fear


We don’t really know but the DSM estimates between 1 and 6% of children and many fewer adults have this experience. You are more likely to have this happen if you are related to someone who has had this happen, but we have no idea why. It usually just goes away in adolescence. If my parents had been the type to take their kids to mental health professionals, I almost certainly would have gotten this diagnosis as a kid. If so, and if my parents had been the drug-giving kind, I might have been prescribed a benzodiazepine (like Valium) for it. Generally, though, it can be treated by comforting your child when they wake up like this, until it goes away. If you think there might have been a triggering event for the condition, therapy might be helpful.

Here are the criteria, quoted word-for-word from the Diagnostic and Statistical Manual of Mental Disorders IV-TR, page 639:

Diagnostic criteria for 307.46 Sleep Terror Disorder

A. Recurrent episodes of abrupt awakening from sleep, usually occurring during the first third of the major sleep episode and beginning with a panicky scream.

B. Intense fear and signs of autonomic arousal, such as tachycardia, rapid breathing, and sweating, during each episode.

C. Relative unresponsiveness to efforts of others to comfort the person during the episode.

D. No detailed dream is recalled and there is amnesia for the episode.

E. The episodes cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

F. The disturbance is not due to  the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

 

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I’m studying Emotionally Focused Couples Therapy, or EFT, this term in my Couples and Family Therapy master’s program. In her book for therapists, Susan Johnson writes that many people, especially those with histories of trauma, have strong fears about expressing strong emotions. She gives five common examples. These are directly quoted from her book, Emotionally Focused Couples Therapy, p. 73:

We may fear that if emotions are unleashed, they will go on forever.

We may fear that we will be taken over by such emotions and our ability to organize our experience, our very sense of self, will disappear.

We fear that we will lose control and be slaves to the impulses inherent in these emotions, and so we may make things worse or actively harm ourselves or others.

We fear we will not be able to tolerate these emotions and will go “crazy.”

We fear that if we express certain emotions, others will see us as strange and/or unacceptable.