The first patient to arrive that morning at the nightmare clinic—Maimonides Sleep Arts & Sciences, in Albuquerque—was a forty-two-year-old administrative assistant named Toni. She wore jeans, black suède sneakers, and a dark floral-print top. Her curly black bangs, large eyes, and pale, heart-shaped face gave her the look of a silent-movie heroine. Toni has endured bad dreams since childhood, but recently they have grown worse. Her father left her family when she was a baby, and died when she was twelve. Her mother, with whom she had been close, died a year ago, in Toni’s own bed; she had moved into Toni’s apartment after developing cancer. An only child, Toni isn’t married, and has no children. Lately, her nightmares have centered, with distressing frequency, on her mother. In the dreams, her mother is alive again, but she is suffering as she did on her deathbed: desperate for morphine, her eyes dull, her mouth dry and hanging open. Her mother is often trying to tell her something, and looking at her beseechingly, but Toni can’t make out the words. These nightmares fill Toni with an overwhelming sadness, and sometimes she wakes up in a cold cloud of fear. She finds herself staring at the clock, counting the hours and, eventually, the minutes, until she has to get up to go to work.
Toni also has apnea, a condition in which breathing is interrupted repeatedly during sleep, making the night much less restful. The apnea had first led her to Maimonides, a few months earlier. The staff had done a sleep evaluation and supplied her with a masklike device that keeps the user’s airways open. Then the doctor in charge of the clinic, Barry Krakow, surprised her by saying that her nightmares might be equally susceptible to treatment. Toni was eager to try: nightmares had been with her all her life, unwanted visitors that she couldn’t turn out.
Many therapists and doctors would also be surprised by the claim that nightmares can be treated directly. In the psychological literature, nightmares have conventionally been thought of as a “secondary” phenomenon—the by-product of anxiety, depression, or post-traumatic stress disorder. Treat the underlying problem, the thinking goes, and the nightmares should fade away. But about twenty years ago Krakow became fascinated with the idea of confronting the nightmare as a problem in itself. Even people who believe that our dreams are freighted with hidden meaning, he reasoned, had to admit that there were few benefits to be gained from the nightmares of many trauma survivors: scenarios that revisit the original horror again and again, making the dreamer fear sleep. (For Samuel Coleridge, chronic bad dreams were a “night’s dismay” that “saddened and stunned the coming day.”) Frequent nightmare sufferers often became convinced that they were at the mercy of their subconscious minds. But what if you could train people to rewrite their troubling dreams?
In 2001, Krakow published a study in the Journal of the American Medical Association that involved a hundred and sixty-eight women who had been the victims of rape or other sexual assaults, and who were beset by nightmares. Some of these dreams replayed the crimes, but many did not. Nightmares, it turns out, rarely involve literal replays of incidents in waking life; post-traumatic dreams come the closest to doing so, and even these often alter the characters or the setting of the episode. Krakow’s theory was that although the subjects’ bad dreams had likely been triggered by the assaults, they persisted because they had become a habit—a “learned behavior.” (He has called the condition a “dream rut.”) Perhaps the women could alter this dynamic and transform their nightmares into good, or at least better, dreams by rehearsing more benign scenarios during the day.
Half the participants maintained their typical sleep routine. The rest were given instruction in evoking pleasant and detailed images in their minds. (In a typical practice exercise for imagery rehearsal, subjects listen to relaxing music, close their eyes, and spend ten minutes recalling a recent day at the beach.) The women in this group wrote down one of their disturbing dreams and were instructed to change it in any way that they wished. They then wrote down the new version in full, and were asked to spend between five and twenty minutes a day conjuring the revised dream. A menacing character, such as a rapist, could metamorphose into a kindly one; a plane that crashed in flames could become one that landed gracefully on a smooth runway; the deep water in which the dreamer was drowning could suddenly reveal itself to be as shallow as a kiddie pool.
The women maintained this regimen for six months, consulting regularly with doctors. At the end of the trial, they were given a formal evaluation. Those who had completed the imagery-rehearsal therapy were having significantly fewer disturbing dreams; their insomnia had improved; and their post-traumatic stress had lessened. Several studies since then have produced similar results with different populations, including elementary-school children and war veterans with combat-related P.T.S.D. At the University of Pittsburgh School of Medicine, the Pentagon has helped fund an ambitious ongoing study of nightmare treatment and imagery-rehearsal therapy for soldiers returning from combat in Iraq and Afghanistan. Anne Germain, a Canadian sleep researcher who is leading the study, told me, “It’s fascinating to me how people can change the content of a nightmare to a non-nightmare. I genuinely believe that people know what they need. Some will change a character; some will include new ways of protecting themselves. One of the advantages of the technique is to give patients the flexibility to change the nightmare in keeping with their own beliefs—their own identity.”
Toni had been working on rewriting her nightmares for about two weeks. At home, she had been going through a handbook written by Krakow, “Turning Nightmares Into Dreams.” She told Linda Trujillo, a health educator who was taking her history, that she was at the point of training herself to summon soothing images before falling asleep. These images were mostly of Ireland, where she had recently travelled with a friend: the emerald countryside, the frequent rain. “Everything is so pretty and peaceful there,” she told Trujillo. “It’s like a nice dream I had when I was little, where the sky was overcast and I was right on the beach, with the cliffs all around me.”
