Myths and realities of male rape – men can be raped too

Myth: Men can’t be sexually assaulted.

Reality: Men can be, and are, sexually assaulted every day. Any man can be sexually assaulted regardless of their size, strength, appearance, occupation, race or sexual orientation. Male rape can happen at home, work, out doors, in a  car, in the military, prisons, in locker rooms, rest rooms, public toilets, in fact just about anywhere a rapist thinks they can get away with it, and it can happen to any male.

It should also be noted that it is not unusual for a male to “freeze” during a rape, in part due to shock, and fear of ones life. Remember, the rapist will no doubt have done this before, and hence be prepared for what happens, but few, if any men, have even considered in their mind the possibility of such things happening and are thus totally unprepared.

Myth: Only gay men are sexually assaulted.

Reality: Although gay men are raped slightly more often than heterosexual men this is due more to the fact that they can be the target anti-gay violence, that often includes acts of rape, plus that gay men are at far more risk of date rape attacks from other men.

Heterosexual males can be, and are, also raped in very large numbers. An F.B.I. statistic put the number of males that will be raped as an adult at 3 %, a number most organisations think is very underestimated. Of this 3%, over 40% identify themselves as exclusively heterosexual.

Myth: It is only gay men that sexually assault other men.

Reality: The vast majority of men who sexually assault other men identify themselves as heterosexual. Many rapists will attack either males or females, while in their  consensual will only have sex with females. Some target males more than females as it gives them even a greater sense of power and control.

This fact helps to highlight another reality, that is, that sexual assault is usually more about violence, anger, domination and control over another person, than it is about lust or sexual attraction.

Myth: Adult men cannot be sexually assaulted by women.

Reality: Although the majority of reported perpetrators are male, (97 to 98%), women can, and do, also sexually assault men but is seldom reported… not that many males feel safe reporting rape anyway.

If you include emotional blackmail as a way of giving the victim no choice, then the number greatly increases. Also don’t think that if a woman rapes you that you have to penetrate her, there are such things as vibrators that she can use on you as well.

If you think a female can not force a male to get an erection against his will, think again, you have little (to no) control over that part of your body with your will power.

Think you could never be forced to gain an erection? Wait till the most important football match you ever want to watch is on TV, then see if your partner can distract that part of your body against your will
You will lose every time.

Think an unconscious (drunk or drugged etc ) male can not get an erection ? Never known a man wake up with morning “wood” or it happen on a bus or at the supermarket, or work, against their will …. the mind has little control on getting it to just go away

Myth: Male rape victims don’t suffer as bad a female rape victims, after all they do not risk becoming pregnant.

Reality: All rape victims suffer in many different ways, some responses are gender specific, some are not.

Male male rape frequently involves higher levels of violence, weapons, and is also more likely to involve multiple assailants. Male rape victims are also more at risk of committing suicide as a result of rape.

As for the risk of becoming pregnant, no male rape victims do not run that risk. However anal rape does have a much higher risk of internal tearing and damage, and with that comes a higher risk of possible HIV transmission.

Myth: Most rapists are strangers.

Reality: Whilst many gang rapes and acts of anti-gay violence are committed by strangers, most rapes, like in women, are committed by people known to the victim. They may be a friend, neighbour, boss or a relative, father, uncle, co-worker, brother or ex partner. They could also be a trades person, or a professional e.g., a doctor, teacher, psychiatrist, police officer or a public servant. One worrying increase is in the amount of rapes during robberies, muggings and house break-in’s in an attempt to stop the person reporting the crime.

Myth: Getting an erection or ejaculation during sexual assault means you “really wanted it” or consented to it.

Reality: This is one of the things that can cause male rape survivors a lot of confusion and guilt when they do not know how things work. For a start I can honestly say that getting an erection shows nothing other than your body responds how it is suppose to do. It is a totally normal thing to happen and has nothing to do with desire. Have you never been on a bus, or sat in an office meeting, and it has gone hard all by it’s self  for no reason ?

