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Nightmares and sleep fighting?

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@barefoot i appreciate the feedback and skepticism. I also am skeptical of meds and I’m not happy about it. I keep getting told I’m a “difficult case” or “maybe we need to find something to take the edge off while you work through this”. Then I also get told I’m not ready to work through difficult trauma stuff yet bc I dissociate a lot. Idk. I’m frustrated. At this rate I’ll be dead before my “window of tolerance” grows even a little.
 
I can’t say there’s a theme except maybe I keep getting hurt or killed by people I know or I am trying to save someone or something and I’m always too late. I actually had a dream my therapist came up behind me and stabbed me in the heart

I have a very similar recurring dream. In it, I'm somehow aware that someone out there wants to kill me...I'm running, scared, panicking...and then I get to the house of someone I know (it's not always the same person – one time it was my therapist's room) and I bang on the door and they open it and I'm in a state telling them I'm so terrified and that someone's trying to kill me and could they please let me in etc. And they let me in, listen, say soothing things, I start to feel calmer because they're going to take care of me and help keep me safe. And then, at some point, I suddenly have a terrible realisation – and I realise that they're the killer (sounds like a bad horror movie!). And just as that truth dawns on me, they plunge a knife into me and then everything goes black and I die. And I wake up, gasping for breath.

I've spoken to my T about it a few times. She interprets it as being a dream about betrayal. And that makes sense to me. So, your dream about being killed by people you know brought up the same thought...the theme of betrayal.

Just to add and this may be way off but could prove helpful: I finally went to a sleep clinic about my parasomnias and did an overnight sleep study earlier this year. They discovered I have sleep apnea. I know you're talking about nightmares rather than night terrors/hallucinations etc but if you are acting things out, it sounds like you may well be slipping in and out of sleep stages, so there may still be some relevance here. I have been using a CPAP machine since February (I'm going to switch to a dental device instead because, for a few reasons, I can't tolerate the CPAP) and, so far, I haven't had a night terror, the number of hallucinations I've had has reduced (though the presence of the mask and all the air blowing and making it hard to breathe has ended up intensifying the panic as I try to come round and work out what's going on) and my nightmares have reduced as well. In fact, I don't think I've had the one I'm just written about above since using the CPAP.

So, for me, I am thinking that the above dream is actually prompted by my apnea – I wake gasping for air not, as I originally thought, because the dream is so intense as I get killed and breathe my last in my dream. But because, in real life, I have actually stopped breathing and my brain has then kind of created this narrative – the dream – as a means of prompting me to wake up and breathe. Something like that anyway – it's complicated and I'm still working it out! So, for me, I think there is a "medical" reason that prompts me to wake up gasping for breath. And my experiences and psyche and trauma background being what it is, I think the dream that prompts that action is still meaningful in its own right.

I had no idea I had sleep apnea but did know I snore. If you are a loud snorer – particularly if you snort yourself awake a lot or find yourself waking up gasping for breath (even if you think the gasping is a result of the dream you've awoken from) – it may be worth getting this checked out. I guess if you live alone, you may not know whether you snore or not or may think you don't but actually you do?!
I have looked at various sleep apnea/CPAP forums (I know how to live an exciting life, right?!) and it seems that several people report nightmares significantly reducing when they started successfully treating sleep apnea. So, it does seem to be "a thing" for a lot of people. Not necessarily your thing. But maybe worth a check?

@barefoot i appreciate the feedback and skepticism

It's not so much that I meant I was being sceptical about use of meds per se. It was more that, you had said you'd been having nightmares for only about 10 days, so it seemed a very fast and quite extreme reaction to me for a doctor to be dishing out medication to you when this wasn't a longer term issue for you. Before I did the overnight sleep study and got the sleep apnea diagnosis, the sleep consultant suggested a couple of routes for us to go down and then medication was mentioned as a last resort if none of the others work and I very much got the feeling that he was really hoping it wouldn't get to that. He seemed very reluctant to go down the prescribed meds route. And I've been having my sleep issues for about 25 years! So it was just startling to me that you would be given such drugs after experiencing nightmares for a week and a half.

