Nightmares, Health, and the Urgent Call to Listen
A sneak peek at new material in A Clinician’s Guide to Dream Therapy
“Distressing dreams are an invitation to heal.” – Clare Johnson
Nightmares are more than unsettling nighttime experiences. They are messengers—vital signals from our body and psyche—that can reveal the state of our mental and physical health. In the second edition of A Clinician’s Guide to Dream Therapy (now available for pre-order, shipping June 2), I make the case that nightmares are not just symptoms of distress but also potential contributors to serious health concerns, including cardiovascular disease and suicide risk.
The new material on nightmares offers a powerful update for clinicians and dreamers alike. It explores the latest research showing that nightmares reflect and affect our autonomic nervous system, our emotional regulation, and even our heart health. When ignored, they may contribute to chronic stress, disrupted sleep, and the myriad mental and physical consequences of these.
Nightmares and the Nervous System
Using the lens of polyvagal theory, we can see how nightmares mirror the body's threat response. Dreams often express our autonomic states: dreams of connection signal safety; nightmares of pursuit or paralysis mirror fight-or-flight or shutdown. But here’s the hopeful part: when dreamers engage with these disturbing images, they can shift their internal states. As one dream example in the new chapter on nightmares and health shows, a simple bath turning warm can signify a shift toward safety and regulation.
Heartbreak—Literally: Dreams and Cardiovascular Health
New research suggests that persistent nightmares may be bad for your heart. Repeated episodes can spike blood pressure, reduce heart rate variability, and strain the cardiovascular system. Recent studies have linked frequent nightmares to increased risk of stroke and heart attack—particularly in trauma survivors like the firefighter profiled in the book, whose untreated PTSD nightmares carry physical consequences:
“John is a retired fireman who suffers from PTSD, unable to forget some of the horrific scenes he encountered as part of his work as a first responder. Although the tough hero culture for firefighters is gradually changing, during his tenure, John was not encouraged to talk about how troubled he was by certain incidents. The tacit message was: tough it out, stay strong and silent. Years later, John’s nightmares visit often, and when they startle him awake, he can feel his heart racing and his palms sweating. He has been putting off therapy to address the trauma he knows is fueling his nightmares because it feels easier not to face it. What he doesn’t realize is that this avoidance not only disrupts his peace of mind but also puts him at higher risk for a heart attack or stroke.”
The chapter goes on to summarize the growing body of research supporting the bi-directional link between nightmares and cardiovascular health.
The Nightmare–Suicide Link
Even more alarming is the strong and under-recognized link between nightmares and suicide risk. Studies show that those with frequent, trauma-related nightmares are significantly more likely to attempt suicide. Yet many clinicians shy away from asking about dreams, fearing they may retraumatize their clients. In truth, silence may be the greater danger. This chapter argues forcefully that asking about dreams—and learning how to treat nightmare distress—is an important suicide prevention strategy.
Dreams as Early Warning Signs
Nightmares don’t emerge in a vacuum – they are like an emotional barometer that tracks internal turbulence and the possibility of storms. For example, a recent study depicts in specific detail how disturbing dreams escalate in frequency and intensity before a suicide attempt. This makes them powerful early warning signs. Learning to track and interpret changes in dream life can help clinicians understand underlying emotional upset that may be brewing, even if it’s below the level of conscious awareness. Dreams often point to underlying issues that we may prefer to avoid, unearthing topics therapy clients otherwise wouldn’t bring up for discussion.
There Is Hope: Treatments That Work
The chapter ends on an empowering note: nightmare treatments are not only effective, but often simple. Techniques like Imagery Rehearsal Therapy (IRT), lucid dreaming practices, talking about the dream and visualizing a way forward – all of these approaches can ease the emotional intensity and reduce nightmare frequency. Our Nightmare Relief protocol combines the best of nightmare treatment research and embodied trauma treatment techniques in a series of simple steps that are outlined in another new chapter that summarizes nightmare treatment. Detailed clinical examples and full session transcripts are included.
This new material in A Clinician’s Guide to Dream Therapy, reflects recent gains in understanding and a shift in the clinical approach to nightmares. No longer can we view nightmares just as symptoms to make note of and ideally to suppress. These intense dreams are early warning signs, somatic metaphors, and—most importantly—the dreams themselves can provide avenues for healing.
If you’ve ever wondered whether dreams matter in the therapy room—or in your own life—this book offers a resounding yes. Nightmares may be frightening, but they can also be life-saving warning signs.
Pre-Order Now:
The second edition of A Clinician’s Guide to Dream Therapy is now available for pre-order and launches June 2. This expanded edition includes insights on the health implications of nightmares, new case studies, and updated treatment protocols. Don’t miss this essential update for therapists, dream workers, and anyone who believes in the transformative power of dreams.
Here is a link to the book’s landing page:
https://drellis.mysamcart.com/a-clinicians-guide-to-dream-therapy-2nd-edition/
And here is the link to pre-order from Routledge:
https://www.routledge.com/A-Clinicians-Guide-to-Dream-Therapy-Demystifying-Dreamwork/Ellis/p/book/9781032806976
They are currently offering a 20% discount. Use the code 25ESA2