Basically, unless you have some medical condition that stops you then you will get an erection when it is manipulated. It is a result of stimulation, and it does not matter if you do not want it to happen or not. There is little you can do to stop it most of the time.

Sadly, some males become confused and think an erection equals arousal equals them wanting it. In reality all it means is that part of the body has nerve endings that respond to touch and that touch can be wanted or not wanted, pleasant or non pleasant. With lubricant you will have even less choice as to how it responds to touch. It is the same as the body will respond to someone tickling you and you will probably laugh, but if it is done at a time or by a person you do not want to tickle you it will still respond.

If you were penetrated, the pressure in the prostate gland also will cause an erection.  Anyone who has ever had a DRE (short for Digital Rectal Exam) of the prostate at their doctors will know that getting an erection often happens during the examination.

Now as far as ejaculation goes, again this is a very normal thing to have happened. In fact, the rapist will very often go out of their way to make sure that you do ejaculate, in order to try to make you more ashamed, (adds to their dominate feeling of power) and also they know it will likely reduce your chances of reporting the crime. First off, it is because it is a normal reaction to stimulation. Second, the pressure on the prostate will, by it’s self, release some fluid, making the penis more sensitive to that stimulation. In fact, it is possible for a doctor to obtain a semen sample during a DRE. Pressure on the seminal vesicle will likewise release a lot of fluid, and could resemble ejaculation to some extent, although may feel different.

One other thing to remember, is that ejaculation against your will, and an orgasm when having a wanted sexual encounter are, two totally different things.

(my degree actually came in useful there…)

Myth: Rape in Gay couples does not exist.

Reality: Rape in marriage or any relationship, straight or gay , can and does often occur. Through physical, psychological or emotional coercion, some men are forced by their partners, to engage in unwanted sexual acts, including oral or anal sex. A spouse, or partner, boyfriend can be charged with the rape of their partner in many countries now. The law recognizes that a spouse is not the property of their partner, to be used sexually by them. Gay relationships deserve the same recognition.

Myth: Male rape only happens in prisons.

Reality: Rape does happen a lot in prisons, there is no doubt about that. In fact, in the USA, it is said that there are far more male rapes every day in prisons alone than there are rapes of all females in the USA. However, males are raped outside of prison every day of every year, in their homes, cars, at work and just about anywhere. Male rape also happens in the military and armed services as well, collages, universities, and all sorts of places.

rape victims should take responsibility for what happened?

A majority of women believe rape victims should take responsibility for what happened, a survey suggests.

Almost three quarters of the women who believed this said if a victim got into bed with the assailant before an attack they should accept some responsibility.

One-third blamed victims who had dressed provocatively or gone back to the attacker’s house for a drink.

The survey of more than 1,000 people in London marked the 10th anniversary of the Haven service for rape victims.

More than half of those of both sexes questioned said there were some circumstances when a rape victim should accept responsibility for an attack.

The study found that women were less forgiving of the victim than men.

Of the women who believed some victims should take responsibility, 71% thought a person should accept responsibility when getting into bed with someone, compared with 57% of men.

An Amnesty International report five years ago found that a significant minority of British people laid the blame for rape at victims themselves.

So over the last 5 years instead of progress we have gone backwards…

Around one in 12 people (8%) believed that a woman was totally responsible for being raped if she’d had many sexual partners. Similarly, more than a quarter of people (30%) said that a woman was partially or totally responsible for being raped if she was drunk, and more than a third (37%) held the same view if the woman had failed to clearly say “no” to the man.

Changes in the law relating to consent mean that an alleged rapist must show that they had taken reasonable steps to ensure that the other person had consented to sex. In this respect the poll exposes a gap between the law and public attitudes.

The poll also shows that the vast majority of the British population has no idea how many women are raped every year in the UK, with 96% of those polled saying they either didn’t know the true extent of rape or that they thought it was far lower than the true figure.