Trujillo nodded. Twenty-three years old, she had been a nightmare sufferer herself before she began to work at the clinic and trained herself in imagery rehearsal. She attributes her nightmares to her parents’ abusive relationship. Lurid and demon-filled, the dreams persisted long after her father had left the house and her mother was happily remarried. Trujillo, who is competent, calm, and cheerful, said that her nightmares were “so debilitating to me during the day that I would just want to cry. I couldn’t believe that my mind could come up with these morbid images.”
After a while, Krakow, a wiry sixty-year-old with glasses and short, steel-gray hair, joined us. A former emergency-room physician, he came late to sleep medicine and has a convert’s zeal for the benefits of a good night’s rest. He is a man of springy, focussed energy, and frowns on caffeine, limiting himself to a cup of cocoa in the afternoon. When he told me, “It’s not that everyone in the world has a sleep disorder, but—they probably do,” he laughed, but he wasn’t entirely joking.
Down the hall were a series of rooms where patients participate in sleep studies, watched over by lab technicians. Electrodes monitor a patient’s heart rate and brain activity, and microphones record snoring patterns. On a table in the hall was a jigsaw puzzle—a suitably unexciting activity for insomnia patients. The room where patients talk about their nightmares is less clinical: dark wicker chairs, silk pillows, torchère lamps.
Krakow sat down, steepled his fingers, and asked Toni if her nightmares had changed at all. “They’re not as severe,” she said, softly. “My mom is still in them, of course, but she’s not always sick, and the settings have changed. They’re more like, I don’t know, streets and hotels.”
Krakow nodded. “Prior to that, the content was constant?” he asked. His conferences with patients tend to be brief, more like a doctor’s checkup than like a psychoanalysis session.
Yes, Toni said: “They’d be at my mom’s house, or my aunt’s trailer—in my home town, where I haven’t lived for a long time. And there’d be freaky occurrences and family fights.”
“So they’re not as disturbing now?” Krakow asked.
“Oh, they’re disturbing,” Toni said. “I’m in competition with different people for things. I’m very anxious, panicked.” Toni was seated on the edge of a leather couch, hunched forward, her hands clasped between her knees.
Krakow asked her if she attributed the changes in the dreams to anything, and Toni, who has a fragile, tentative air, said that she didn’t know for sure, but that it had all happened during the past two weeks.
“That’s a good prognostic sign,” Krakow said. “Your mind is moving, changing. Nightmare patients, especially post-traumatic ones, may have a narrower range of dreams, with similar intensity, and the patient is so overexposed that they’re thinking, Is this ever going to go away?” He asked her to come back in a month. Before she left, Krakow told her, “Dreams naturally want to change. People who have nightmares often don’t recognize that.”
Ross Levin, a sleep specialist who has a private practice in New York, also uses imagery-rehearsal therapy to treat nightmares. He recently told me about a male patient who kept having terrible dreams about the blades of the ceiling fan above his bed turning into knives. “His mother was schizophrenic,” Levin explained. “One time, when he was a child, he woke up and saw her standing over him with a knife. I mean, that’s about as bad as it gets. That’s, like, ‘Psycho’ territory.” Still, the man hadn’t suffered from nightmares until someone broke into his apartment one night, while he was sleeping. Levin recalled that the patient “came up with the idea of decorating the ceiling fan with plants. He was really into plants. He did it for real—put all kinds of viney things on the ceiling fan—but then he also incorporated it into his daytime dream routine, so that when he saw the blades in his mind at night they would turn into leaves.”
A woman I spoke with in New York, an art-history graduate student in her late twenties named Yael, had been plagued for years by dreams set during the Holocaust. She had been raised in Israel, and moved to the United States three years ago. Yael’s husband, a doctor, told her about a sleep clinic at Montefiore Medical Center, in the Bronx, and she made an appointment. After several sessions with Shelby Harris, a psychologist who uses imagery-rehearsal therapy, she began reimagining the concentration camps of her recurrent nightmares as, of all things, summer camps. The gray-and-white tones of Middle Europe were replaced by bright, sunlit landscapes. She told herself, “Yes, I’m here, but there are trees and a lake, and everything is fine.” Within two weeks, her dreams had conformed to the new narrative.
In another nightmare, Yael was under water, and desperate to come up. “At that moment in my dream, I realized that I was going to die,” she told me. As she lunged toward the surface, she saw a ring of sharks that she’d have to swim through first. She recalled that, in the dream, she said to herself, “Why do they have to be sharks? They could be dolphins.” She went on, “I dreamed that I swam right up through a ring of dolphins. I woke up so happy.”
Despite such outcomes, imagery-rehearsal therapy has its detractors. Some patients feel that it is too simple, even gimmicky. And some therapists say that the technique—which is an intellectual cousin of cognitive-behavioral therapy—is an insufficient approach, because it does not seek to get at the roots of the disorder it treats. In other words, nightmares may be the least of a patient’s problems. One defender of a more traditional therapeutic approach is Ernest Hartmann, a professor of psychiatry at the Tufts University School of Medicine. He says, “I suppose you could say, ‘Well, yes, there are reasons behind them, but, still, it’s the damn nightmare that’s bothering the patient, so let’s treat that.’ But I’m not a great enthusiast.” Other therapists prefer to prescribe a drug. Prazosin, originally developed to treat high blood pressure, has been shown to relieve nightmares in some chronic sufferers—though the nightmares typically resume once patients stop taking it.
