Our CPD Advanced skills Workshops

We advise anyone who is interested in joining this group to attend our Stage 1 course first.

Nightmares are a classic symptom of Post-Traumatic Stress Disorder (PTSD) and this course provides a simple, step-by-step approach to working with nightmares that minimises the danger of re-traumatisation. We also introduce participants to the work with ordinary dreams. Finding a way to avoid re-traumatisation is an essential part of working with people suffering from trauma. Trauma is a “blocked” process that needs processing so that it can be stored and remembered the same way as normal memories. Contemporary research has shown that nightmares and other sleep disturbances can be “stuck” patterns. Some approaches to working with trauma suggest that nightmares can be alleviated if the person can change the ending (e.g. Gehrman and Harb, 2010). However, if this is done by consciously rehearsing the narrative of the nightmare, it can lead to re-traumatisation, distress, and drop-out from therapy.
 
Based on systemic, embodied and trauma recovery approaches we support trauma clients to stay within the therapeutic window by beginning the therapy session with safety and stabilization. Working with nightmares involves re-visiting the trauma (in some way) and it is not always possible for sufferers to do this until they are stable and have the resources to calm themselves if they become triggered by the work. Using our framework, as the client processes the content of the trauma, they are able to stay in the present, aware of bodily sensations, and not become flooded by emotion. As a result of this work, the negative elements of the nightmare are transformed, allowing the client to move on from the “stuck” process.
 
Working with embodied experiences connected to trauma is a much more gentle exposure than working with the traumatic narrative. Because narrative can be a powerful trigger, we use indirect imaginal exposure processing so that clients are more likely to stay within the therapeutic window (Briere and Scott, 2006).
 

• Addressing Ordinary Dreams and Parasomnias

  • Models of Dreaming: Explain how the Standard Model of Dreaming, Dreams Without Dreaming, and the Cultural–Social Model of Dreams are applied to understand and interpret dream content. This can help contextualize the client's experiences within broader psychological and cultural frameworks.

• Revision of Stage 1: Re-establishing Safety and Stability

  • Readiness for Trauma Processing: Emphasize the importance of creating a safe therapeutic environment before delving into trauma processing. Detail how the therapy encourages a transition from narrative to embodied experiences of memories and the application of Dual Representation Theory in practice.

• Establishing External and Internal Safety

  • Scaffolding Techniques: Provide specific examples of techniques used to build internal resources, such as grounding exercises or visualization.

  • Routine Homework: Assign consistent, manageable tasks that reinforce skills learned in therapy, such as journaling sleep patterns or practicing relaxation techniques before bed.

• Continuous Psychoeducation

  • Normalizing Symptoms: Ensure clients understand that symptoms of trauma, such as disrupted sleep or heightened vigilance, are normal and expected responses that can be managed and mitigated through therapy.

• Sleep Hygiene and Symptom Management

  • Improving Sleep Hygiene: Offer practical advice on creating a conducive sleep environment and developing pre-sleep routines that promote restful sleep.

  • Trigger Identification and Management: Teach clients to recognize and manage triggers, especially those that may disrupt sleep, like certain media exposures or nighttime routines.

• Motivation and Coping Techniques

  • Progressive Muscle Relaxation: Guide clients through the steps of this technique and how it can be used effectively to reduce physical tension and promote relaxation.

  • Integrating Coping Techniques: Discuss how these techniques can be seamlessly integrated into daily life to enhance overall well-being and resilience.

• Creative and Self-regulation Techniques

  • Inner Protectors and Anchoring: Describe how these creative visualization techniques help clients establish a sense of safety and presence during distressing moments.

  • Robust Self-regulation Skills: Ensure that clients develop these skills to remain within their window of tolerance during sessions and in everyday situations.

• Externalizing Dream Content

  • Mapping Nightmares: Introduce techniques for clients to map out nightmares, helping them to distance themselves from distressing content while gaining insight into their subconscious fears.

  • Shift from Narrative to Embodied Experiences: Further detail the therapeutic process of moving from discussing the narrative content of dreams to exploring their physical and emotional impacts through sensory processing.

• Embodied Re-processing

  • Advanced Nightmare Re-processing: Outline specific techniques and therapeutic approaches for safely re-engaging with and reprocessing nightmares to transform their impact.

  • Safe Processing Techniques: Describe how therapists can guide clients to safely enter and process nightmare content without exacerbating trauma symptoms.

• General Integration and Continued Support

  • Daily Activities and Relationships: Emphasize the importance of applying learned techniques to improve daily life and relationships.

  • Reinforcing Safety and Sleep Hygiene: Continue to support clients in maintaining safety and improving sleep hygiene as part of ongoing care.

In this workshop, our participants learn through reflecting on the experiences they get from doing different exercises. As a result of this training, participants will learn:
(1)          how the nightmare can be broken into its various components which can be processed individually, and how nightmares can be re-processed without rehearsing the painful narratives which can re-traumatise clients;
(2)          how ordinary dreams can be broken into their various components to help the client process the whole dream;
(3)          how nightmare and dream re-processing can be incorporated into counselling or psychotherapy sessions.
 
Through this training, participants are introduced to systemic, experiential and embodied techniques in nightmare and dream re-processing. For the purposes of training and research, we are collaborating with Tom Stoneham (a philosophy professor) and several researchers at the University of York. Tom has developed a Cultural–Social Model of dreams, which provides an alternative theoretical foundation for working with dreams and nightmares. The theory postulates that our dream content is largely determined by external social and cultural factors whereas most theories heavily rely on internal psychological processes.