Only 4% of respondents even thought the number of women raped exceeds 10,000 per year when the true figure is likely to be well in excess of 50,000:

I know I shouldn’t let this poll get to me… but it does… so according to the general population a woman should monitor their dress and behaviour always on the look out for rape, whereas the men are fine and allowed to jump on whatever woman they want? I kind of wonder how many of the women who took this poll keep by their own rules: never drink, never wear revealing clothing, never flirt, etc…

So then… was it my fault? Was it my fault when I was 16 and a guy held a knife to my throat? Was it my fault when my landlord manipulated and blackmailed me into dating him and then tied me up before raping me? Was it my fault when my landlord and his friend held me down, beat me and took it in turns to rape me?

Myths and facts of self-harm.

Self-harm is usually a failed suicide attempt.

This myth persists despite a wealth of studies showing that, although people who self-injure may be at a higher risk of suicide than others, they distinguish betwen acts of self-harm and attempted suicide. Many, if not most, self-injuring people who make a suicide attempt use means that are completely different to their preferred methods of self-inflicted violence.

People who self-injure are crazy and should be locked up.

Tracy Alderman, Ph.D., author of The Scarred Soul, addressed this:

“Fear can lead to dangerous overreactions. In dealing with clients who hurt themselves, you will probably feel fear. . . . Hospitalizing clients for self-inflicted violence is one such form of overreaction. Many therapists, because they do not possess an adequate understanding of SIV, will use extreme measures to assure (they think) their clients’ best interests. However, few people who self-injure need to be hospitalized or institutionalized. The vast majority of self-inflicted wounds are neither life threatening nor require medical treatment. Hospitalizing a client involuntarily for these issues can be damaging in several ways. Because SIV is closely related to feelings of lack of control and overwhelming emotional states, placing someone in a setting that by its nature evokes these feelings is very likely to make matters worse, and may lead to an incident of SIV. In addition, involuntary hospitalization often affects the therapeutic relationship in negative ways, eroding trust, communication, rapport, and honesty. Caution should be used when assessing a client’s level of threat to self or others. In most cases, SIV is not life threatening. . . . Because SIV is so misunderstood, clinicians often overreact and provide treatment that is contraindicated.

People who self-harm are just trying to get attention.

A wise friend once emailed me a list of attention-seeking behaviors: wearing nice clothing, smiling at people, saying “hi”, going to the check-out counter at a store, and so on. We all seek attention all the time; wanting attention is not bad or sick. If someone is in so much distress and feel so ignored that the only way they can think of to express their pain is by hurting his/her body, something is definitely wrong in their life and this isn’t the time to be making moral judgments about their behavior.
That said, most poeple who self-injure go to great lengths to hide their wounds and scars. Many consider their self-harm to be a deeply shameful secret and dread the consequences of discovery.

Self-inflicted violence is just an attempt to manipulate others.

Some people use self-inflicted injuries as an attempt to cause others to behave in certain ways, it’s true. Most don’t, though. If you feel as though someone is trying to manipulate you with SI, it may be more important to focus on what it is they want and how you can communicate about it while maintaining appropriate boundaries. Look for the deeper issues and work on those.

Only people with Borderline Personality Disorder self-harm.

Self-harm is a criterion for diagnosing BPD, but there are 8 other equally-important criteria. Not everyone with BPD self-harms, and not all people who self-harm have BPD (regardless of practitioners who automatically diagnose anyone who self-injures with BPD).

If the wounds aren’t “bad enough,” self-harm isn’t serious.

The severity of the self-inflicted wounds has very little to do with the level of emotional distress present. Different people have different methods of SI and different pain tolerances. The only way to figure out how much distress someone is in is to ask. Never assume; check it oput with the person.

psychs, family, and referals… are we beyond treatment?

next week we are  going to see our 23rd psychologist… 23rd!!! In 6 years we have managed to bemuze, confuse and dismay over 20 psycholoists!!! And that is not counting the psychiatrists… 7 of them we’ve seen so far…

Sometimes we wonder if we are just beyond treatment, or that maybe we do not deserve it… in  the last 12 months we have seen 5 psychologists and 3 psychiatrists, most of which referred us after less than 5 sessions… Are we really THAT messed up? Or maybe we are just difficult to work with… Michelle has caused a few to refer us by yelling and threatening them, but in fairness they were  nasty to us first… like that private psych we saw, the one who said there was noting wrong with us, that we just wanted a “label” to that we had an excuse for being unable to move out of our social class!!! what the hell??? We didn’t ask to be born to a working class family, and what difference does that make anyway??? How are wealthier people “better” than us? He said that we wanted a “label” as an excuse for being lazy… lazy??? Between the body ages of 16 snd 19 we studied full time, had 2 part time jobs, cooked all the meals, did all the housework and paid rent, all while being beaten and raped by the bad man. So we’re LAZY are we???

