English Mental health and gender-based violence English version | Page 118

108 Dealing with troubled sleep and nightmares
TO THE TRAINER
PART II : THE TRAINING

Dealing with troubled sleep and nightmares

Aim . To learn what can be done to help survivors deal with bad dreams and nightmares .
Many theories seek to explain the function of dreaming . A number consider that dreams are a way of processing events of the day ; they carry some information about what a person did or dealt with . Though it is hard to investigate dreams , some research on the effects of sleep deprivation has showed that people deprived of sleep are likely to develop psychoses . This strengthens the theory that dream sleep helps to process information .
During dream sleep , a person is not physically able to move his or her body . This is called dream paralysis . In deep sleep , by contrast , we are able to move . When trauma survivors wake up from a nightmare , dream paralysis can trigger trauma reactions , because the nightmare replays the trauma and their paralysis reminds them of being trapped in a helpless state during the traumatic event . When this happens , a survivor can enter a frozen state , connected to our passive defence system , which is both extremely frightening and makes it harder still for her to end the paralysis .
It is important to be aware that , in many cultures , a person who has nightmares is believed to be cursed by evil spirits . Suggesting that dreams are ways to process events in our lives can give survivors the courage to work on improving their sleep and may lessen the impact of nightmares .
Survivors need to discover what helps them . By asking a survivor what her room looks like and whom she sleeps with , a helper can identify and list effective reminders of safety and anchors to the present . If a survivor cannot read , helpers can make a list of symbols , or practise until the survivor knows what to do by heart .
Alert the participants that they need to be aware of cultural differences . In some cultures women are comfortable having objects close to their bed that remind them they are safe and anchor them in the present . In other societies , such behaviour may be strange and might be associated with curses , voodoo or evil spirits . Find out what is acceptable and appropriate in the local culture .
DISCUSSION
Discussion . Dealing with nightmares : good reminders .
Rehearse the different forms of support that are available to survivors who have nightmares . Add suggestions to the list on the flip chart .
Find out if the participants ’ communities have access to light .
Remind the participants that they can prepare lists for the survivors they work with , as the helper did for the Butterfly Woman .