This article originally appeared on VICE US.
Twilight swells into every corner of a strange house. I’m standing at one end of a long, empty hall. There are no windows or entrances to other rooms. There are just white walls and a door at the opposite end. My heartbeat creeps into my throat. I need to leave.
This might sound like a familiar dream. One many of us have had at one time or another. Except, my dream has a plot twist: physical pain.
I sprint down the hall, but with each step the door slips further away. I run faster, focused, trying to beat whatever twisted game I’m being forced to play. I’m unaware that something is lingering in the shadows until it’s too late. It grabs my ankle and I nosedive onto the floor. The soft evening glow fades into starry darkness, and an excruciating pain travels through my head. I feel each wave of agony wind through my nerves, stabbing and ripping as they surge. Something warm trickles down my face. Blood. I wake up, unable to catch my breath and wrecked with emotion. But there’s more. I still feel pain.
My experience—the feeling of physical pain during dreams—is not common (or at least commonly reported), says Benjamin Baird, a researcher at the Center for Sleep and Consciousness at the University of Wisconsin-Madison. Feeling the pain carry over after waking up is even less common—but it happens. One Reddit user, PiroLargo, describes a dream in which their teeth are falling out in pieces. “I could feel stinging and pulling as they fell out. I could feel the heat of the dark red blood cascading from my mouth too,” they posted in a thread about dreams. A handful of other users commented with their own experiences of feeling pain in their dreams, which lingered after they woke up.
“One time, I dreamed that a swarm of bees or wasps attacked my feet. When I woke up, my feet were burning and tingly. It was very painful,” commented Piper Andrews, who goes by the Reddit user name SpiderWifey.
Very little is known about the frequency and nature of pain in dreams. One study from 1998 asked a sample of 185 participants to record their dreams for two consecutive weeks. A total of 3,045 dreams were reported in the home dream logs. Eighteen of these dreams contained unambiguous references to the subject experiencing pain. The pain participants felt was described as intense, realistic, localized to a specific area of the body, and often the result of a violent encounter with another “character.”
So, is the pain that we feel in dreams real or is it all in our heads?
“I would argue that even ‘actual’ pain is kind of all in your head,” says Erin Wamsley, an assistant professor of psychology at Furman University in South Carolina. The conscious experience of pain, Wamsley explains, occurs when pain-related areas of your cerebral cortex—the outermost layer of your brain responsible for consciousness and higher thought processes—become active. When you’re awake and you sustain an injury, like stubbing a toe, for example, this is typically triggered by the activation of pain receptors in your peripheral nervous system. In other words, you feel the pain in your brain, not your toe. While you’re sleeping, Wamsley explains, sensory regions of the brain become active without outside input. “This is why during dreaming you can ‘see’ without actual visual input to the retina, and ