Nightmare

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

A nightmare is a dream which causes a strong unpleasant emotional response from the sleeper, typically fear or horror, or the sensations of pain, falling, drowning or death. Such dreams can be related to physical causes such as a high fever, or psychological ones such as psychological trauma or stress in the sleeper's life, or can have no apparent cause. If a person has experienced a psychologically traumatic situation in life—for example, a person who may have been captured and tortured—the experience may come back to haunt them in their nightmares. Sleepers may waken in a state of distress and be unable to get back to sleep for some time.

Occasional nightmares are commonplace, but recurrent nightmares can interfere with sleep and may cause people to seek medical help. A recently proposed treatment consists of imagery rehearsal. This approach appears to reduce the effects of nightmares and other symptoms in acute stress disorder and post-traumatic stress disorder.

Practitioners of lucid dreaming claim that it can help conquer nightmares of this type, rather than of the traditional type (see below).

Historic use of term

Nightmare was the original term for the state later known as waking dream (cf. Mary Shelley and Frankenstein's Genesis), and more currently as sleep paralysis, associated with rapid eye movement (REM) sleep. The original definition was codified by Dr Johnson in his A Dictionary of the English Language and was thus understood, among others by Erasmus Darwin and Henry Fuseli, to include a "morbid oppression during sleep, resembling the pressure of weight upon the breast."

Such nightmares were widely considered to be the work of demons and more specifically incubi, which were thought to sit on the chests of sleepers. In Old English the name for these beings was mare or mære (from a proto-Germanic *marōn, related to Old High German and Old Norse mara), hence comes the mare part in nightmare.

Folk belief in Newfoundland, South Carolina and Georgia describe the negative figure of the Hag who leaves her physical body at night, and sits on the chest of her victim. The victim usually wakes with a feeling of terror, has difficulty breathing because of a perceived heavy invisible weight on his or her chest, and is unable to move i.e., experiences sleep paralysis. This nightmare experience is described as being "hag-ridden" in the Gullah lore. The "Old Hag" was a nightmare spirit in British and also Anglophone North American folklore.

Various forms of magic and spiritual possession were also advanced as causes. In nineteenth century Europe, the vagaries of diet were thought to be responsible. For example, in Charles Dickens's A Christmas Carol, Ebenezer Scrooge attributes the ghost he sees to "... an undigested bit of beef, a blot of mustard, a crumb of cheese, a fragment of an underdone potato..." In a similar vein, the Household Cyclopedia (1881) offers the following advice about nightmares:

"Great attention is to be paid to regularity and choice of diet. Intemperance of every kind is hurtful, but nothing is more productive of this disease than drinking bad wine. Of eatables those which are most prejudicial are all fat and greasy meats and pastry... Moderate exercise contributes in a superior degree to promote the digestion of food and prevent flatulence; those, however, who are necessarily confined to a sedentary occupation, should particularly avoid applying themselves to study or bodily labor immediately after eating... Going to bed before the usual hour is a frequent cause of night-mare, as it either occasions the patient to sleep too long or to lie long awake in the night. Passing a whole night or part of a night without rest likewise gives birth to the disease, as it occasions the patient, on the succeeding night, to sleep too soundly. Indulging in sleep too late in the morning, is an almost certain method to bring on the paroxysm, and the more frequently it returns, the greater strength it acquires; the propensity to sleep at this time is almost irresistible."

See also

• Sleep disorder
• Night terror
• Sleep paralysis
• Hag
• Lucid dream
• Glossary of Traumatology

Notes

• Max Eastman visited Sigmund Freud's apartment in Vienna, in 1926. He saw a print of Fuseli's The Nightmare, next to Rembrandt's The Anatomy Lesson. Ernest Jones chose another version of Fuseli's painting as the frontispiece of his book On the Nightmare, however neither Freud nor Jones mentioned those paintings in their writings about the classic nightmare.
• Recent exhibits: Gothic Nightmares: Fuseli, Blake and the Imagination. 15 February – 1 May (2006); Tate Britain, Millbank, London SW1P 4RG.
• When considered a disease, nightmares are classified as follows:
  • ICD-10 code = F51.5
  • ICD-9 code = 307.47

References

• Anch, A.M., & Browman, C.P., & Mitler, M.M., & Walsh, J.K. (1988). Sleep: A scientific perspective. New Jersey: Prentice-Hall, Inc.
• Harris J.C. (2004). Arch Gen Psychiatry. May;61(5):439-40. The Nightmare. (PMID 15123487)
• Jones, Ernest (1951). On the Nightmare (ISBN 0-87140-912-7) (pbk, 1971; ISBN 0-87140-248-3).
• Forbes, D. et al. (2001) Brief Report: Treatment of Combat-Related Nightmares Using Imagery Rehearsal: A Pilot Study, Journal of Traumatic Stress 14 (2): 433-442
• Siegel, A. (2003) A mini-course for clinicians and trauma workers on posttraumatic nightmares.
• Burns, Sarah (2004). Painting the Dark Side : Art and the Gothic Imagination in Nineteenth-Century America. Ahmanson-Murphy Fine Are Imprint, 332 pp, University of California Press, ISBN 0-520-23821-4.
• Davenport-Hines, Richard (1999). Gothic: Four Hundred Years of Excess, Horror, Evil and Ruin. North Point Press, p160-61.
• Simons, Ronald C and Hughes, Charles C (eds.)(1985). Culture-Bound Syndromes. Springer, 536pp.
• Sagan, Carl (1997). The Demon-Haunted World: Science as a Candle in the Dark .

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