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The nightmares are part of a (slow and painful) processing of PTSD events. Suppressing them may not be helpful and actually just kick the can down the road. The

The nightmares are part of a (slow and painful) processing of PTSD events. Suppressing them may not be helpful and actually just kick the can down the road. The benefits of an interrupting device would only make sense in an extended longitudinal study crossed against a group who fully grieved, undertook guided introspection, had their stories heard, and received intimate talk-therapy or similar psychological support.

endisneigh 4y ago
Is there any proof of this? This is also a strange comment as the article says they’re doing trials to prove efficacy. > Currently, NightWare is prescribed to 400 patients in the US, 98 percent of whom are active-duty military or veterans. A new study in the peer-reviewed Journal of Clinical Sleep Medicine shows that participants who used NightWare at least 50 percent of the time had significantly better self-reported sleep quality compared to participants not using NightWare. “The results of our first published clinical trial demonstrate NightWare’s efficacy, and Apple technology is a critical part of that,” says Hannah, NightWare’s CEO. “NightWare benefits from so many of the singular features of the Apple ecosystem — the hardware and design of Apple Watch, the quality control standards, the ease of software integration and deployment — it all comes together to create a system that is changing lives.”
- nonrandomstring 4y ago
  Proof of what?
  - smallnix 4y ago
    That "nightmares are part of a (slow and painful) processing of PTSD events".
  - endisneigh 4y ago
    > The nightmares are part of a (slow and painful) processing of PTSD events. Suppressing them may not be helpful and actually just kick the can down the road.
    - nonrandomstring 4y ago
      Why do you think people have nightmares?
      - more_corn 4y ago
        It sounds like you have decided why people have nightmares. I’m curious if you have any evidence to support your conclusion or if you just made it up.
      - endisneigh 4y ago
        I’m not a psychologist. I’m sure it differs per person depending on many variables.
        nonrandomstring 4y ago
        Yes it's very much an individual experience with many functions and variables. Here's some (see summary [1]); Functional threat modelling for templating past events onto avoiding future harms, Valli,Revonsuo et al (Centre for Cognitive Neuroscience, University of Turku) "The threat simulation theory of dreaming (TST) () states that dream consciousness is essentially an ancient biological defence mechanism, evolutionarily selected for its capacity to repeatedly simulate threatening events." Integration and consolidation of past events. Physiology and psychology of dreams, Alan S Eiser (Department of Neurology, University of Michigan Sleep Disorders Center Ann Arbor) "... direct and systematic investigation could be made of such topics as the occurrence, qualities, recollection, and childhood development of dreaming...neurobiological research, including lesion and brain imaging studies, have established a clearer view of the functional neuroanatomy of REM sleep and dreaming." Processing difficult, complicated, unsettling thoughts. Affect integration in dreams and dreaming, Gary Grenell (Faculty, Seattle Psychoanalytic Society and Institute, USA) "The processes by which dreaming aids in the ongoing integration of affects into the mind are approached here from complementary psychoanalytic and nonpsychoanalytic perspectives. One relevant notion is that the dream provides a psychological space wherein overwhelming, contradictory, or highly complex affects that under waking conditions are subject to dissociation, splitting, or disavowal may be brought together for observation by the dreaming ego." [1] https://www.psychologytoday.com/us/blog/sleep-newzzz/201502/why-do-we-dream https://www.psychologytoday.com/us/blog/sleep-newzzz/201502/...
- jorgesborges 4y ago
  I think the deeper point being made here is that while stopping nightmares does effectively stop nightmares, it might not address the trauma producing them — and by suppressing the nightmare you suppress a potential avenue of healing. I understand these treatments are necessary and let people live when life might otherwise be intolerable. But there’s definitely a wider discussion to be had addressing the extent to which our mental health apparatus is designed to suppress symptoms rather than to become healthier.
  - nonrandomstring 4y ago
    Exactly. Though it's sad, to my mind, that this is dubbed "the deeper point". Is it not extraordinarily obvious that treating the symptoms instead of the cause is bad medicine. If there is a "deeper" point it is to question why shallow, expedient, temporary symptomatic treatment is valued above long-term root-cause change. I guess that's a question of our age.
    - lotsofpulp 4y ago