Anyway… let us not get into a social class rant… we have a bit of a thing about people looking down on and judging us over the parents income… what does their income even matter anyway? It’s not like we see any of it, we haven’t even lived with them, let alone being part of their “family” for 7 years anyway, when do we get judged on who WE are and not on who THEY are?

we are frustrated right now…

Orthorexia

Why is it that we always get the “controversial” disorders? Lol

6 years ago I was anorexic, I “recovered” but still had the diagnosis of “EDNOS”, my doctor said it was Orothexia, but as this isn’t a “real” disorder EDNOS was the official diagnosis. During this period though my focus shifted, it was no longer and weight, calories, size, etc… Now it was about trying to be clear, pure, and uncontaminated. At first I just avoided E-numbers, then preservatives, then additives… over time the list got longer and longer… if we ever went out to eat or ate at someone else’s house so I didn’t know 100% what was inside the food then I had to “cleanse” myself… this would involve either purging or binge drinking pints upon pints of water and if I was not able to do either of these then I would need to “bleed out the contamination” later on that night by “blood letting”

Sometimes it would happen at home too… I never knew if I could or couldn’t eat something until I’d tried it… and the list of what I couldn’t eat seemed to be getting bigger and bigger…

By the end I was avoiding so much that I was barely eating, it had gotten to the point where my food intake wasn’t much more than it had been during my anorexic period, at one point it go down to my living off apples, oranges and vitamin supliments…. As well as this my purging and water binging had begun to mess up my electrolyte balance.

16 months ago I ended up admitted to hospital for a suspected heart attack!!! It ended up that I was having multiple tachycardic episodes… after several tests it ended up that my heart muscle had being damaged from the electrolyte issues… even now my heart has not recovered, apparently if my old diet had continued for much longer I would have died…

Though to be honest my eating still isn’t great, the list of things I avoid is still high and I still cannot eat anything pre-packaged, anything from a take-away, anything cooked by anyone other than myself, andthing where I cannot source all the ingredients, etc… but at least I’m no longer risking death

Why should WE prove anything to YOU?

I’m annoyed… seriously annoyed… Got banned from a DID forum for “making a mockery of DID” and being a “sorry excuse for a human being”… I don’t even know what I did!!! No one in real life takes anything I say seriously (oter than jack) and now I’m havng to prove myself online as well… should just go back to hiding it

It took 6 years for medical professionals to take us seriously. For 6 years they said stupid things like “stress”, “homesickness” and even “attention seeking”… 6 bloody years… Maybe the mother is right eh? maybe this is all an act to feel “special”? maybe the psychiatrist is right, maybe I am just using it as an excuse to self-harm and take ODs?

And even now about 60% of people think it’s all made up, then again about 50% of people don’t seem to believe in DID at all… I’m trying to change that, tring to spread awareness and educate people, so that others don’t get accused of lying, get things thrown at them, get shunned, and get belittled by doctors.

But now… now I have to prove to online people ASWELL as real life people that I am ill… my god!!! Seriously, why should I have to prove ANYTHING to YOU???? What I experiance is what I experiance, unless we find a way to put you into the brain so you can expriance it too there is no way to prove it is there? But here’s the thing… why would I lie? There are far easier disorders to fake, and why would I fake it anyway?  Why would I mock any illness? Why would anyone?

I understand that the internet breeds suspision, that noone can ever truely know who is at the otherside of the screne (as it were), but if you accuse someone of something then you need to at least explain why… then I can scan a letter from my ex-psych (as I have got one for these such occations) and send it to you. We did not fight for 6 years to be taken seriously by doctors only to then have fellow multiples accuse us of lying. If we are lying then maybe YOU are lying? Thought about that?