Increasingly, however, scientists are taking the view held by G. William Domhoff, a psychologist and sociologist at the University of California, Santa Cruz, and a leading dream researcher. He calls imagery-rehearsal therapy “a clear advance,” and argues that the technique, in addition to being effective, reflects contemporary scientific thinking about dreams. Dreams may or may not perform a cognitive or emotional function—that question is still fervently debated among academics. But, even if the utility of dreams is unclear, they still have meaning, Domhoff says, for they are “stories that are clearly based on some of our deepest concerns.”
In ancient Greece, dreams were often thought to be premonitions—messages from the gods. For Plato, dreams also represented a frightening breakdown of reason. “In these circumstances nothing is too outrageous,” he writes. “A person acts as if he were totally lacking in moral principle and unhampered by intelligence. In his dreams, he doesn’t stop at trying to have sex with his mother and with anyone or anything else—man, beast, or god.”
The notion of dreams as otherworldly visitations persisted in Western culture into the nineteenth century. Coleridge, who frequently awoke his household by screaming during nightmares, was influenced by popular philosophical writings that attributed bad dreams to malevolent spirit forces. The image of the nightmare as an incubus—a demon hovering over, or straddling, a recumbent figure—invoked both the helplessness of the sleeper and his or her vulnerability to rapacious sex. (It also may have served as an explanation for wet dreams.) “The Nightmare,” the Romantic painting by Henry Fuseli, became one of the most reproduced images in European art; its ravished sleeper, with her soft, outflung limbs entwined in gauzy bedclothes, suggested that in slumber we are subject to bewitching depredations beyond our control. In the Victorian era, the scientific consensus held that dreaming was pathological. As one journal essay put it, “No one dreams when he is sound asleep. Dreams take place only during an imperfect or perturbed sleep.” Meanwhile, dream books—coded guides to symbols and portents in dreams—became enormously popular, keeping alive the idea of dreams as prophecies.
In 1899, Sigmund Freud published his manifesto, “The Interpretation of Dreams.” He produced not only a revolutionary argument for the vital importance of dreams as “the royal road to a knowledge of the unconscious”; he also established the idea that they were about the past, not the future. Through dreams, Freud argued, we had access to our most deeply submerged personal histories, including memories of early childhood. Tracking down those hidden meanings involved complex detective work for the analyst—a translation of symbols nested artfully within narratives.
Freud had comparatively little to say about nightmares, which didn’t fit his theories particularly well. Nightmares did not preserve sleep by disguising forbidden longings; they often jolted people awake. And they were hard to classify as wish fulfillments, even as elaborately concealed ones. Not that Freud didn’t try. Some of his patients’ horrifying dreams were wish fulfillments, he maintained, because the patients were masochists. In other cases, a gruesome dream could be peeled back to reveal an erotic wish at its core. He once argued that a nightmare that plagued a young female patient—dominated by the image of her little nephew dead, in his coffin—represented her secret desire to be reunited with a family friend she had a crush on, and who would likely turn up at the funeral.
In his 1920 book “Beyond the Pleasure Principle,” Freud amended the idea that all dreams are wish fulfillments. After the First World War, Freud had been much affected by the recurrent nightmares of shell-shocked veterans, in which they returned again and again to scenes of battle. These awful dreams, he allowed, had nothing to do with the pursuit of pleasure and the release of tension that most dreams embodied. Instead, they represented a compulsive pattern of repetition that was the mind’s attempt to create some sort of stability.
Other psychoanalysts elaborated on Freud’s thinking on nightmares. In 1931, Ernest Jones published an influential book arguing that “an attack of the Nightmare is an expression of a mental conflict over an incestuous desire.” Freudian ideas about dreams held sway until the final decades of the twentieth century, when critics began denouncing them as pseudoscience. (In 1993, Frederick Crews famously declared that psychoanalysis “seems to produce a good many more converts than cures.”) For doctrinaire Freudians, Hartmann told me, dreams were seen as “meteorites that fall to the earth and are to be picked apart for clues to this distant, alien dream world.” But most therapists have begun to see dreams as more like gemstones—distinctive but not unfamiliar, and not so hard to make sense of. When Hartmann analyzes a dream, he’s less interested in decoding it fully than in understanding “the emotional gist,” which is often conveyed in a central image—a raging fire, a merciless pursuer. “And the emotional gist usually shows a great deal of continuity with whichever concerns are dominating our waking lives,” he says.
The next patient at Krakow’s clinic was a forty-four-year-old woman named Mary. She had frequent nightmares, which had recently become disturbingly violent. She was unemployed and had just taken in two friends (and their pets) who had lost their homes. Her relationships with both her mother and her husband sounded troubled, and she was on medication for depression, migraines, and nerve pain. She met first with Trujillo, who asked her if she had suffered any “traumatic exposure.”
“Pretty much all my doggone life,” Mary said. She was raised in a strict Catholic household, and was beaten daily as a child. At twenty, she became pregnant by a married man, and gave the baby up for adoption. Mary, who was wearing a T-shirt with the slogan “Earth is our Mother,” came off as intelligent and caustically funny. She said of some pills she had been taking, “I was up to a hundred and fifty milligrams on those bad boys,” and described a former doctor as a “cocky S.O.B.”
When Trujillo asked her about nightmares, Mary said that she’d had them almost nightly since childhood. “They’re more intense now,” she said. “I’m getting killed, or I die in them. When I was younger, it was always like I was being chased and I couldn’t get away or I couldn’t defend myself.” Asked to describe her current emotional state, she said, “I’m more anxious. I’m more pissed off.” She was angry with her former boss, whom she had found overbearing. She told Trujillo, “I’ve had some strange nightmares lately. A lot of them are in Gary, Indiana, and Gary is, like, nowhere near an airport, but in one there’s a plane crash and we see it coming but it’s too late. We can’t do anything about it. I can’t get out of the way. In one of them, I was literally splattered up against my house.” In another recurring nightmare, she’s ripping off the earrings of women she’s angry with, leaving them bloodied; in another, which takes place in a church, she tries to save a woman from an assailant with a semi-automatic weapon but ends up being shot herself.
Trujillo said to Mary, “Your dreams can teach you something.” They were a call of distress, she said, a way for her brain to prod her into asking, “Hey, what’s going on? I need to handle this.”
Krakow came in and had a consultation with Mary. After a while, she confided that she sometimes thought about suicide. To Krakow, this was a clear indication that she wasn’t ready to do imagery rehearsal. In his handbook, he emphasizes that nightmare therapy initially can be upsetting. “In the first few weeks, you may find yourself spending too much time thinking about the problem of bad dreams, and for some people this can promote more bad dreams,” he warns. “Moreover, working with imagery and imagination . . . can also stimulate your mind to produce more images, and some of these images may be in the form of more disturbing dreams.” The nightmares don’t usually begin to abate for at least two weeks.
Krakow told Mary that she should wait to begin nightmare treatment until traditional therapy, or new medication, had made her more stable. “As much as I’m a believer that nightmares make coping harder, I don’t want to put more burden on you right now,” he said.
The final patient of the day was Joan, who is thirty-seven, a sergeant in the Air Force, and currently the administrator of a medical clinic on a military base. All her life, Joan has had striking dreams, and has been able to recall them with cinematic detail. She is confident and articulate, and in some ways she seemed more fascinated by her nightmares than petrified by them. For Joan, it seemed, the main problem with her bad dreams was that they had exacerbated a protracted case of insomnia that first gripped her after she returned from a tour of duty in Afghanistan, in 2008. Joan was in charge of travel for Air Force personnel, and felt a lot of pressure to help people get home promptly. Still, she doesn’t feel that she experienced any particular trauma, and thinks that the insomnia developed because she didn’t adjust well to the changes in time zone and work schedule which accompanied her return to America. “I started getting migraines and they were perpetuating the insomnia,” she told me. “It was a combination of not sleeping well and ruminating and dwelling on the frustration of not sleeping.”
Then a foundering romantic relationship began preoccupying her when she woke up in the night, and her insomnia worsened. The dreams intensified and darkened. “I’m having these very emotionally jolting dreams,” she told me. “I’m exhausted, and then when I actually get to sleep I’m getting woken by these dreams.”
This was Joan’s second visit to the clinic. She is tall, with a firm handshake, a warm, crinkly smile, and artfully cut shoulder-length hair. She wore a pressed oxford shirt, diamond earrings, and chic black-leather boots. Meeting with Trujillo, she said that she had been striving, with some success, to curb her tendency to check the clock each time she woke up. “After Dr. Krakow shared with me the problems with time-monitoring, I made it my intention to not look at the clock,” she said. “It was probably a couple of days, and I started to feel a dramatic difference. My energy level was up. I found difficult situations more tolerable.”
Joan’s demeanor is so coolly logical—she spoke of sleep as a “valuable commodity”—that it was a little surprising when she described one of the wild nightmares that disrupt her sleep. “One night, I had this amazing ‘Jurassic Park’-type dream. There were huge snakes and serpents sailing through the air and, below me, I could see these gargantuan crocodiles and clear water and I’m just trying to escape them. There are armies of spiders—all things that terrify me. And, in my dream state, I’m just marvelling at the size of these things that I’m trying to avoid being eaten by, or bitten by, or, you know, just savagely ripped apart by.”
She went on, “So I’m negotiating my way through this underground maze of Jurassic creatures. And then I’m in this huge dirt cave, and I can see up about a hundred yards ahead of me is this opening—the mouth to freedom.” She saw that some children were also trapped inside the cave. “One of the little girls, I realize, has been bitten by a highly poisonous spider. Her brain starts hemorrhaging—it’s actually quite sick—and her head just splits open and this mass of yellow pus is just exuding from it, and little spider eggs, thousands of them, are just exploding from the ooze.” She paused. “In my dream state, I remember looking up at that opening, and hearing myself saying that this is the only way out of this place.” She woke up, terrified and exhausted. “But I was also thinking how amazing it is that I’m able to dream in color, and in several dimensions. If there could be a video recorder for the brain, that would be so fantastic.”