      > Is it not extraordinarily obvious that treating the symptoms instead of the cause is bad medicine. What if there is no known way to treat the cause?
      - FollowingTheDao 4y ago
        There is a treatment, but they don't want to use it yet. It is all about Neuronal Nitric Oxide Synthase and Glutamate. https://link.springer.com/article/10.1007/s00213-022-06212-7 https://link.springer.com/article/10.1007/s00213-022-06212-7 In fact, this may treat most neurological disorders. Increasing nNOS as a treatment has been overlooked for the last two decades. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2413191/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2413191/ https://www.sciencedirect.com/science/article/abs/pii/S0166432822003965 https://www.sciencedirect.com/science/article/abs/pii/S01664... This is how I cured my Schizoaffective Bipolar Disorder: https://onlinelibrary.wiley.com/doi/full/10.1111/gbb.12193 https://onlinelibrary.wiley.com/doi/full/10.1111/gbb.12193
- akira2501 4y ago
  In particular I find things based on "self-reported" results to be highly suspect, particularly when the comparison is between a relatively expensive technological therapy and simply doing nothing. There's no blinding and no placebo control and no comparison of measurable results over a long period of study.
crazygringo 4y ago
I'm unaware of any evidence for that. To the contrary, people with PTSD can suffer chronic nightmares for the rest of their lives and show no improvement at all. Recovering from PTSD involves a lot of therapy of the kind you're suggesting. But the idea that diminishing the strength/duration of nightmares would somehow interfere either with that therapeutic process or the self's own healing processes seems entirely unsupported. Obviously a device like this should be used in conjunction with healing therapy. But healing therapy can take a long time, and continuing to suffer nightmares during that process seems counterproductive.
- nonrandomstring 4y ago
  The content of nightmares is the reporting that feeds into the processes of reflection and therapeutic correction. No dreams, no clue as to what specifically lies at the core of an unresolved traumatic experience. Unpleasant as they are, they are also useful indicative tools toward recovery.
  - crazygringo 4y ago
    First, it's one stream of reporting among many. Free journaling, free association, recounting, there are so many tools therapists use. And second, you don't need 1,000 nightmares to gather that reporting. Ten or twenty will be sufficient. But the idea that nightmares need to be kept ongoing has absolutely no basis.
    - nonrandomstring 4y ago
      > you don't need 1,000 nightmares to gather that reporting. Ten or twenty will be sufficient. Glad we've established the principles and now we're just arguing over the details :)
      - heavenlyblue 4y ago
        I have grown up reading books by people of the opinion you hold, making strong, very easy to believe claims about human mind. None if that is true. All people I know who followed these teachings never really struggled in life but they have a heck of a ton to say about how others should live their life. Honestly I only think that those who hold opinions like yours (without any factual support) are a cancer, but besides the point: Can you please provide any peer reviewed research to support your opinion?
more_corn 4y ago
PTSD re-processing of events is probably more traumatic than therapeutic. Most trauma treatment is focused on breaking the cycle of repetition in order to move pst the traumatic events.
- nonrandomstring 4y ago
  Correct. Reprocessing is almost always re-traumatising. That is the nature of therapy. It gets worse before it gets better. Breaking the cycle requires causal insight. Breaking the cycle is not the same as suppressing it. One does not move past unprocessed trauma, one moves through it.
  - dougmwne 4y ago
    Let me offer a different mental model. Instead of a queue that needs to be processed to reach a productive conclusion, what if we view PTSD like more of a stuck process that just sits there taking up a core's resources without doing anything valuable?
    - nonrandomstring 4y ago
      Thats a very interesting analogy that moves the discussion beyond "Gods will", "cancerous opinions" and endless bleating for "proof" that occupies some other outbursts. I think stuckness is a good metaphor. And yes I see where you are going with that - persistent nightmares are taxing, waking up feeling physically drained etc. There seems a strong case for instrumental suppression, much as anti-depressants can help set the necessary conditions for long-term therapy. But I'd take the metaphor further and suggest the nightmares are processes that are signalling, but those signals are not acted upon. We sometimes need help in interpreting and verbalising those signals so that we can hear them ourselves. My objection would be to blocking those signals as a first recourse (and allowing that to become a normalised response to intrusive reliving as other self-medication is so often with veterans I've had contact with).

