Lucid Dreaming in The Treatment of Post-Traumatic Stress Disorder

By J. Timothy Green

Lucid Dreams as a Treatment for PTSD

Post-Traumatic Stress Disorder (PTSD) is a condition that results when an individual is exposed to a traumatic event that involved "actual or threatened death or serious injury, or a threat to the physical integrity of self or others."

While many people are able to resume normal lives following such events, others are less fortunate. Many people develop intense fear, a sense of helplessness and even horror for extended periods of time following the trauma. The traumatic event is persistently re-experienced in the form of images, thoughts, or perceptions.

Individuals suffering from PTSD generally avoid stimuli associated with the traumatic event and sometimes experience a numbing of general responsiveness that was not present prior to the trauma. There are symptoms of increased arousal, an exaggerated startle response and difficulty falling asleep in patients suffering from PTSD. Especially troublesome for adults are recurrent nightmares of the event and, in children, nightmares that occur with or without recognizable content.

The Realities of PTSD

The most recent estimate is that up to 50% of veterans of the Iraq and Afghanistan war have returned with emotional, and/or, psychological problems and the most often diagnosed psychological problem, by far, among returning veterans is PTSD.

Of all the symptoms associated with PTSD, the most difficult to deal with for many are the often intense and recurrent nightmares that occur for months, years, even decades following the traumatic event.

Many veterans and others with PTSD have such difficulty dealing with nightmares they resort to abusing alcohol and other substances in an attempt to simply get through the night without waking up from terrifying dreams. This compounds the clinical picture as the individual develops a secondary problem with substance abuse.

Others become sleep deprived because they either cannot or will not go to sleep for fear of experiencing yet another, terrible nightmare. Both substance abuse and sleep deprivation can lead to irritability, anxiety, depression and, in some cases, suicide.

Given this scenario, one would think that those mental health professionals who work with PTSD patients would be interested in any therapeutic modality that would be helpful with this population. Yet, there is a clinical modality that has not yet made its way into the treatment of PTSD that is extremely effective in most cases in completely eliminating reoccurring nightmares. That modality is lucid dreaming.

Lucid Dreams to Combat Post-Traumatic Stress Disorder

A lucid dream is one in which the dreamer becomes conscious during the dream that he or she is, in fact, dreaming. The person continues to sleep and dream, but once lucid, they are as conscious as they are during their daily waking life. And if while conscious within the dream state, the person is able to face the fearful dream images that have been haunting their nightmares, that particular dream will never reoccur.

Exactly why this happens is open to debate, but clinical experience has consistently shown this to be the case. My own conclusion is that the nightmare is a subconscious attempt to make the individual aware of something. Once the person not only becomes aware, but literally becomes conscious within the dream state, the dream has served its purpose and there is no psychological reason for it to reoccur.

Another possible explanation, especially with recurrent dreams, is that they are a psychological attempt to end a difficult, even terrifying event, in a less traumatic manner. During lucid dreams, the individual is able to face the frightening images in his or her dreams and have the dream end in a more favorable and less traumatic manner.

A Case Study Involving a Dog Attack

A few years ago I was seeing a 12-year-old girl in psychotherapy who had been attacked by two dogs. Her younger brother was being mauled and she ran to help him. In doing so, she was also severely bitten. Although her physical injuries healed, she continued to have the same repetitive dream during which the two dogs were chasing her. In her dream, she ran to a nearby tree and hid behind it, terrified the dogs were about to attack her.

I explained lucid dreaming to her and suggested that each night as she fell asleep she mentally and emotionally visualize herself back into the dream at the point where she was hiding behind the tree. As she imagined herself behind the tree, I suggested she say to herself, "This is my dream." I explained that if she was able to become aware that she was dreaming, there is nothing to fear from the dogs who were only images in her dream. This being the case, she could then change the dream in any way she wished to.

Two weeks later she walked into my office and proudly announced that she had followed my suggestions. Her nightmare had reoccurred and as she was hiding behind the tree she suddenly realized she was dreaming. She stepped out from behind the trees, looked at the dogs and told them she wanted them to turn into hot dogs, which they did. She then ate the hot dogs. Her nightmare never reoccurred.

A Case Study Involving a Vietnam Veteran

In a more recent case, I was working with a Vietnam veteran who had had the same reoccurring nightmare for decades. He had been in a firefight during which his best friend had been killed a few feet away from him. In the dream he always saw his buddy fall, struggled to get to him, saw blood flowing from his neck and watched as he died.

Because his dream was always the same, I suggested he pick one particular moment in the dream and each night as he fell asleep to mentally and emotionally visualize himself back in that particular moment and remind himself that he was dreaming. He decided to use the moment when he found that his buddy had died as the signal he was dreaming.

One night not long after our session, he again had the nightmare. But this time as he reached his friend he realized that this was a dream and he could choose to redirect it in any manner he wished. He decided to tell his friend to get up, that the war was over and they were all going home. In the dream, his friend sat up, smiled and they got up and walked off the battlefield. At this writing, it has been over two years since he has had this nightmare, one that had haunted his nights for three decades.

The Future of Lucid Dreaming in Psychotherapy

Dream work has been part of psychotherapy since the very beginning. I believe the reason lucid dream work has not yet made its way into clinical practice is because it grew out of sleep and dream research. As is so often the case, it takes time for advances in research to make their way into clinical practice.

Regardless, the average person can fairly easily learn to have lucid dreams and those who suffer from nightmares would probably be highly motivated to do so. The total cost involved is hiring a therapist to teach lucid dreaming either in groups or individually. There are no negative side effects, foreseeable dangers or foreseeable negative consequences involved in learning to have lucid dreams and, most importantly, this modality has the potential to help literally millions of PTSD sufferers completely eliminate recurrent nightmares.

Considering all of these factors, the idea of not making this methodology available to those suffering from PTSD is inexcusable.

J Timothy GreenAbout The Guest Author

J. Timothy Green, PhD is a clinical psychiatrist and writer in private practice in Mission Viejo, California. To contact him for this treatment over Skype, email him at jospeverde[at]aol[dot]com.

About The Author

About The Author

Rebecca Casale is a lucid dreamer and a science writer with a special interest in biology and the brain. She is the founder of World of Lucid Dreaming and Science Me.