So have your stupid forum, ignore how much having someone invalidate us hurts. But in future at least have evidence to back up your claim if you are going to bann someone and accuse them of these things.

Useful books and articles on DID, dissociation and trauma

We’ve had a few requests for sources on dissociation, PTSD, DID, etc. Now bare with us, we are not very good at referancing lol, so hopefully got the format right

Benjamin, L. R., & Benjamin, R. (1993). Interventions with children in dissociative families: A family treatment model. Dissociation

Braun, B. G. (1985). The transgenerational incidence of dissociation and multiple personality disorder: A preliminary report. In R. P. Kluft (Ed.), Childhood antecedents of multiple personality (pp. 127–150). Washington, DC: American Psychiatric Press.

Coons, P. M. (1985). Children of parents with multiple personality disorder. In R. P. Kluft (Ed.), Childhood antecedents of multiple personality. Washington, DC: American Psychiatric Press

Dell, D. F., & Eisenhower, J. W. (1990). Adolescent multiple personality disorder: a preliminary study of eleven cases. Journal of the American Academy of Child and Adolescent Psychiatry

Kluft, R. P. (1986). Treating children who have multiple personality disorder. In B.G. Braun (Ed.), Treatment of multiple personality disorder. Washington, DC: American Psychiatric Press

McMahon, P. P., & Fagan, J. (1993). Play therapy with children with multiple personality disorder. In R. P. Kluft & C. G. Fine (Eds.), Clinical perspectives on multiple personality disorder (pp. 253–76). Washington, DC: American Psychiatric Press

Waters, F. W. (1990). Profile of nine cases of childhood multiple personality disorder (Summary). Paper presented at Seventh International Conference on Multiple Personality/Dissociative States, Chicago, IL

Journal of Trauma & Dissociation

Lauren E. Duncan, Linda M. Williams. Gender role socialization and male-on-male vs. female-on-male child sexual abuse. Sex Roles: A Journal of Research, November 01 1998. Page(s): 14

J. LeDoux. The Emotional Brain. New York: Simon & Schuster, 1996.

D. Laub & N. Auerhahn. Knowing and not knowing massive psychic trauma: forms of traumatic memory. International Journal of Psychoanalysis(1993) 74, 287-302.

L.Nadel & W. Jacobs. Traumatic memory is special. Current directions in psychological science (1998) 7(5), 154-157

M. Hunter. Abused boys: The neglected victims of sexual abuse. Americam journalof psychiatry (1993) 150, 1043-1047

Patterns if sexual abuse among men

Study of victims of male rape

Sidran Institute

Also the books that we review here are pretty good sources of information

Rape is funny…

The sad thing is, sexual aggression in men is normalised and even praised in our society, to the detriment of all genders. Rape is not a joke. Rape is, in every case, a violation of law, international and domestic. It is not acceptable to have sex with a woman without her consent. It is not acceptable to joke about it or create the appearance that rape is funny, amusing, or acceptable. Making light of this horrific crime is a slap in the face to survivors of rape and women everywhere.

80 percent of all rapes are never reported to the police. Males report rape at even lower rates than females. The incontrovertible fact is that victims already feel hesitant to come forward, to speak, to tell their story, without feeling as if the world considers it a joke.

For those of you who wonder why rape victims get all super sensitive about rape jokes, well, this is why. Before you’re raped, rape jokes might be uncomfortable, or they might be funny, or they might be any given thing. But after you’re raped, they are a trigger. They make you remember what was done to you. And if the joke was about something that wasn’t done to you, not in quite that way, you can really easily imagine how it would feel, because you know how something exactly like that felt. Rape jokes stop being about a thing that happens out there, somewhere, to people who don’t really exist, and if they do they probably deserved it, and they start being about you. Rape jokes are about you. Jokes about women liking it or deserving it are about how much you liked it and deserved it. And they are also jokes about how, in all likelihood, it’s going to happen to you again.