I asked Joan if she’d miss these surreal dreamscapes if therapy made them disappear. Earlier, Krakow had told me, “We occasionally have people who drop out of therapy, saying, ‘I attach too much meaning to my nightmares.’ ” But Joan was adamant: “I wouldn’t regret not having the dreams.” She wanted to sleep soundly again. Joan seemed like a good candidate for imagery-rehearsal therapy. She has a strong visual imagination, and a capacity for lucid dreaming—the experience of recognizing that you are dreaming while you are dreaming, sometimes to the point of being able to steer the narrative. No more than twenty per cent of people regularly have lucid dreams, as Joan does, but there is some evidence that you can be trained to do so.
As we talked, I realized that Joan was less attached to her nightmares than excited by the idea that the brain projected different movies for itself every night, and that she could help edit them. “I feel it’s amazing, the ability you have to participate in your dreams and direct yourself,” she said. “It’s adrenalizing.”
One standard definition of a nightmare is a dream so frightening that it awakens the sleeper. (Think of a scene from a B movie, in which a troubled sleeper thrashes around, like a fish on a line, and sits up with a full-throated scream.) But a lot of recent dream research suggests that this is inaccurate. Less than a quarter of chronic nightmare sufferers report that they are always awakened by their nightmares. And, in a recent study, Antonio Zadra, a psychologist at the University of Montreal, found that fear was the signal emotion in seventy per cent of nightmares. In the remaining thirty per cent, other emotions predominated: sadness, anger, frustration. The most bizarre nightmare scenarios are not necessarily the most terrifying, or the most common. In another Zadra study, people reported disturbing dreams about “interpersonal conflicts” or feelings of “sadness/helplessness” more frequently than they reported ones about bloodthirsty demons or humongous insects. We tend to think that our dreams are weirder than they generally are, because we remember best the ones with Felliniesque characters and inexplicable lurches: the ex-husband who suddenly becomes a giant, vicious panther. (And we don’t usually see the metamorphosis—one moment he’s this, the next he’s that—which is weird in itself.) As Zadra puts it, “There’s a reporting bias in what we choose to share. You’re not going to say to your wife at the breakfast table, ‘You’ll never believe what I dreamed last night! I was stuck in traffic!’ ”
Depending on the study, between eight and thirty per cent of adults report that they have nightmares at least once a month, and in the course of a lifetime virtually everybody has them. The numbers are higher when people keep a dream log. Sleep studies in a laboratory don’t offer a more precise accounting of the phenomenon, because—to the great annoyance of nightmare researchers—people almost never have nightmares while under scientific observation. No one knows exactly why, but Ross Levin told me, “For most of us, being watched and looked over might be a little creepy—you know you have wires attached to you, you’re on camera—but for nightmare patients it might actually be comforting.” Barry Krakow suggests that embarrassment over nightmares might be another reason for people’s inhibition when they are under scrutiny by a stranger.
Nightmares are more common among children than among adults, and more common among women than among men. The gender difference may be explained, in part, by the fact that women are better than men at remembering their dreams, and perhaps more willing to admit that they have nightmares. The German dream researcher Michael Schredl has coined the term “dream socialization” to describe a cultural predisposition among women and girls to discuss their dreams, and assign meaning to them. (How many unicorn-embossed dream journals have you seen on the bedside tables of teen-age boys?) It’s also true that women, who tend to report feeling more stress than men, wake up more often in the night, and sleep interruptions make dreams easier to remember. Still, even when dream recall is taken into account, women have more nightmares than men, starting in adolescence, which is also when women begin experiencing higher rates of depression and anxiety.
Most nightmares, like most dreams we remember, occur in the stage of sleep known as REM, or rapid eye movement, which accounts for about a quarter of the time that the average adult spends asleep. During REM periods, we are physically immobilized but physiologically active: heart rates are elevated, breathing is irregular. Nightmares are different from night terrors, which typically occur in the first, slow-wave stage of sleep, and which tend to be plotless flashes of panic. Nightmares are narratives. They have major and minor characters, settings, plot twists, and nuanced emotional valences.
The themes of nightmares, however, seem to be surprisingly universal. In the few studies that have been done across different cultures, the most common scenario involves the dreamer being pursued or attacked. Michael Schredl found, in a recent study of more than a thousand young adults, that some other common subjects are finding yourself in threatening surroundings, taking a test for which you aren’t prepared, suffering paralysis, being late to an important event, and having people close to you die or disappear. Then there are the common scenarios that are disquieting, if not exactly nightmarish: suddenly having all your teeth fall out, for instance, or showing up in public naked. People around the world seem to alight on the same sturdy metaphors for shame, loss, and mortality.
Though scientists agree on the broad themes that animate nightmares, they haven’t looked very systematically at the form of storytelling that occurs in a nightmare. “We know a lot about their frequency,” Antonio Zadra says. “But we know almost nothing about their actual content. How do they unfold? Do they tend to start off as negative scenarios or become that way, and, if the latter, then what’s the trigger? How does the plot turn? Is it the entrance of a particular character?” Zadra has recently been trying to pinpoint some basic narrative commonalities; one of his first preliminary findings is that most bad dreams are set indoors.
