Sep 23, 20183 min read

Nightmare Ninja - a CBT Game to Rescript Nightmares

Updated: 1 day ago

I have parents call me frequently with complaints of their children having nightmares, as it is a very common problem. Nightmares can be very distressing for children and parents. Many children become afraid to go to sleep at night in fear of what they will experience after they close their eyes.

I’ve had great success in using cognitive behavioral counseling in treatment. To accomplish this, I help the child articulate their nightmare and then rescript it with a hero who can come in and defeat the bad guy in the dream. I will usually have the child draw a picture of the nightmare while they tell the details they remember. Many of my clients do fine. I also have many who will change the subject, draw a random picture not related to the nightmare, or will simply state that they do not want to.

My greatest challenge has been resistance. I find that many children with a history of trauma are reluctant to talk about it. It is scary for them. They don’t enjoy feeling the deep emotion related to their trauma and are fearful of verbalizing their experience. Games help to reduce the anxiety related to talking about the issue at hand. If I ask the question directly, they tend to clam up. However, if the same question is on a game card, it does not seem as threatening. I occasionally have a client who will not answer a game card, which is fine. However, most of the time they are happy to give answers. The game breaks up the discussion into easy, small answers rather than having to tackle the whole thing at once. For instance, they may answer one question about the bad guy in the dream and then they get a break while I take a turn. The child’s next question may be a coping skill. It allows them time to regroup between each question.

When I play games with a client, I try to pay attention to their behavior and expressions to see if they want to engage in a discussion about the issue, or if they are in a hurry to move past a question that was anxiety-provoking. If they want to talk at length, we put the game on hold and let them process it. If they give a short answer and appear uncomfortable, I move on quickly. My goal is to allow them a chance to process their nightmare in the least threatening way possible. The first time we discuss it I may get very short answers, but they will usually feel more comfortable and at ease the next time.

This game has four sets of cards: Antagonist cards, Protagonist cards, Defeating the Monster, and Coping Skills. The Antagonist cards focus on describing details of the bad guy in the dream. This includes motivation for the harm, physical details, strengths, and weaknesses. The Protagonist cards focus on the child’s experience in the dream. It is to help them articulate the details of what happened to them, what they were thinking and feeling, and what they were doing in the dream. The Defeating the Monster cards are designed to rescript the dream. This is where they create a superhero who will rescue them from the bad guy. Finally, the coping skill cards are there to help the children identify how to avoid triggers that can lead to nightmares, thought-stopping and replacement techniques, and healthy bedtime habits.