endisneigh 4y ago

Is there any proof of this? This is also a strange comment as the article says they’re doing trials to prove efficacy. > Currently, NightWare is prescribed to 400 patients in the US, 98 percent of whom are active-duty military or veterans. A new study in the peer-reviewed Journal of Clinical Sleep Medicine shows that participants who used NightWare at least 50 percent of the time had significantly better self-reported sleep quality compared to participants not using NightWare. “The results of our first published clinical trial demonstrate NightWare’s efficacy, and Apple technology is a critical part of that,” says Hannah, NightWare’s CEO. “NightWare benefits from so many of the singular features of the Apple ecosystem — the hardware and design of Apple Watch, the quality control standards, the ease of software integration and deployment — it all comes together to create a system that is changing lives.”

nonrandomstring 4y ago
Proof of what?
- smallnix 4y ago
  That "nightmares are part of a (slow and painful) processing of PTSD events".
- endisneigh 4y ago
  > The nightmares are part of a (slow and painful) processing of PTSD events. Suppressing them may not be helpful and actually just kick the can down the road.
  - nonrandomstring 4y ago
    Why do you think people have nightmares?
    - more_corn 4y ago
      It sounds like you have decided why people have nightmares. I’m curious if you have any evidence to support your conclusion or if you just made it up.
    - endisneigh 4y ago
      I’m not a psychologist. I’m sure it differs per person depending on many variables.
      - nonrandomstring 4y ago
        Yes it's very much an individual experience with many functions and variables. Here's some (see summary [1]); Functional threat modelling for templating past events onto avoiding future harms, Valli,Revonsuo et al (Centre for Cognitive Neuroscience, University of Turku) "The threat simulation theory of dreaming (TST) () states that dream consciousness is essentially an ancient biological defence mechanism, evolutionarily selected for its capacity to repeatedly simulate threatening events." Integration and consolidation of past events. Physiology and psychology of dreams, Alan S Eiser (Department of Neurology, University of Michigan Sleep Disorders Center Ann Arbor) "... direct and systematic investigation could be made of such topics as the occurrence, qualities, recollection, and childhood development of dreaming...neurobiological research, including lesion and brain imaging studies, have established a clearer view of the functional neuroanatomy of REM sleep and dreaming." Processing difficult, complicated, unsettling thoughts. Affect integration in dreams and dreaming, Gary Grenell (Faculty, Seattle Psychoanalytic Society and Institute, USA) "The processes by which dreaming aids in the ongoing integration of affects into the mind are approached here from complementary psychoanalytic and nonpsychoanalytic perspectives. One relevant notion is that the dream provides a psychological space wherein overwhelming, contradictory, or highly complex affects that under waking conditions are subject to dissociation, splitting, or disavowal may be brought together for observation by the dreaming ego." [1] https://www.psychologytoday.com/us/blog/sleep-newzzz/201502/why-do-we-dream https://www.psychologytoday.com/us/blog/sleep-newzzz/201502/...
jorgesborges 4y ago
I think the deeper point being made here is that while stopping nightmares does effectively stop nightmares, it might not address the trauma producing them — and by suppressing the nightmare you suppress a potential avenue of healing. I understand these treatments are necessary and let people live when life might otherwise be intolerable. But there’s definitely a wider discussion to be had addressing the extent to which our mental health apparatus is designed to suppress symptoms rather than to become healthier.
- nonrandomstring 4y ago
  Exactly. Though it's sad, to my mind, that this is dubbed "the deeper point". Is it not extraordinarily obvious that treating the symptoms instead of the cause is bad medicine. If there is a "deeper" point it is to question why shallow, expedient, temporary symptomatic treatment is valued above long-term root-cause change. I guess that's a question of our age.
  - lotsofpulp 4y ago
    > Is it not extraordinarily obvious that treating the symptoms instead of the cause is bad medicine. What if there is no known way to treat the cause?
    - FollowingTheDao 4y ago
      There is a treatment, but they don't want to use it yet. It is all about Neuronal Nitric Oxide Synthase and Glutamate. https://link.springer.com/article/10.1007/s00213-022-06212-7 https://link.springer.com/article/10.1007/s00213-022-06212-7 In fact, this may treat most neurological disorders. Increasing nNOS as a treatment has been overlooked for the last two decades. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2413191/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2413191/ https://www.sciencedirect.com/science/article/abs/pii/S0166432822003965 https://www.sciencedirect.com/science/article/abs/pii/S01664... This is how I cured my Schizoaffective Bipolar Disorder: https://onlinelibrary.wiley.com/doi/full/10.1111/gbb.12193 https://onlinelibrary.wiley.com/doi/full/10.1111/gbb.12193
akira2501 4y ago
In particular I find things based on "self-reported" results to be highly suspect, particularly when the comparison is between a relatively expensive technological therapy and simply doing nothing. There's no blinding and no placebo control and no comparison of measurable results over a long period of study.