In a similar spirit, William Domhoff has, for many years, been analyzing long dream series—like those of a widower he calls Ed, who lost a beloved wife, Mary, to ovarian cancer, and who for twenty-two years kept a journal in which he recorded a hundred and forty-three dreams about her. (“I am walking with Mary, who is wearing a white dress,” Ed writes in one entry. “She looks terrific—as she had prior to the last recurrence of the disease. She has been resurrected for a particular purpose that is not made clear in this dream. I comment on how terrific she looks, even though she had been in the grave only a short while ago. There was no decay nor any indication that she had been dead. But as I speak I realize I should not have said anything, because she doesn’t know she had been dead and is now resurrected. My remarks disturb her greatly. Her mood changes from one of smiling happiness into surprised sorrow. Something in her belly begins to bulge and throb.”) Many of his nightmares conformed to this structure: Ed is at first overjoyed at seeing Mary again, then is suddenly unsettled by the realization that she is dead, or horrified, as in the dream above, at having to tell her that she is.
For the most part, though, our sense of what nightmares generally look and feel like comes from fiction, especially from movies—from the surreal dreamscape that Salvador Dali designed for Alfred Hitchcock’s “Spellbound” to the twisted fantasias of David Lynch. Such cinematic sequences succeed better than most nightmare studies do in re-creating what it feels like to be transfixed by frightening images that are screened in the projection room of one’s mind. It makes intuitive sense, then, that the relationship also works in reverse—if filmmakers draw on nightmares, their films, in turn, sometimes give us bad dreams. Parents are always warning kids that scary movies will sow nightmares. Scientific support for this notion is, so far, only tentative. In a study published in 2000, when children were asked to attribute their bad dreams to a cause, they did frequently cite something that they had seen on TV. There is also evidence that dream villains and monsters evolve over time, in response to popular culture. Michael Schredl looked at several nightmare studies from the twentieth century, and found that dreams of the bogeyman were common in the twenties; dreams of ghosts, devils, and witches reigned in the fifties and sixties; and those of movie villains predominated in the nineties. Tore Nielsen, who directs the Dream and Nightmare Laboratory at Sacré-Coeur Hospital in Montreal, told me that “Freddy Krueger has really gotten into dreams, and so has Voldemort.” Still, at least one recent study, conducted by Schredl with two hundred and fifty German children between the ages of nine and thirteen, found that nightmares were not more frequent among the kids who watched more TV or played more computer games. “Nightmares are clearly reflecting the media, and what children see there,” Schredl says. “But it’s not clear, at least for now, that it increases the actual number of nightmares.”
The phenomenology of dreaming remains surprisingly imprecise. For example, according to Eric Schwitzgebel, a philosopher at the University of California, Riverside, most Americans now claim that they dream in color. So did most people who asked themselves that question before the early twentieth century, including Aristotle, Descartes, and Freud. But in the middle of the twentieth century most people began reporting that they dreamed in black-and-white. In 2006, Schwitzgebel and two Chinese colleagues, Changbing Huang and Yifeng Zhou, performed a study on Chinese high-school and university students. Those who belonged to the groups that had been watching television and movies in color the longest were the most likely to report dreaming in color. Schwitzgebel’s team speculated that, in fact, “dreams may be neither colored nor black and white, leaving the colors of most of their objects unspecified, as novels do. Perhaps it takes time and energy to fill in all the colors in a richly detailed scene, with the result that most of our dream imagery is fairly sketchy, even if that sketchiness is not recognized by the dreamer.”
Yet if one gives credence to the accounts of dreams by Sigmund Freud and his patients—many of which are overstuffed scenarios that take pages to lay out, and include formidable chunks of dialogue—dreams today often seem to be quicker and choppier than they once were, more closely resembling a YouTube video than a novel. If you ask friends to describe their nightmares, you’ll frequently hear film terms: suddenly we cut to this, or pan to that, or dissolve to the stalker, standing silhouetted in the doorway. Dreams have always favored the visual: we don’t experience them primarily as auditory phenomena, and hardly at all as olfactory ones. But more than that, as the British psychoanalyst Susan Budd writes in a 1999 essay, “Modern patients don’t often produce the kinds of dreams that Freud had. Modern dreams mostly seem to be shorter and more fragmentary, and this is because the dream is undoubtedly a cultural as well as a neurobiological product.”
Although the impact of scary movies on nightmares is uncertain, researchers have no doubt that frightening events in the real world trigger more frequent nightmares—even for people with no direct experience of the event. When the Loma Prieta earthquake hit California, in October, 1989, ninety-two college students living in the San Francisco Bay Area had about twice as many nightmares—about earthquakes, but about other scary stuff as well—in the following weeks than did a control group of students in another part of the country. Ernest Hartmann studied dreams in the weeks after the attacks of September 11, 2001. Surprisingly, not one of the nearly nine hundred dream reports he collected was about planes flying into towers. At the same time, the dreams he looked at had significantly more, and more intense, central images than a typical set of dream reports. Often, the bad dreams centered on other kinds of disasters, such as tidal waves.
According to Hartmann, nightmares that stay with us for a long time—what Carl Jung called “big” dreams—are almost invariably dominated by one potent image. As he sees it, these images, though harrowing, are ultimately fortifying. Dreaming about trauma, like talking it over in therapy, helps render it less “uniquely distressing,” he says, and weaves it into a fabric of memories that we can live with. For most people, the terror quotient gradually recedes and may be replaced by feelings of vulnerability. These new visions may “portray something or someone other than the dreamer as victim,” and they won’t necessarily seem like nightmares. (Hartmann cites an example of a man who was grieving over the death of his mother. He reported dreaming that “this huge mountain has split apart and there are pieces lying around. I am supposed to make arrangements to take care of it.”) This process of “integration” occurs, Hartmann believes, because “the powerful new experience has been incorporated into the dreamer’s emotional knowledge,” better preparing him to face crises in the future.
