Tag: Rosalind Cartwright

Warnings From Sleep: Nightmares and Protecting The Self

“All of this is evidence that the mind, although asleep, is constantly concerned about the safety and integrity of the self.”

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Rosalind Cartwright — also known as the Queen of Dreams — is a leading sleep researcher. In The Twenty-four Hour Mind: The Role of Sleep and Dreaming in Our Emotional Lives, she explores the role of nightmares and how we use sleep to protect ourselves.

When our time awake is frightening or remains unpressed, the sleeping brain “may process horrible images with enough raw fear attached to awaken a sleeper with a horrendous nightmare.” The more trauma we have in our lives the more likely we are to experience anxiety and nightmares after a horrific event.

The common feature is a threat of harm, accompanied by a lack of ability to control the circumstances of the threat, and the lack of or inability to develop protective behaviors.

The strategies we use for coping effectively with extreme stress and fear are controversial. Should we deny the threatening event and avoid thinking about it better than thinking about it and becoming sensitized to it?

One clear principle that comes out of this work is that the effects of trauma on sleep and dreaming depend on the nature of the threat. If direct action against the threat is irrelevant or impossible (as it would be if the trauma was well in the past), then denial may be helpful in reducing stress so that the person can get on with living as best they can. However, if the threat will be encountered over and over (such as with spousal abuse), and direct action would be helpful in addressing the threat, then denial by avoiding thinking about the danger (which helps in the short-term) will undermine problem-solving efforts and mastery in the long run. In other words, if nothing can be done, emotion-coping efforts to regulate the distress (dreaming) is a good strategy; but if constructive actions can be taken, waking problem-solving action is more adaptive.

What about nightmares?

Nightmares are defined as frightening dreams that wake the sleeper into full consciousness and with a clear memory of the dream imagery. These are not to be confused with sleep terrors. There are three main differences between these two. First, nightmare arousals are more often from late in the night’s sleep, when dreams are longest and the content is most bizarre and affect-laden (emotional); sleep terrors occur early in sleep. Second, nightmares are REM sleep-related, while sleep terrors come out of non-REM (NREM) slow-wave sleep (SWS). Third, sleepers experience vivid recall of nightmares, whereas with sleep terrors the experience is of full or partial amnesia for the episode itself, and only rarely is a single image recalled.

Nightmares abort the REM sleep, a critical component of our always on brain, Cartwright explains:

If we are right that the mind is continuously active throughout sleep—reviewing emotion-evoking new experiences from the day, scanning memory networks for similar experiences (which will defuse immediate emotional impact), revising by updating our organized sense of ourselves, and rehearsing new coping behaviors—nightmares are an exception and fail to perform these functions.

The impact is to temporarily relieve the negative emotion. The example Cartwright gives is “I am not about to be eaten by a monster. I am safe in my own bed.” But because the nightmare has woken me up, the nightmare is of no help in regulating my emotions (a critical role of sleep). As we learn to manage negative emotions while we are awake, that is, as we grow up, nightmares reduce in frequency and we develop skills for resolving fears.

It's not always fear that wakes us from a nightmare. We can also be woken by anger, disgust, and grief.

Cartwright concludes, with an interesting insight, on the role of sleep in consolidating and protecting “the self.”:

[N]ightmares appear to be more common in those who have intense reactions to stress. The criteria cited for nightmare disorder in the diagnostic manual for psychiatric disorders, the Diagnostic and Statistical Manual IV-TR (DSM IV-TR), include this phrase “frightening dreams usually involving threats to survival, security, or self-esteem.” This theme may sound familiar: Remember that threats to self-esteem seem to precede NREM parasomnia awakenings. All of this is evidence that the mind, although asleep, is constantly concerned about the safety and integrity of the self.

The Twenty-four Hour Mind goes on to explore the history of sleep research through case studies and synthesis.

The Science of Sleep: Regulating Emotions and the Twenty-four Hour Mind

“Memory is never a precise duplicate of the original; instead, it is a continuing act of creation.”

***

Rosalind Cartwright is one of the leading sleep researchers in the world. Her unofficial title is Queen of Dreams.

In The Twenty-four Hour Mind: The Role of Sleep and Dreaming in Our Emotional Lives, she looks back on the progress of sleep research and reminds us there is much left in the black box of sleep that we have yet to shine light on.

In the introduction she underscores the elusive nature of sleep:

The idea that sleep is good for us, beneficial to both mind and body, lies behind the classic advice from the busy physician: “Take two aspirins and call me in the morning.” But the meaning of this message is somewhat ambiguous. Will a night’s sleep plus the aspirin be of help no matter what ails us, or does the doctor himself need a night’s sleep before he is able to dispense more specific advice? In either case, the presumption is that there is some healing power in sleep for the patient or better insight into the diagnosis for the doctor, and that the overnight delay allows time for one or both of these natural processes to take place. Sometimes this happens, but unfortunately sometimes it does not. Sometimes it is sleep itself that is the problem.

