Michelle Carr had vivid nightmares as a kid. It wasn’t until she was in college that she learned about lucid dreaming, a fairly rare phenomenon in which the dreamer can consciously shape the dream. She found that she could use lucid dreams to rewrite her own nightmares and conquer her fear of them.
The experience inspired her to pursue dream research. In 2011, a few years after her first encounter with lucid dreaming, Carr began a Ph.D. under Tore Nielsen, a well-known nightmare expert, at the Dream and Nightmare Laboratory in Montreal. Today she calls herself a dream engineer: She helps people rescript their dreams as a researcher and therapist at the University of Rochester Sleep and Neurophysiology Laboratory in New York.
Two to 6 percent of people have nightmares at least weekly.
Carr works with people who suffer particularly frequent nightmares—around 2 to 6 percent of people have them at least weekly. For these individuals, sleep becomes something to fear. It can upend their mental health, leading to clinically significant anxiety and depression, and in the most extreme cases, suicide risk. Normally, dreams make novel associations between elements of your memory and experience. In nightmares, strong emotions seem to interrupt this process, leading to a repetitive script, says Carr. But researchers have identified some effective therapies that can break the cycle.
I recently talked with Carr about nightmare interventions.
Are there any established clinical interventions for nightmares?
Yes, the most well-known is called imagery rehearsal therapy. It's very standardized. It's a form of cognitive behavioral therapy, and it's evidence-based. If somebody has a recurring bad dream, they can try to rewrite it, come up with a new ending for it, and practice visualizing this new ending while awake. There are many different variations of this therapy.
How do the variations differ?
They are all driven by different forces. So you might focus mostly on the emotion of the dream, or the metaphors in the dream, or the body sensations in the dream. One of the ones I work with most closely is really trying to see what your body is feeling like in the dream, and how you can change the dream so that you feel more safe and secure in your body.
And how does that approach compare to lucid dreaming?
The main difference is that with lucid dreaming, you're actually rewriting a nightmare within sleep, so you're changing the way you respond to a nightmare while it's occurring.
That can be even more powerful for people because you're really in the dream space and you see how, if you just realize it's a nightmare, you're not as emotional. Or if you change your behavior a little bit in the dream, confronting something you’re scared of instead of running away from it, the dream completely shifts and transforms into something else. You're more able to regulate your fear.
What do people misunderstand about nightmares?
Nightmare sufferers tend to have this belief that they're completely out of control of their dreams, like there's nothing they can do about them. If you show them that they do have some control over what they’re dreaming about, that can be really empowering. 
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