This is clearly not what happens with the four to eight per cent of people who can’t shake off nightmares, and have them at least once a week. Some of these people suffer from nightmares because they have P.T.S.D. But others have not been touched by any obvious trauma, and may not otherwise suffer from anxiety, depression, alcoholism, or a serious mental illness that can undermine sleep. No one knows for sure why such people are susceptible to chronic nightmares. But one theory, proposed by Hartmann in the late eighties, and which has been supported by subsequent studies, is that these dreamers have “thin boundaries.” When given a diagnostic questionnaire, these people tend to score high on sensitivity and imagination; they easily identify with their childhood self; and they have a propensity for daydreaming and déjà-vu experiences.
Reading about Hartmann’s theory, I thought of Yael, the art-history graduate student who was preoccupied by nightmares of the Holocaust. She had told me, “With movies, I feel more—I relate more than other people seem to. Afterward, I’m still thinking about it—more than that—I’m putting myself in the situation the characters were in during the movie and thinking, What would I do? How would I react? More so, even, with a book. Because you really imagine it.”
In Yael’s case, this feeling was particularly intense when the movie or the book had to do with the Holocaust, the subject that had so fascinated and appalled her as a girl. She had read everything she could about it, frequented Holocaust museums and memorials, even walked down the street imagining herself as a child living in Nazi Germany. At thirteen, she made a deliberate decision to stop immersing herself in Holocaust history. “I just couldn’t really handle it anymore,” she says. Now, as a grad student, she is focussing on seventeenth-century Dutch art. But not long ago she was supposed to write a paper about the paintings of Samuel Bak, a Holocaust survivor. Though his images were “not blunt or obvious,” she said, she started “doing a lot of stuff to avoid writing that paper. I was afraid that the images would trigger nightmares.”
Yael’s story suggests that some people might be more sensitive to nightmares than others. Several recent studies have looked at that question and concluded that a subject’s psychological well-being was more tied to her attitude about having nightmares than to how often she had them. As Antonio Zadra, the Montreal researcher, put it, “Some people will have a nightmare a month and be very distressed by them. Others may have them weekly and think, I’m not going to get therapy! They must be doing something useful.”
In recent decades, as psychoanalysis has lost its cultural prestige, new theories about dreams have begun to emerge. Many of them try to gauge the evolutionary role of dreams. According to Antti Revonsuo, a Finnish cognitive scientist, dreams may have evolved in humans as “threat simulations,” in order to help protect the species. Like pilots training on flight simulators, or gamers evading robots on computer screens, our ancestral selves used dreams to rehearse ways of avoiding danger. In a 2009 paper in the American Journal of Psychology, Revonsuo and a co-writer, Katja Valli, theorized that “modern humans still possess this ancient defense mechanism,” though it probably no longer fulfills its original biological function, since the modern environment is so different from the one in which the system evolved. (Fewer mastodons, more traffic.) One problem with this notion is that even though many nightmares involve perilous scenarios, the threats are often not at all realistic but, rather, oblique, metaphorical representations of disquiet, or inexplicable obstacles that keep us from getting somewhere we urgently need to go. Moreover, very few nightmares climax with the dreamer defeating whatever it was that was threatening him. In a 2006 study by Zadra, the threat was vanquished in only seventeen per cent of recurring dreams that contained a menacing element; the subject woke up thirty-seven per cent of the time; and in forty per cent the threat was fulfilled. The threat-simulation theory is what evolutionary scientists call a “just-so” story: a seductive but unprovable supposition about the origins of human behavior.
One of the newest theories about the function of nightmares comes from Ross Levin, the New York sleep specialist, and Tore Nielsen, the Montreal researcher. Their view is that dreaming may serve the adaptive function of “fear memory extinction”: desensitizing the sleeper to something scary through repeated exposure in a less frightening context. Dreams recombine memory fragments, some of which are scary or anxiety-producing, into a palpably alien scenario. Someone might dream of walking down a dark, deserted street where a shadowy figure is striding, threateningly, toward her. But dreams also add memory elements that are not frightening—“non-aversive,” in Levin and Nielsen’s behaviorist terminology. The crepuscular figure might step into a pool of light, revealing herself to be the dreamer’s best friend. Like Revonsuo’s theory, this one presumes that, for evolutionary reasons, our brains are primed to be vigilant, always evaluating potential threats. Levin told me, “Dreaming is kind of like nightly exposure. We’ve got this bank of memories, and REM sleep seems to activate them neurochemically. The limbic system gets massively activated and projects up to all these areas of the brain and seems to unlock access to these memories. Memory doesn’t get encoded as a whole thing—it gets broken down in these little bits and pieces.” This process, Levin says, is a “perfect recipe” for taking some of the sting out of a frightening stimulus. If you’re afraid of snakes “and you see a snake but it’s in a zoo, it’s a little bit more O.K. If it’s in a movie, same thing. And it’s the same with a dream.” Emotions drive this process, Levin claims—the more stress you are under, and the more anxious you tend to be generally, the more that emotion will flood your sleep. If too much negative emotion floods it, then the “fear memory extinction” system breaks down and you end up with repeated nightmares instead.