Cartwright underscores that our brains like to run on “automatic pilot” mode, which is one of the reasons that getting better at things requires concentrated and focused effort. She explains:

We do not always use our highest mental abilities, but instead run on what we could call “automatic pilot”; once learned, many of our daily cognitive behaviors are directed by habit, those already-formed points of view, attitudes, and schemas that in part make us who we are. The formation of these habits frees us to use our highest mental processes for those special instances when a prepared response will not do, when circumstances change and attention must be paid, choices made or a new response developed. The result is that much of our baseline thoughts and behavior operate unconsciously.

Relating this back to dreams, and one of the more fascinating parts of Cartwright's research, is the role sleep and dreams play in regulating emotions. She explains:

When emotions evoked by a waking experience are strong, or more often were under-attended at the time they occurred, they may not be fully resolved by nighttime. In other words, it may take us a while to come to terms with strong or neglected emotions. If, during the day, some event challenges a basic, habitual way in which we think about ourselves (such as the comment from a friend, “Aren’t you putting on weight?”) it may be a threat to our self-concepts. It will probably be brushed off at the time, but that question, along with its emotional baggage, will be carried forward in our minds into sleep. Nowadays, researchers do not stop our investigations at the border of sleep but continue to trace mental activity from the beginning of sleep on into dreaming. All day, the conscious mind goes about its work planning, remembering, and choosing, or just keeping the shop running as usual. On balance, we humans are more action oriented by day. We stay busy doing, but in the inaction of sleep we turn inward to review and evaluate the implications of our day, and the input of those new perceptions, learnings, and—most important—emotions about what we have experienced.

What we experience as a dream is the result of our brain’s effort to match recent, emotion-evoking events to other similar experiences already stored in long-term memory. One purpose of this sleep-related matching process, this putting of similar memory experiences together, is to defuse the impact of those feelings that might otherwise linger and disrupt our moods and behaviors the next day. The various ways in which this extraordinary mind of ours works—the top-level rational thinking and executive deciding functions, the middle management of routine habits of thought, and the emotional relating and updating of the organized schemas of our self-concept—are not isolated from each other. They interact. The emotional aspect, which is often not consciously recognized, drives the not-conscious mental activity of sleep.

Later in the book, she writes more about how dreams regulate emotions:

Despite differences in terminology, all the contemporary theories of dreaming have a common thread — they all emphasize that dreams are not about prosaic themes, not about reading, writing, and arithmetic, but about emotion, or what psychologists refer to as affect. What is carried forward from waking hours into sleep are recent experiences that have an emotional component, often those that were negative in tone but not noticed at the time or not fully resolved. One proposed purpose of dreaming, of what dreaming accomplishes (known as the mood regulatory function of dreams theory) is that dreaming modulates disturbances in emotion, regulating those that are troublesome. My research, as well as that of other investigators in this country and abroad, supports this theory. Studies show that negative mood is down-regulated overnight. How this is accomplished has had less attention.

I propose that when some disturbing waking experience is reactivated in sleep and carried forward into REM, where it is matched by similarity in feeling to earlier memories, a network of older associations is stimulated and is displayed as a sequence of compound images that we experience as dreams. This melding of new and old memory fragments modifies the network of emotional self-defining memories, and thus updates the organizational picture we hold of “who I am and what is good for me and what is not.” In this way, dreaming diffuses the emotional charge of the event and so prepares the sleeper to wake ready to see things in a more positive light, to make a fresh start. This does not always happen over a single night; sometimes a big reorganization of the emotional perspective of our self-concept must be made—from wife to widow or married to single, say, and this may take many nights. We must look for dream changes within the night and over time across nights to detect whether a productive change is under way. In very broad strokes, this is the definition of the mood-regulatory function of dreaming, one basic to the new model of the twenty-four hour mind I am proposing.

In another fascinating part of her research, Cartwright outlines the role of sleep in skill enhancement. In short, “sleeping on it” is wise advice.

Think back to “take two aspirins and call me in the morning.” Want to improve your golf stroke? Concentrate on it before sleeping. An interval of sleep has been proven to bestow a real benefit for both laboratory animals and humans when they are tested on many different types of newly learned tasks. You will remember more items or make fewer mistakes if you have had a period of sleep between learning something new and the test of your ability to recall it later than you would if you spent the same amount of time awake.

Most researchers agree “with the overall conclusion that one of the ways sleep works is by enhancing the memory of important bits of new information and clearing out unnecessary or competing bits, and then passing the good bits on to be integrated into existing memory circuits.” This happens in two steps.

The first is in early NREM sleep when the brain circuits that were active while we were learning something new, a motor skill, say, or a new language, are reactivated and stay active until REM sleep occurs. In REM sleep, these new bits of information are then matched to older related memories already stored in long-term memory networks. This causes the new learning to stick (to be consolidated) and to remain accessible for when we need it later in waking.

