YOU MIGHT SAY that Patrick McNamara--a Boston University School of Medicine associate professor of neurology and director of its Evolutionary Neurobehavior Laboratory--is in a frightening line of work. As a sleep researcher, he is hunting for new ways to treat people with nightmare disorder (also known as dream anxiety disorder). Being chased by a malevolent entity, McNamara says, is one of the most-common recurring nightmares that patients report experiencing over and over again.
"Very often, people with chronic nightmares report dreaming about being chased or attacked by supernatural or demonic beings. They can't really see their attackers' faces but they know their intent is to harm them. People also report being chased by animals like snakes or bears. Bears are very frequent in these types of dreams, where you're trying to get safe, throwing up obstacles between you and the predator, feeling like you're about to be attacked."
A nightmare like that might give anyone a bit of anxiety, but terrifying dreams, if they keep occurring, can induce more than just fleeting fear. McNamara points out that recurring nightmares can have profound long-term effects, especially for children. In the U.S., between half and two-thirds of children and up to 15% of adults have frequent nightmares. "Recurring nightmares are really significant predictors. They foretell mental health trouble."
For children, that trouble can come in the form of adolescent and adult psychosis, including anxiety, depression, stress, and suicidal ideation. In adults, distressing nightmares often can be a sign of post-traumatic stress disorder (PTSD). Despite the documented clinical effects of nightmares--including distress, loss of sleep, and generalized anxiety--McNamara indicates that we still lack easy-to-use, effective treatments for nightmare disorders.
Imagery rehearsal therapy, the current gold standard for treatment, attempts to teach patients to replace nightmare imagery with less-frightening versions. According to McNamara, success of the treatment is varied and typically short term because it relies on a person's ability and willingness to conjure up realistic nightmare imagery in their mind's eye, which some patients can do better than others. Naturally, most young children are even less capable of willfully controlling an imagined visual narrative than adolescents or adults.
Research in the last decade has hinted that modern technology may enable a more-tangible...