It is not unusual for men to experience trouble sleeping and have nightmares following child sexual abuse or sexual assault. The trouble with nightmares is that they can not only be unsettling in and of themselves, but can bring back painful, upsetting memories associated with sexual abuse or sexual assault. Nightmares can occur days, weeks, months or years after an abusive event, appear just once or be recurring. They can appear from nowhere, be hard to understand and if their content refers to sexual abuse be difficult to explain to others. Below is some information about nightmares, along with some suggestions as to how to deal with them.

Some effects of nightmares



Nightmares can produce the following effects:

Feelings of loneliness, distress, vulnerability, fear, anxiety, sadness, anger, guilt and shame.

Physical reaction, such as breathing difficulties, chest tightness, sweating and shaking.

Sleeping difficulties – problems going to bed and to sleep, fear of sleeping alone or sleeping with someone.

Unfortunately, societal expectations that a man should always feel in control and be able to handle anything that is thrown at him can add to men’s difficulties in dealing with these common effects. These unrealistic gender expectations can have men evaluating themselves in relation to their capacity to manage nightmares and can make it difficult to ask for help.

Afterwards, I just didn’t sleep. I’d wake up in a cold sweat, all tensed up. My house mates told me they could hear what sounded like a muffled scream. I just couldn’t tell them.

Understandably, following nightmares men can become preoccupied with their content, trying to sort them out and make sense of them. However, often the silence and secrecy surrounding sexual abuse can get in the way of men speaking with partners, friends and family.

Things you can do to manage nightmares at the time



Nightmares happen and there are things you can do in the short term and long term to deal with them. Below are some ways of managing nightmares when they occur:

Reassure yourself that you are safe and that the traumatic event that you are remembering is NOT happening now.

Breathe slowly and deeply.

Be aware of and understand your body’s response as natural physiological reactions to a traumatic experience; try to slow these physical reactions by continuing to breathe deeply and slowly, try to see and imagine your muscles relaxing.

Locate yourself in the present; check your present reality by looking around, touching things, stamping your feet, looking in the mirror or talking to yourself.

Confirm your physical safety – turn on the lights, walk around the house, check the locks.

Have a drink of water.

Wash your face or have a warm bath or shower.

Focus on something else: read a book or magazine, watch TV, listen to the radio or relaxing music.

Talk with a partner, friend or relative who is supportive.

What you can do if nightmares persist



If, in the morning, you can put aside the nightmare and concentrate on getting on and doing what it is important to you then do. If, however, a nightmare persists or becomes particularly disruptive you might try the following exercise.

Pick an unpleasant dream/nightmare, one that is not a direct replay or a re-enactment of a distressing event and write it down. Write the unpleasant dream down in as much detail as you can. Only in this telling of the dream change the ending so that it suits you. Remember it is your choice to do this and that you can stop writing or thinking about the dream and do something else any time you want. Now, get to know this new preferred version of the dream, rehearse it each night for about 5-15 minutes prior to going to sleep. Once you have rehearsed the dream, perform a relaxation exercise, one that you are familiar with and helps you to fall asleep peacefully. If you wake up, it can be useful to repeat this relaxation exercise, breathing deeply and slowly. When you are satisfied that you have re-storied the unpleasant dream to better suit you, you can choose to work on another nightmare that is slightly more intense than the last. Make sure that this process is a gradual increase in intensity and do not work with more than 2 nightmares in one week. Also take care of yourself; you do not have to over describe the upsetting content within the dream.

This is just one way of dealing with nightmares. If it isn’t working for you or if you find it is inviting of flashbacks during the day then stop. Some people have found it useful to write down the dreams and their reaction to it in a diary or a journal, as a way to get it out of their head. If you continue to be disturbed by nightmares or feel there is something you wish to work out, it can be useful to find an experienced counsellor who you can work with.

Acknowledgement: Adapted from information provided within Brisbane sexual assault service, information sheet – ‘Managing Nightmares’ and Krakow Hollifield et al, “Imagery Rehearsal Therapy for Chronic Nightmares in Sexual Assault Survivors with Posttraumatic Stress Disorder”. Journal of the American medical Association Vol. 286 No 5, 1 August 2001