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Nightmare Protocol

The document provides step-by-step instructions for changing recurring nightmares through cognitive behavioral techniques. It involves choosing a target nightmare, writing down the details, imagining an alternative positive outcome, rehearsing the changed nightmare during the day and before bed, and using relaxation techniques. It also outlines good sleep hygiene practices like maintaining a consistent schedule, avoiding screens and food/drinks before bed, and relaxation strategies if unable to sleep due to anxiety or rumination, such as deep breathing, meditation, reading or listening to public radio.

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Laura Garzon
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1K views3 pages

Nightmare Protocol

The document provides step-by-step instructions for changing recurring nightmares through cognitive behavioral techniques. It involves choosing a target nightmare, writing down the details, imagining an alternative positive outcome, rehearsing the changed nightmare during the day and before bed, and using relaxation techniques. It also outlines good sleep hygiene practices like maintaining a consistent schedule, avoiding screens and food/drinks before bed, and relaxation strategies if unable to sleep due to anxiety or rumination, such as deep breathing, meditation, reading or listening to public radio.

Uploaded by

Laura Garzon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Nightmare Protocol, Step by Step When Nightmares Keep You from Sleeping

1. Practice relaxation, pleasant imagery, and coping skills first, to be sure you are ready
to work on changing your nightmares. Do progressive relaxation, paced breathing,
and/or Wise Mind exercises; listen to music or guided imagery; review the distress
tolerance crisis survival skills

2. Choose a recurring nightmare you would like to work on. This will be your target
nightmare. Select a nightmare you can manage now. Put off trauma nightmares until
you are ready to work with them—or, if you target a trauma nightmare, skip Step 3.

3. Write down your target nightmare. Include sensory descriptions (sights, smells,
sounds, tastes, etc.). Also include any thoughts, feelings, and assumptions about
yourself during the dream.

4. Choose a changed outcome for the nightmare. The change should occur before
anything traumatic or bad happens to you or others in the nightmare. Essentially, you
want to come up with a change that will prevent the bad outcome of the usual nightmare
from occurring. Write an ending that will give you a sense of peace when you wake up.
Note: Changes in the nightmare can be very unusual and out of the ordinary (e.g., you
might become a person with superhuman powers who is able to escape to safety or fight
off attackers). Changed outcomes can include changed thoughts, feelings, or
assumptions about yourself

5. Write down the full nightmare with the changes.

6. Rehearse and relax each night before going to sleep. Rehearse the changed nightmare
by visualizing the entire dream with the changes each night, before practicing relaxation
techniques.

7. Rehearse and relax during the day. Visualize the entire dream with the change, and
practice relaxation as often as possible during the day
Sleep Hygiene Protocol When You Can’t Sleep,

What to Do Instead of Ruminating


To Increase the Likelihood of Restfulness/Sleep:

1. Develop and follow a consistent sleep schedule even on weekends. Go to bed and get
up at the same times each day, and avoid anything longer than a 10-minute nap during
the day.

2. Do not use your bed in the daytime for things like watching TV, talking on the phone,
or reading.

3. Avoid caffeine, nicotine, alcohol, heavy meals, and exercise late in the day before
going to sleep.

4. When prepared to sleep, turn off the light, and keep the room quiet and the
temperature comfortable and relatively cool. Try an electric blanket if you are cold;
putting your feet outside of the blanket or turning on a fan directed toward your bed if
you are hot; or wearing a sleeping mask, using earplugs, or turning on a “white noise”
machine if needed.

5. Give yourself half an hour to at most an hour to fall asleep. If it doesn’t work,
evaluate whether you are calm, or anxious (even if only “background anxiety”), or
ruminating.

6. Do not catastrophize. Remind yourself that you need rest, and aim for reverie (i.e.,
dreaminess) and resting your brain. Sell yourself on the idea that staying awake is not a
catastrophe. Do not decide to give up on sleeping for the night and get up for the “day.”
If You Are Calm but Wide Awake:

7. Get out of bed; go to another room and read a book or do some other activity that
will not wake you up further. As you begin to get tired and/or sleepy, go back to bed.

8. Try a light snack (e.g., an apple). If You Are Anxious or Ruminating

9. Use the cold water TIP skill. Get right back in bed and do the paced breathing TIP
skill. (See Distress Tolerance Handout 6: TIP Skills: Changing Your Body Chemistry.)
Remember, if you have any medical condition, get medical approval before using cold
water.

10. Try the 9–0 meditation practice. Breathe in deeply and breathe out slowly, saying in
your mind the number 9. On the next breath out, say 8; then say 7; and so on until you
breathe out saying 0. Then start over, but this time start with 8 (instead of 9) as you
breathe out, followed by 7, and so on until you reach 0. Next start with 6 as you breathe
out, and so on to 0. Then start with 5, then with 4, and so on until you have gone all the
way down to starting with 1. (If you get lost, start over with the last number you
remember.) Continue until you fall asleep.

11. Focus on the bodily sensation of the rumination (rumination is often escape from
difficult emotional sensations).

12. Reassure yourself that worries in the middle of the night are just “middle-of-the-
nightthinking,” and that in the morning you will think and feel differently.

13. Read an emotionally engrossing novel for a few minutes until you feel somewhat
tired. Then stop reading, close your eyes, and try to continue the novel in your head.

14. If rumination doesn’t stop, follow these guidelines: “If it’s solvable, solve it. If it is
insolvable, go deep into the worry all the way to the “catastrophe”—the very worst
outcome you can imagine—and then imagine coping ahead with the catastrophe. (See
Emotion Regulation Handout 19: Build Mastery and Cope Ahead.)

If nothing else works, with eyes closed, listen to public radio (BBC, NPR, etc.) at low
volume (use headphones if necessary). Public radio is a good choice for this, because
there is little fluctuation in voice tone or volume.

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