The model is thought-provoking, but it offers a fairly narrow view of dreams. William Domhoff, the Santa Cruz scholar, says, “Dreams are not just about our memories. They’re about our concerns—how we conceive the world. In waking life, my thoughts aren’t just driven by what I’m looking at outside my window. I’m also imagining this, anticipating that. Something similar is true for dreaming life. We have this thinking capacity that goes beyond reassembling memory fragments, and that results in the use of images and the juxtaposition of ideas in a much more creative and figurative sense.”
Domhoff has come to believe that nightmares don’t really help us solve problems. He notes that people who rarely, if ever, recall their dreams “seem to do just as well in life as recallers.” Moreover, recurrent nightmares don’t seem to be doing their sufferers any service. But that’s not to say that dreams in general aren’t meaningful, or useful. People who reflect on their dreams can gain insight into their priorities and preoccupations, past and present—or, if they’re creative types, dip into them for artistic inspiration. Domhoff’s Web site, DreamBank.net, has collected some twenty-five thousand accounts of dreams, including nightmares. You can find dream reports from, among others, a child molester, blind people, a transvestite, college students, grade-school kids, and widowers such as Ed. Trolling through them is a little like being able to read the minds of all the people in your subway car: fascinating, embarrassing, overwhelming. Following the precepts of his mentor, Calvin S. Hall—a psychologist who published a popular book, “The Meaning of Dreams,” in 1953—Domhoff believes that researchers, rather than analyzing individual dreams, should evaluate a person’s dreams over time, and quantify how often certain themes, characters, and emotions appear in them. Such an assessment can reveal something essential about the person. Dreams, Hall maintained, are “the embodiments of thoughts” and, in aggregate, offer a reliable guide to the way we feel about our lives. Or, as Domhoff writes on his Web site, “Give us 1,000 dreams over a couple of decades and we can give you a profile of the person’s mind that is almost as individualized and accurate as her or his fingerprints.” Indeed, dreaming life can sometimes feel like a parallel universe, in which you regularly revisit a host of scenarios that resonate for you, year after year: the panicked call that won’t go through; your parents’ house, which is suddenly revealed to have hidden passageways and unexplored wings.
Antonio Zadra said of the new theories, “I’m leaning more toward Domhoff. Setting aside the question of whether any dreams have a function, I would doubt that nightmares do. The new evolutionary theories are certainly interesting, in that they make us look at dreams from a different perspective, and think about what pressures in our ancestral environment might have made having nightmares an advantage—regulating fear, regulating emotion. But since nightmares tend to be related to poor scores on psychological well-being, if they have a function, it doesn’t seem to be working. The research shows that when people get rid of their nightmares their sleep improves, their health improves—they’re better off.” Zadra prefers to think of nightmares as a powerful symptom. “Nightmares might be psychologically meaningful,” he said. “They can reveal that something is amiss, that you’re experiencing affect that is too intense in the daytime. But I don’t think they have a biological function that’s useful for individuals. If they did, people who don’t have nightmares would be missing out on something—and, clearly, they’re not.”
A few months after my visit to Dr. Krakow’s sleep clinic, I spoke on the phone with the patients I had met, to see how they were doing. Toni, the woman whose mother had died in her apartment, had been engaged in imagery-rehearsal therapy for about six months. She still had nightmares, but they were less severe and less frequent—three times a week instead of every night. Bad dreams woke her up less often, and when they did it was easier to get back to sleep, partly because she had got better at soothing herself with relaxing imagery, often of Ireland, and with New Age Celtic music. She continued to do daily visualization, and felt that it helped. She had opened a box of old photographs, and was spending time looking at images of her mother in her fifties, to try to replace the sick woman of her nightmares. And it was working: in Toni’s new dreams about her mother, her mother was vibrant, her hair dark and full again. Often, the new dreams had a comic tone: in one, her mother arrived at Toni’s house in a car with smoke spewing extravagantly out of the hood, like something in an “I Love Lucy” episode. Toni’s waking life was also improving. She had left the apartment where she had taken care of her dying mother and moved into a more spacious place. She was looking forward to going on a road trip with a friend to San Diego, where the band AC/DC was giving a concert.
Mary, who had been having the roughest time, had switched to a new antidepressant, and now felt more “clearheaded.” The suicidal thoughts had disappeared, and she’d found some new people to talk to who were supportive and understanding, including Linda Trujillo, from the sleep clinic. She still had severe nightmares, though, and remained interested in imagery-rehearsal therapy. “I want to try all the tools out there that I can use,” she said.
Joan, the Air Force sergeant, was still trying to work out her romantic relationship, and was up for a big promotion at the base. She continued to have nightmares that were remarkably phantasmagoric, but, like Toni, she found it easier to get back to sleep when they woke her. She felt more rested when she started the day. And even though her nightmares remained lush—the images staying with her longer after she woke up—she felt she had more control over them. Recently, she said, she’d been having a nightmare about tornadoes, and she’d experienced a moment of lucid dreaming. “In this last dream, the sky was just blackened with funnel clouds,” she recalled. “I was up in the sky. I wasn’t very fearful of what was going on, though I kept hearing myself saying, ‘It’s just a dream, fly through it.’ So I could feel my dream-self calming down. But I was still dreaming.” Joan paused. “It was a fantastic feeling.” ♦