crazygringo 4y ago

I'm unaware of any evidence for that. To the contrary, people with PTSD can suffer chronic nightmares for the rest of their lives and show no improvement at all. Recovering from PTSD involves a lot of therapy of the kind you're suggesting. But the idea that diminishing the strength/duration of nightmares would somehow interfere either with that therapeutic process or the self's own healing processes seems entirely unsupported. Obviously a device like this should be used in conjunction with healing therapy. But healing therapy can take a long time, and continuing to suffer nightmares during that process seems counterproductive.

nonrandomstring 4y ago
The content of nightmares is the reporting that feeds into the processes of reflection and therapeutic correction. No dreams, no clue as to what specifically lies at the core of an unresolved traumatic experience. Unpleasant as they are, they are also useful indicative tools toward recovery.
- crazygringo 4y ago
  First, it's one stream of reporting among many. Free journaling, free association, recounting, there are so many tools therapists use. And second, you don't need 1,000 nightmares to gather that reporting. Ten or twenty will be sufficient. But the idea that nightmares need to be kept ongoing has absolutely no basis.
  - nonrandomstring 4y ago
    > you don't need 1,000 nightmares to gather that reporting. Ten or twenty will be sufficient. Glad we've established the principles and now we're just arguing over the details :)
    - heavenlyblue 4y ago
      I have grown up reading books by people of the opinion you hold, making strong, very easy to believe claims about human mind. None if that is true. All people I know who followed these teachings never really struggled in life but they have a heck of a ton to say about how others should live their life. Honestly I only think that those who hold opinions like yours (without any factual support) are a cancer, but besides the point: Can you please provide any peer reviewed research to support your opinion?

more_corn 4y ago

PTSD re-processing of events is probably more traumatic than therapeutic. Most trauma treatment is focused on breaking the cycle of repetition in order to move pst the traumatic events.

nonrandomstring 4y ago
Correct. Reprocessing is almost always re-traumatising. That is the nature of therapy. It gets worse before it gets better. Breaking the cycle requires causal insight. Breaking the cycle is not the same as suppressing it. One does not move past unprocessed trauma, one moves through it.
- dougmwne 4y ago
  Let me offer a different mental model. Instead of a queue that needs to be processed to reach a productive conclusion, what if we view PTSD like more of a stuck process that just sits there taking up a core's resources without doing anything valuable?
  - nonrandomstring 4y ago
    Thats a very interesting analogy that moves the discussion beyond "Gods will", "cancerous opinions" and endless bleating for "proof" that occupies some other outbursts. I think stuckness is a good metaphor. And yes I see where you are going with that - persistent nightmares are taxing, waking up feeling physically drained etc. There seems a strong case for instrumental suppression, much as anti-depressants can help set the necessary conditions for long-term therapy. But I'd take the metaphor further and suggest the nightmares are processes that are signalling, but those signals are not acted upon. We sometimes need help in interpreting and verbalising those signals so that we can hear them ourselves. My objection would be to blocking those signals as a first recourse (and allowing that to become a normalised response to intrusive reliving as other self-medication is so often with veterans I've had contact with).