Then I also get told I’m not ready to work through difficult trauma stuff yet bc I dissociate a lot.

I got told this too – my therapist said about two years ago that she didn't feel it was in service to me to try to do the deeper work because I had so much resistance and was severely dissociating in most sessions and that would then pretty much write off the rest of my week. She said it was actually potentially harmful because I was getting retraumatised every session and that wasn't what therapy was for and she didn't feel she would be doing her job properly if she just allowed this pattern to continue. I was really, really gutted because it all felt so hard and so pointless. And because, intellectually, I really wanted to do that work – I felt committed to it and really willing. And she "wasn't letting me' do what I wanted to do. But, the reality was, when it came to trying to do it, I just couldn't stop the dissociation kicking in and it was a pretty brutal experience each time.

Gutted as I was, in retrospect, I really feel she made the right call. I wasn't ready. I was trying to force the process but it couldn't really be forced. And the more I tried to throw myself in, the more my head went and the more negative impact that had - more dysregulation, more symptomatic, reduced day-to-day functioning because it took days to bring my head back fully online, more sleep disturbances...

Anyway – I kept going to therapy, just didn't work directly on trauma (though, of course, we knew about that stuff so it still formed a context to our work)

I now haven't dissociated for over a year. Still get a bit spacey sometimes when the going gets tough. But not full on dissociating. And nothing that lasts for days like before.

So, please don't be too discouraged. You may be dissociating too much and have too much resistance to be able to do that deeper work right now. But that doesn't mean you won't ever be able to do it. For me, I think, that powerful desire to do it and then the constant failure every week to actually do it led to me feeling very frustrated with myself, very despondent about therapy, and I think I created a lot of pressure for myself around it. Once I got over feeling gutted about pressing pause on trauma work, I think some of that pressure was relieved. So, it's definitely an option, which could work for you? Pause the trauma work. Work on other stuff. Chip away at the resistance by just showing up every session, staying present and staying in relationship with your T. For me, I think a lot of it was about spending more time just tolerating being in the space with my T because the intimacy and vulnerability had felt so anxiety-making and overwhelming. So building my tolerance to that, which in turn increased my sense of safety in the space and trust in my T...I think those things have really helped me to keep my head in the room. And when I had improved with those things, it meant that we could revisit some of the harder stuff.

Sorry...I've written an essay! Wishing you the best with all of this – the sleep stuff and the dissociation/therapeutic progress issue. Hang in there because, even if you feel a bit stuck right now, these things really can change!
 
@barefoot i actually did have a sleep study done and I don’t have sleep apnea which everyone was surprised apparently lol.

I have been stressing out bc I have 2 court cases that should be coming to a conclusion soon and they are regarding my injury and being attacked at work which just brought up a whole bunch of crap that I didn’t know was there and landed me in the psych hospital for a few days. It’s been a year and a half since the attacked or longer and I got screwed over and fired and I just really don’t want to deal w all that stuff again and relive it bc I felt like no one took me seriously that the guy was dangerous . Not to mention the 4 surgeries I had to have bc of him.

I’ve been trying to work on being more mindful and I hate it bc I feel it gives my bad memories the opportunity to pounce and I automatically dissociate. I’ve always had sleep issues. From 6 years old I was hit by a tornado and couldn’t sleep, still can’t, without a fan or something making noise bc the sound of storms was too upsetting. I’ve tried trazodone, got used to it, melatonin, yoga, all that crap. I don’t really like the meds and like I said now I feel too tired.

Trauma work is frustrating bc I want to tackle the stuff and my therapist is like “no, slower”. I’ve been w her almost 6 years. She told me I’m not ready for a job again for at least 6 months so that’s super frustrating bc I can’t sit still. She’s great, I just get impatient.
 
Update: my nightmares have decreased in intensity. Now they’re just weird and have a lot more snakes? The hell? I’ve also gone from nightmares and barely sleeping to sleeping way too much like 10+ hours and a nap from the meds I believe. See psych next week. There has to be a balance? But I am no longer throwing myself off the bed or accidentally punting the dogs off the bed so they’re happy and I’m less bruised.
 
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