What I'm Noticing About My Clients' Dreams as a Therapist During COVID-19

I have lived by myself in New York City for many years. Spending time unaccompanied is familiar and comfortable for many who live in single households in Manhattan. Even though I love people, I often retreat in order to recharge, so I never thought that the solitary nature of the lockdown was going to have an impact on me. But hearing from how others are struggling with the isolation has helped me recognize that I was wrong.

I’m a therapist, and many of my clients have shared with me that they have been having vivid dreams of people they haven’t seen — or thought of — in years, and nightmares of events they had not remembered in a long time. Their accounts made me notice that their dreams shared many similarities, and that I also was having comparable experiences. I’ve been having dreams about very random people and events I had basically forgotten.

The “coincidence” piqued my curiosity and I pushed myself to do some digging to find an explanation. It’s well-documented that the current crisis has had an impact on our dreams — but this was different. It was the specific nature of the random acquaintance memories during our sleep that made me think there was something even more interesting — and possibly quite alarming — going on.

We dream because our brain processes the emotions, memories and information that were absorbed throughout the day. Even though  there are many different theories about dreaming and memory, it’s broadly accepted that, during sleep, the brain goes through all the collected information and decides what to keep and what to forget.

The events won’t be completely deleted but they will be stored in different places depending on our need to have them accessible. Whatever we need to live and survive will be easier to retrieve. Everything else will be archived.

Nightmares bring out images connected to strong emotions — like fear, terror, distress or anxiety — to indicate that there is something important that needs to be attended to, because we’re probably in danger. Nightmares may be reminders that there is something we need to resolve. They will continue to do this until we become proactive in processing the emotions carried by the dream by getting rid of the threats and ending unfinished business.

Nightmares are not harmless. There is a real risk to our mental health from having them persistently. The brain doesn’t distinguish real from imaginary, and if our dreams are related to traumatic events we may suffer (re)traumatization during this process. If we constantly experience fear while asleep, our body will activate survival mechanisms.

So what does this have to do with having nightmares about unrelated people and events during the lockdown? Shouldn’t we be dreaming instead of the virus (which some people are), or of more relevant scenarios like losing our savings  or getting evicted, if that is what is likely triggering the fear?

From my vantage point, analyzing both what my patients are going through, what I’ve experienced and what I know about trauma, I’d theorize that the brain is trying to find an explanation for the daily level of stress almost all of us are enduring during this pandemic. And it’s not just the most severely affected, as even those who seem to have their lives “under control” are dealing with similar stress levels. Since we collectively have never experienced something similar to this, all the memories that may resemble (aka remind us of) this type of situation are re-surfacing in case they can help us decipher the source of our anxiety and maybe even find a remedy. Another type of memory, that is related to a “suspected enemy” (perhaps people you don’t think about but have a negative reaction to) is coming back for the same reason.

I have noticed that many of my clients, and the clients of my supervisees, were reporting they were “daydreaming” as an anomaly. Some of them daydreamed about the future with positive outcomes, but many of them were having new strange thoughts and intrusive images.

That didn’t surprise me first, since I know that when we have so much more time in our hands, we tend to do it; even if we bake a new bread recipe every day, I bet there are long segments in our days without a task. When we are idle, our brain activates something called the “Default Mode Network” (DMN), a group of brain regions that show lower levels of activity when we are engaged in a particular task like paying attention — but higher levels of activity when we are awake and not involved in any specific cognitive exercise. This is important, because it is during these times that we might be daydreaming, remembering, envisioning the future, making some planning, having some automatic self-talk or getting trapped in ideas about how others see us. It tends to be either very creative, or very ego-preoccupied.  What clients were sharing about having intrusive thoughts and scary images didn’t sound like the typical daydreaming or idle “thinking.” It sounded more like flashbacks or nightmares while awake.

Flashbacks are intrusive thoughts that remind us of a past traumatic event. But the images reported by the clients were not like that. They were about random people and situations, similar to the dreams and nightmares. I asked many of them if they were emotions associated with the images; they mostly responded that they were disturbing, made them feel angry and puzzled them. Was what they were seeing a new type of flashback that is distinct from what we already know about flashbacks?

My theory about why the nightmares are taking such a specific shape fits this type of daydreaming: it is not about past trauma. It is about a new one. The brain is trying to find out an explanation of our constant fear, sadness, loneliness and confusion from the last weeks by bringing up possible subjects that we could blame.

As a trauma therapist, I immediately see that, even without noticing it, we are experiencing a subtle but sustained traumatization due to the fact that our nervous system is actively trying to avoid danger day and night. So much so that it’s even going to the extreme of finding novel ways for us to notice danger. It got me so curious that I kept asking clients about their dreams.

One client said “more than dreams, they are like ‘visions.’ I feel like someone else is in my place. I’ve been seeing shadows, and the other day I ‘saw’ a guy I used to hang with in high school seated on my sofa.” Others also shared having had at least one incident recently where they thought they had seen something that was not there. These visions fall into a category that has always intrigued me from the trauma symptoms; they can’t be called flashbacks because they are not “images” from the traumatic event, and they are not hallucinations either because the person experiencing them knows they are not real. I won’t go into trying to define them, but I want to shed light on them because they happen frequently after a traumatic event, which reinforces my point about the gravity of the mental consequences that the pandemic is carrying on.

The amount of effort in digging so deeply into our memory database must be super taxing. People are reporting they are sleeping 8 to 10 hours a day and yet still feel tired. Our systems seem to be really busy solving the puzzle of the pandemic.

We would all love to know the explanation behind why our dreams are more vivid than before. Clinically, regardless of the reason, there is something else we can be thinking about, which is their impact on our mental health. Instead of just simple anxiety dreams, we should consider them intrusions. And we should become proactive in finding a way to regulate our system and get rid of them. As a professional, it’s worthy to spend my time listening, but I also want to make sure that we don’t just accept every consequence of the pandemic as a given. Our minds are as powerful as to bring back acquaintances in order to give us a sign; they are also capable of reversing the effects of traumatization.

Going back to normal seems to be what everyone would like to believe is a panacea — if only we could move on and forget this ever happened everything would be OK again. Maybe the nightmares would stop. ,

But if we pretend that that’s the solution, we could be putting ourselves at risk again. The traumatization could continue quietly in the background. We talk a lot about safety, but there is none for now, and we don’t know when there will be. So what we can do is not turn a blind eye to the issues we’re encountering, and instead believe that, no matter what, we have lived, and it has been awesome. If we practice gratitude for what we have experienced and felt in our one life, maybe our brain will find its way to better memories to tap into for our day or night dreaming. Yes, this seems almost too basic, but it’s the simplest truths, even when it comes to complicated mental health matters, that hold the most weight.

We must battle uncertainty with assurance. Right after we make our next loaf of bread.