As for the effect of alcohol has before sleep, Carlyle Smith, a Canadian Psychologist, found that it reduces memory formation, “reducing the number of rapid eye movements” in REM sleep. The eye movements, similar to the ones we make while reading, are how we do scanning of visual information.

The mind is active 24 hours a day:

If the mind is truly working continuously, during all 24 hours of the day, it is not in its conscious mode during the time spent asleep. That time belongs to the unconscious. In waking, the two types of cognition, conscious and unconscious, are working sometimes in parallel, but also often interacting. They may alternate, depending on our focus of attention and the presence of an explicit goal. If we get bored or sleepy, we can slip into a third mode of thought, daydreaming. These thoughts can be recalled when we return to conscious thinking, which is not generally true of unconscious cognition unless we are caught in the act in the sleep lab. This third in-between state is variously called the preconscious or subconscious, and has been studied in a few investigations of what is going on in the mind during the transition before sleep onset.

Toward the end, Cartwright explores the role of sleep.

[I]n good sleepers, the mind is continuously active, reviewing experience from yesterday, sorting which new information is relevant and important to save due to its emotional saliency. Dreams are not without sense, nor are they best understood to be expressions of infantile wishes. They are the result of the interconnectedness of new experience with that already stored in memory networks. But memory is never a precise duplicate of the original; instead, it is a continuing act of creation. Dream images are the product of that creation. They are formed by pattern recognition between some current emotionally valued experience matching the condensed representation of similarly toned memories. Networks of these become our familiar style of thinking, which gives our behavior continuity and us a coherent sense of who we are. Thus, dream dimensions are elements of the schemas, and both represent accumulated experience and serve to filter and evaluate the new day’s input.

Sleep is a busy time, interweaving streams of thought with emotional values attached, as they fit or challenge the organizational structure that represents our identity. One function of all this action, I believe, is to regulate disturbing emotion in order to keep it from disrupting our sleep and subsequent waking functioning. In this book, I have offered some tests of that hypothesis by considering what happens to this process of down-regulation within the night when sleep is disordered in various ways.

Cartwright develops several themes throughout The Twenty-four Hour Mind. First is that the mind is continuously active. Second is the role of emotion in “carrying out the collaboration of the waking and sleeping mind.” This includes exploring whether the sleeping mind “contributes to resolving emotional turmoil stirred up by some real anxiety inducing circumstance.” Third is how sleeping contributes to how new learning is retained. Accumulated experiences serve to filter and evaluate the new day’s input.

What is the purpose of dreaming? And more on Circadian Rhythms

Continuing with our recent exploration of sleep, I came across this passage by sleep researcher Rosalind Cartwright in The Twenty-four Hour Mind: The Role of Sleep and Dreaming in Our Emotional Lives, on the role of dreams:

Despite differences in terminology, all the contemporary theories of dreaming have a common thread—they all emphasize that dreams are not about prosaic themes, not about reading, writing, and arithmetic, but about emotion, or what psychologists refer to as affect. What is carried forward from waking hours into sleep are recent experiences that have an emotional component, often those that were negative in tone but not noticed at the time or not fully resolved. One proposed purpose of dreaming, of what dreaming accomplishes (known as the mood regulatory function of dreams theory) is that dreaming modulates disturbances in emotion, regulating those that are troublesome. My research, as well as that of other investigators in this country and abroad, supports this theory. Studies show that negative mood is down-regulated overnight. How this is accomplished has had less attention.

I propose that when some disturbing waking experience is reactivated in sleep and carried forward into REM, where it is matched by similarity in feeling to earlier memories, a network of older associations is stimulated and is displayed as a sequence of compound images that we experience as dreams. This melding of new and old memory fragments modifies the network of emotional self-defining memories, and thus updates the organizational picture we hold of ‘who I am and what is good for me and what is not.’ In this way, dreaming diffuses the emotional charge of the event and so prepares the sleeper to wake ready to see things in a more positive light, to make a fresh start. This does not always happen over a single night; sometimes a big reorganization of the emotional perspective of our self-concept must be made — from wife to widow or married to single, say, and this may take many nights. We must look for dream changes within the night and over time across nights to detect whether a productive change is under way. In very broad strokes, this is the definition of the mood-regulatory function of dreaming, one basic to the new model of the twenty-four hour mind I am proposing.

(*Update*) While not on dreams, this passage on circadian rhythms from Zoobiquity: What Animals Can Teach Us About Health and the Science of Healing, fits very much into our recent look at sleep:

Studies have shown that disrupting circadian rhythms by even one hour during the switch to daylight saving time may increase depression, traffic accidents, and heart attacks. These rhythms affect consumption and metabolism in animals—it is hard to imagine that they aren't also playing a role in human appetites as well. Controlling environmental light with lamps, TVs, and computers gives us incredible flexibility and productivity. But it interrupts daily and yearly cycles that were billions of years in the making and are shared by countless creatures on our planet.