What is dream related OCD?
| You’re ready to end your day and climb into bed. You think about everything you’ve done that day; the highs and lows. Before you realize it, your stream of consciousness is now governed by the inevitable brain activity that happens to us all. Maybe you’re falling out of a 100 story building from the 99th floor, but never hit the ground. Perhaps you’re running with the feeling that you’re being chased, but can never identify who or what you’re trying to escape. Some will recall their dreams once they awake, shrug, and move on throughout their day, while others may wake up and assign various meanings to what they remember and look for ways in which the dreams may be applicable to their lives. People with fear of dreaming OCD may experience obsessions related to their dreams—for people with OCD, common and sometimes unsettling dreams can trigger overwhelming OCD episodes, full of anxiety, rumination, and compulsive behaviors. Dream OCD can present in very distinct ways. Those with this OCD subtype may have vivid and memorable dreams about their deepest fears. Often, individuals with this subtype may fear that these dreams will come to pass in real life. Some who present with dream OCD may also believe that there is a correlation between their dreams and reality, especially if they have actually dreamed of a previous event that seemed to have manifested in the past. Dreams may even be related to other intrusive or bothersome thoughts in life, leaving people confused as to how they can get better. |
Dream related OCD – Common obsessions
- What if my dreams actually materialize?
- What if my obsessions manifest in my dreams?
- What if my dreams trigger new obsessions?
- What if my dreams feel and seem real?
- What if my dreams are telling me I need to take a certain action in my life?
- What if I die in my dreams?
- What if I get stuck in a dream?
- What if I can never wake up from a dream?
- What if my dreams mean that I’m a bad person?
- What if I never stop having these bad dreams?
Common triggers
People with Dream OCD may be triggered by situations that make them feel anxious, uncomfortable, or fearful. Unsettling dreams can cause people to feel like they are out of control and uncertain of what will happen. Vivid dreams can momentarily feel real upon waking up, which can result in confusion about reality. A simple dream can also be the catalyst for intrusive thoughts that can be the cause of mental anguish.
- Exposure to any information about symbolism in dreams
- Experiencing intrusive thoughts before going to sleep
- Watching a documentary about the spiritual explanation of dreams
- Verbally disclosing disturbing dreams
- Reading about precognitive dreams
- Watching movies centered around confusion between dreams and reality
- Having a disturbing or strange dream
- Getting little or poor sleep
How can I tell if it’s OCD fear of dreaming, and not anxiety?
It’s usually apparent that an individual is experiencing Dream OCD when they are experiencing consistent intrusive thoughts/obsessions about their dreams. Another important aspect of Dream OCD includes compulsions, which are behaviors an individual will perform in response to the anxiety that is produced by the intrusive thought or obsession.
Common compulsions
When people with Dream OCD experience intrusive thoughts, images, feelings, or urges that cause distress, they may engage in behaviors called compulsions, which may alleviate anxiety caused by the dream-related obsession, or may be perceived to prevent a feared outcome. Unfortunately, these compulsions only temporarily relieve anxiety related to Dream OCD and, more often than not, perpetuate the OCD cycle, leading to more intrusive thoughts and increasing the intensity of the obsessions.
Compulsions performed mentally or physically by people with Dream OCD include:
- Delaying sleep (Avoidance)
- Researching scientific basis of dreams
- Rumination about what previous dreams mean and/or how they may relate to reality
- Mental review about most recent and old dreams
- Reassurance seeking from psychics or others thought to have knowledge about dreams
- Confession about an action or decision made in a dream
- Tracking dream content
- Substance use
How to treat fear of dreaming in OCD
| Fear of dreaming can be debilitating for people who struggle with it, but it is highly treatable. By doing exposure and response prevention (ERP) therapy, it’s possible to effectively manage dream-related obsessions and intrusive thoughts. The overall objective of ERP is to develop exposures, situations designed to safely trigger anxiety related to obsessions, while refraining from compulsions like delaying sleep or confessing behaviors that occurred in a dream. The first step to beginning ERP for dream OCD is developing a comprehensive hierarchy, which is essentially a treatment plan. The hierarchy will assist with identifying obsessions, compulsions, and triggers, while also providing a model for exposure development. It’s imperative that exposures target the fear associated with dreams and the stimuli that trigger these fears. For instance, if an individual is compulsively avoiding thinking about their dreams, a relevant ERP exercise could be dream journaling about the parts of a dream that are memorable and using the imagination to fill in and embellish parts there is no memory of, all without engaging in compulsions for temporary anxiety relief. Exposure and Response Prevention therapy shows us that facing our deepest fears can lead us to freedom from time-consuming compulsions. In time, you can find yourself in control of your life and willing to take on challenging feelings like anxiety and uncertainty. |
If you’re struggling with OCD, I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.
We look forward to working with you.