Night terrors

Dr. Karen Explains . . .

Children that experience night terrors, also called “sleep terror disorder,” experience intense fear as well as rapid breathing and sweating, and are often unresponsive to the efforts of others to comfort them during the episode. Typically the child does not remember the dream and there is amnesia for the entire episode. In essence, the child does not know he has night terrors.

Parents of children that have night terrors are often told not to tell their child that he is having night terrors so as to not scare their child or to negatively effect their child’s concentration on typical day-to-day thoughts and activities. I disagree with this advice and think it is imperative that you talk with your child about his night terrors.

In working with children that experience night terrors, I explain to the family that when something is bothering the child so deeply that it is too painful to think about during the day, his “conscious state of mind”–as a coping method–locks away his pain in a box inside of his mind so he can focus on his life during the day.

Since the conscious mind has a lot to focus on during the day (friends, activities, school, etc.) it makes sense that his mind locks away the pain because it is trying to protect him. At night, however, the “subconscious mind” goes to work, and it is in the child’s sleep state that his subconscious mind knows there is a locked box with painful thoughts in it and wants to unlock it because it is the secrets that we keep from ourselves that plague us in our awake state/during the day in ways that we do not realize.

Because the conscious mind (the day mind) keeps putting the feelings in the box that he has not figured out how to cope with, has not discussed his feelings about or has not come up with a solution for the problem(s), it is the subconscious mind that is trying to figure out a creative way to open up the box and address the issues. One creative solution results in night terrors. I explain to the family that the best way to resolve the night terrors and experience a healthy life is to confront what is bothering the child by “unlocking the box.”

When night terrors are not discussed and dealt with, the child’s hidden pain plagues him in other areas of his life. For example, the child may experience distress or impairment in social and other important areas of functioning without realizing the interconnection between his night terrors and his daytime behavior.

It has been my experience that most of the children that experience night terrors are experiencing something very painful in their life that they are struggling to reconcile. Therefore, parents of children with night terrors should work with a counselor that specializes, or has an expertise, in children. Having help from a skilled counselor allows the safe dialogue and explorative journey of helping the child to uncover what he may be locking away, address the problem, confront the problem, and come up with solutions and/or coping methods. By involving the parents with this process it helps educate them about what the child is feeling and allows the child to feel he can then turn to his parents when he is experiencing emotional pain. As a family therapist, I am all for educating one’s child and parents about the mind. The more a child understands, the more he is able to cope effectively since he is armed with knowledge. It is in the awareness a child has by day that a child can rest by night.

You can call your insurance directly and request a list of providers in the network that are either a child psychologist, a marriage and family therapist, or a social worker that specializes in childhood issues. Most insurance plans have on their list each provider’s specialty. When you contact the provider specify that “sleep terror disorder” is the presenting problem and inquire about their experience and confidence in treating that specific problem.

This article written by Dr. Karen Ruskin appeared in Pediatrics for Parents: Vol. 26, Issue #1 & 2, Jan/Feb 2010.