Apart from that joking about things reinforces misconceptions and beliefs, people start to actually think that rape victims deserved it… NO ONE DESERVES TO BE RAPED!!! They start to believe that rape isn’t real, that people enjoy it but feel ashamed of the action the next day and so “cry rape”… and so slowly we develop a culture where rape becomes almost normal, and even acceptable… but rape is a crime, it’s not a joke, not a punch-line, not normal and DEFANTLY not acceptable. It also acts to belittle the experiance, making those who have been through rape feel that maybe it wasn’t a big deal, maybe they are overreacting, being pathetic…

The crux of the argument is this: rape jokes are triggering to rape survivors and reinforce rape myths, and seeing as so many women have survived rape, it might be considerate not to be joking about rape when you have no idea if someone listening has been affected by it

Hypervigilance

One of the diagnostic criteria for PTSD is hypervigilance. Hypervigilance is watchfulness or checking one’s surroundings that is over and above what is normal or reasonable. Hypervigilance takes many forms. It is what makes some of us always choose an aisle seat or one where our back is to a wall. It’s what makes some of us carry defensive weapons such as guns, knives, mace or pepper spray, a police whistle or a mobile phone set to 999. It makes some of us cross the street to avoid suspicious people. Some of us have alarm systems, multiple locks, window locks, high fences, guard dogs, etc. Another form of hypervigilance is studying people very carefully in an attempt to look deeply into their soul to determine exactly what they are made of. Hypervigilance is included in the cluster of symptoms referred to as “increased arousal”. This cluster also includes difficulty sleeping, irritability or outbursts of anger, difficulty concentrating, and exaggerated startle response.

This increased arousal stems directly from our trauma and the form it takes is shaped directly by the nature of our trauma. If we have difficulty sleeping, it may be because we were afraid to go to sleep or stay asleep for fear of an attack of some sort while we were not conscious to repel it or avoid it. If we are irritable, it may be to warn people to keep their distance or to not behave in ways that might trigger us. If we can’t concentrate it may be because we are too busy trying to monitor all inputs from possible dangers. If we startle easily it may be because we learned to jump quickly to get out of harm’s way. And if we are hypervigilant it is probably because we saw our environment as having multiple and unpredictable dangers that we should be on constant alert for. In fact, much of the time our hypervigilance helps to keep us safe.

However, the “hyper” in hypervigilance suggests that we do more than is normal or reasonable. It is too much because it is an inconvenience or an encumbrance. While it is probably true that we with PTSD are indeed safer because of all the precautions that we take, it is probably also true that our hypervigilance does often get in the way. It may be that we deprive ourselves of going certain places and of partaking in certain events. For example, we don’t go to an event because we can’t get an aisle seat, or because we don’t know what kind of people are going to be there. Sometimes we see people looking at us and we think that they are judging us or are hostile toward us. Sometimes we are afraid to eat certain foods because we are afraid of being poisoned or made ill. And, there are probably numerous other examples of ways in which hypervigilance inconveniences us.

Nightmares and PTSD

Nightmares refer to complex dreams that cause high levels of anxiety or terror. In general, the content of nightmares revolves around imminent harm being caused to the individual (e.g., being chased, threatened, injured, etc.). When nightmares occur as a part of PTSD, they tend to involve the original threatening or horrifying set of circumstances that was involved during the traumatic event. For example, a rape survivor might experience disturbing dreams about the rape itself or some aspect of the experience that was particularly frightening.

Nightmares can occur multiple times in a given night, or one might experience them very rarely. Individuals may experience the same dream repeatedly, or they may experience different dreams with a similar theme. When individuals awaken from nightmares, they can typically remember them in detail. Upon awakening from a nightmare, individuals typically report feelings of alertness, fear, and anxiety. Nightmares occur almost exclusively during rapid eye movement (REM) sleep. Although REM sleep occurs on and off throughout the night, REM sleep periods become longer and dreaming tends to become more intense in the second half of the night. As a result, nightmares are more likely to occur during this time.

How common are nightmares?

