child who is bullied by a peer who repeatedly destroys his or her homework papers before they can be turned in) When the source of a nightmare or night terror has been successfully identified and dealt with or eliminated, nightmares and night terrors typically disappear.

Therapeutic stories can be quite effective in helping a child (typically ages 4-7) eliminate their nightmares and/or change the content of these dreams. Stories to treat nightmares can be individualized to reflect the details of a particular child’s distressing dreams. These stories can be read in a treatment session, recorded for the child to listen to as needed, or read by a parent or other caring adult during the day or even at bedtime. The use of props, such as the balloon used in the following example, seems to increase the child’s feelings of mastery over a scary figure in a nightmare.

The story structure which follows is appropriate for nightmares that are a common part of child development and often eliminate those caused by disclosed traumas. However, if undisclosed trauma is suspected, statements that encourage disclosure can be added where appropriate to the story.

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