Chapter 9 – Improving Sleep

Happy Friday! Coping with Trauma Related Dissociation (by Suzette Boon, Kathy Steele and Onno Van Der Hart), isn’t the kind of book that puts a person to sleep… until now! This week’s chapter is all about improving your zzzz’s. There’s some generic advice you’ve probably seen before, but then it dives into something really interesting: why it’s particularly hard to sleep if you have DID.

I read this chapter few months ago when we first got this book (yep, I skipped ahead!) and did the homework. I’m sleeping a hell of a lot better, with less medication.

If you’re not getting 7 to 8 hours of sleep a night, tell your therapist. If you don’t have a therapist, it’s homework time.   

Sleep problems come in more flavors than ice-cream.

Falling asleep, staying asleep, nightmares, teeth grinding, hallucinations, twitching, restless legs… the book has a depressingly long list. When you speak to a doctor or psychiatrist about sleep medication, it’s important to be honest. There are lots of medications and non-chemical therapies you can try to treat this stuff.

“There are numerous causes of or contributing factors to sleep problems in those with dissociative disorders. Often more than one factor is involved, making it important to receive a comprehensive assessment for serious sleep difficulties.”

Traumatization, anxiety, depression, caffeine, booze, drugs, late night video game marathons, not exercising enough, exercising too much… basically all the fun things. One or more could be the reason you can’t sleep.  

Other than cutting out the fun stuff, what can you do?

Actually, quite a bit. You can make your sleeping area feel safe by removing triggers and adding anchors, across all 5 senses, for all of your parts. Sleep with a stuffed animal if you need to. Listen to your parts needs, and follow any urges you get. 

“Remember that parts can be stuck in the past and experience themselves as young, and your job as an adult is to help those parts of you feel secure and safe in the present.”

Savage truths, Kathy Steele, savage. That line got my attention AND hurt my feelings.

If your inner communication is going well, you should agree on a consistent bedtime. If you’ve got parts running around at night writing their magnum opus, making dumb drops in Fortnight or painting D&D minis, make time for it during the day. Write it in your schedule and do it. Follow-through builds trust.

The chapter wraps up with tips for specific sleep problems, like this one:

If You Wake Up After a Nightmare

  • If you wake up at night after a disturbing dream or nightmare, or feel anxious and panicky, it is important to be able to calm down and comfort yourself and other parts that are anxious. Work with yourself and your therapist to develop various ways to help yourself.   
  • The first step is always to get your bearings in the present. Use all of the anchors to the present that you have put in your bedroom. Talk to yourself quietly and tell yourself out loud where you are.
  • Turn on the light and get out of bed. Perhaps have something to drink and find something to distract you.
  • Splash cool water on your face, hands, and back of your neck. This will help you get more present and awake.
  • Consciously slow your breathing. Try some breathing exercises.
  • Do some gentle stretching exercises to help your body reorient to the present.
  • If you have a pet, spend a little time petting or cuddling with them.
  • If you have physical symptoms, such as a bad taste in your mouth, or pain or discomfort, be mindful in talking to yourself inwardly as you do things to soothe yourself (for instance, brush your teeth, have a non-caffeinated drink, suck on a mint or hard candy, massage painful muscles): “I am in the present now. Whatever happened to me is over. I am safe. My mouth, my legs, my body, etc., are in the present. I am doing all I can to help all parts of myself.” Try to be aware of any internal sense of what might help.
  • Some people find that it helps if they write down a distressing dream or image then put it away, tear it up, or bring it to therapy. The idea is not to go further into the experience, but to contain it by putting it on paper and leaving it until a more appropriate time.
  • You might try “changing” your nightmare. Add a supportive or strong person to the dream, invent a way out of the situation, or give yourself special powers to overcome any sense of powerlessness or fear in the dream. Your therapist may be able to help you with this kind of technique.
  • Some people wake up from a nightmare and find they are unable to move. Although this is extremely uncomfortable and even frightening, it will not last for very long. It is simply the state of being paralyzed by fear. If this happens to you, make sure you have some anchors to the present visible from every angle from the bed: on your left, your right, even on the ceiling.
  • Even though you cannot yet move, you can begin to see the anchor and gradually perceive you are in the present. This perception will help your body shift out of that paralysis mode. Try starting with a tiny movement, for instance, blinking your eyes, and just barely twitching your toe or little finger. When you do this, then move the opposite toe or finger. Then make a slight movement with your hand or foot, then your arms or legs. Continue slowly and patiently until your entire body has  become more able to move.” 

If this seems at all helpful, chapter 9 is probably going to be your jam.

Oh, and don’t forget to do your homework! 

Sweet dreams,
– Probably Nick

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