The prevalence of nightmares varies by age group and by gender. Nightmares are reportedly first experienced between the ages of 3 and 6 years. From 10% to 50% of children between the ages of 3 and 5 have nightmares that are severe enough to cause their parents concern. This does not mean that children with nightmares necessarily have a psychological disorder. In fact, children who develop nightmares in the absence of traumatic events typically grow out of them as they get older. Approximately 50% of adults report having at least an occasional nightmare. Estimates suggest that between 6.9% and 8.1% of the adult population suffer from chronic nightmares.

Women report having nightmares more often than men do. Women report two to four nightmares for every one nightmare reported by men. It is unclear at this point whether men and women actually experience different rates of nightmares, or whether women are simply more likely to report them.

How are nightmares related to PTSD?

A person does not have to experience nightmares in order to have PTSD. However, nightmares are one of the most common of the ‘re-experiencing’ symptoms of PTSD, seen in approximately 60% of individuals with PTSD. A recent study of nightmares in female sexual assault survivors found that a higher frequency of nightmares was related to increased severity of PTSD symptoms. Little is known about the typical frequency or duration of nightmares in individuals with PTSD.

Are there any effective treatments for nightmares?

Yes. There are both psychological treatments (involving changing thoughts and behaviors) and psychopharmacological treatments (involving medicine) that have been found to be effective in reducing nightmares.

Psychological Treatment

In recent years, Barry Krakow and his colleagues at the University of New Mexico have conducted numerous studies regarding a promising psychological treatment for nightmares. This research group found positive results in applying this treatment to individuals suffering from nightmares in the context of PTSD. Krakow and colleagues found that crime victims and sexual assault survivors with PTSD who received this treatment showed fewer nightmares and better sleep quality after three group-treatment sessions. Another group of researchers applied the treatment to Vietnam combat veterans and found similarly promising results in a small pilot study.

The treatment studied at the University of New Mexico is called ‘Imagery Rehearsal Therapy’ and is classified as a cognitive-behavioral treatment. It does not involve the use of medications. In brief, the treatment involves helping the clients change the endings of their nightmares, while they are awake, so that the ending is no longer upsetting. The client is then instructed to rehearse the new, nonthreatening images associated with the changed dream. Imagery Rehearsal Therapy also typically involves other components designed to help clients with problems associated with nightmares, such as insomnia. For example, clients are taught basic strategies that may help them to improve the quality of their sleep, such as refraining from caffeine during the afternoon, having a consistent evening wind-down ritual, or refraining from watching TV in bed.

Psychologists who use cognitive-behavioral techniques may be familiar with Imagery Rehearsal Therapy, or may have access to research literature describing it.

Psychopharmacological Treatment

Researchers have also conducted studies of medications for the treatment of nightmares. However, it should be noted that the research findings in support of these treatments are more tentative than findings from studies of Imagery Rehearsal Therapy. Part of the reason for this is simply that fewer studies have been conducted with medications at this point in time. Also, the studies that have been conducted with medications have generally been small and have not included a comparison control group (that did not receive medication). This makes it difficult to know for sure whether the medication is responsible for reducing nightmares, or whether the patient’s belief or confidence that the medication will work was responsible for the positive changes (a.k.a., a placebo effect).

Some medications that have been studied for treatment of PTSD-related nightmares and may be effective in reducing nightmares include Topiramate, Prazosin, Nefazodone, Trazodone, and Gabapentin. Because medications typically have side effects, many patients choose to try a behavioral treatment first.

What happens if nightmares are left untreated?

Nightmares can be a chronic mental health problem for some individuals, but it is not yet clear why they plague some people and not others. One thing that is clear is that nightmares are common in the early phases after a traumatic experience. However, research suggests that most people who have PTSD symptoms (including nightmares) just after a trauma will recover without treatment. This typically occurs by about the third month after a trauma. However, if PTSD symptoms (including nightmares) have not decreased substantially by about the third month, these symptoms can become chronic. If you have been suffering from nightmares for more than 3 months, you are encouraged to contact a mental health professional and discuss with him or her the behavioral treatments described above.