Studies of frequencies of nightmares among adults show that one third to one half of all adults experience occasional nightmares. A study of college students found that almost three-quarters of a group of 300 had nightmares at least once a month. In another study, five percent of college freshmen reported having nightmares at least once a week. If this rate applies to the general population, then we might find that more than ten million Americans are plagued by wholly realistic horrifying experiences every week!
Some factors that seem to contribute to nightmare frequency are: illness (especially fever), stress (caused by situations like the difficulties of adolescence, moving, hard times at school or work), troubled relationships and traumatic events, like being mugged or experiencing a serious earthquake. Traumatic events can trigger a long lasting series of recurrent nightmares.
Some drugs and medications can cause an increase in nightmares. The reason for this is that many drugs suppress REM sleep, producing a later effect of REM-rebound. If you go to sleep drunk, you may sleep quite soundly, but dream little, until five or six hours into sleep. Then, the alcohol’s effect has mostly worn off and your brain is prepared to make up for the lost REM time. As a result, you will dream more intensely than usual for the last few hours of your sleep time. The intensity is reflected in the emotionality of the dream, which often will be unpleasant.
There are a few drugs which seem to increase nightmares by increasing the activity of some part of the REM system. Among these are l-DOPA, used in the treatment of Parkinsonism, and beta-blockers, used by people with some heart conditions. Since research has shown that lucid dreams tend to occur during periods of intense REM activity, I believe that drugs that cause nightmares may also facilitate lucid dreaming. This is a topic I plan to research in years to come. I think that whether an intense REM period leads to dreams that are pleasantly exciting or terrifying depends on the attitude of the dreamer.
Thus, it is to the dreamer’s attitude that I think we should look in seeking a treatment for nightmares. For example, people rarely experience nightmares in the sleep laboratory, because they have a feeling of being observed and cared for. Likewise, children who awaken from nightmares and crawl into bed with their parents feel safe from harm and thus are less likely to have more bad dreams.
I believe the best place to deal with unpleasant dreams is in their own context, in the dream world. We create our nightmares out of the raw material of our own fears. Fears are expectations—why would we fear something we thought would never happen? Expectations affect our waking lives, but even more so, they determine our dream lives. When in your waking life, you walk down a dark street, you fear that someone will threaten you. However, for some dark figure to actually leap out at you with a knife depends on there really being some knife-bearing thug hiding in an alley nearby waiting for a victim. On the contrary, if you dream of walking down a dark street, fearing attack, it is almost inevitable that you will be attacked, because you can readily imagine the desperate criminal waiting for you. But, if you had not thought that the situation was dangerous, there would be no thug, and no attack. Your only real enemy in dreams is your own fear.
Most of us harbor some useless fears. Fear of speaking in public is a common example. In most cases, no harm will result from giving a speech, but this fact does not prevent many people from being as frightened of public speaking as they would be if faced by a life threatening situation. Likewise, to be afraid in a dream, while understandable, is unnecessary. Even when fear is useless, it is still quite unpleasant, and can be debilitating. An obvious way to improve our lives is to rid ourselves of unnecessary fear. How is this done?
Research on behavior modification treatment for phobias shows that it is not enough for a person to know intellectually that the object of their fear is harmless. Snake phobics may “know” perfectly well that garter snakes are harmless, but they will still be afraid to pick one up. The way to learn to overcome fear is to face it—to approach the fearsome object or situation little by little. Each time you encounter the feared thing without harm you learn by experience that it cannot hurt you. This is the kind of approach we propose for overcoming nightmares. Many anecdotes demonstrate that the approach is effective, and can even be used by children.
None of our proposed treatments for nightmares require that you interpret the symbolism of the unpleasant images. Much fruitful work can be accomplished in dreams by working directly with the images. Waking analysis (or interpretation while in the dream) may help you understand the source of your anxieties, but will not necessarily help you outgrow them. For instance, consider again the fear of snakes. The classical interpretation of snake phobia is that it is a disguised anxiety about sex, especially regarding the male member, and in fact most snake phobics are women. A much more plausible biological explanation is that humans come into the world prepared to easily learn to fear snakes, because avoiding venomous snakes has obvious survival value. However, providing this information doesn’t cure the phobia. What does help, as mentioned above, is for the phobic to slowly become accustomed to dealing with snakes. Likewise, dealing directly with dream fears, learning they cannot harm us, can help us to overcome them.
 E. Hartmann, The Nightmare (New York: Basic Books, 1984).
 S. LaBerge, L. Levitan, and W. C. Dement, “Lucid Dreaming: Physiological Correlates of Consciousness during REM Sleep,” Journal of Mind Behavior 7 (1986): 251-258.
. S. Freud, “Introductory Lectures on Psychoanalysis,” in Standard edition of the Complete Psychological Works of Sigmund Freud, Vol. 15 (London: Hogarth Press, 1916-17), 222.
 Hartmann, op. cit.; A. Kales et al., “Nightmares: Clinical Characteristics of Personality Patterns,” American Journal of Psychiatry 137 (1980): 1197-1201.
 J. A. Gray, “Anxiety,” Human Nature 1 (1978): 38-45.
 C. Green, Lucid Dreams (London: Hamish Hamilton, 1968); S. LaBerge, Lucid Dreaming (Los Angeles: J. P. Tarcher, 1985).
 I. Shah, The Way of the Sufi (London: Octagon Press, 1968), 79.
. H. Saint-Denys, Dreams and How to Guide Them (London: Duckworth, 1982), 58-59.
 P. Tholey, “A Model of Lucidity Training as a Means of Self- Healing and Psychological Growth,” in Conscious Mind, Sleeping Brain, eds. J. Gackenbach and S. LaBerge (New York: Plenum, 1988), 263-287.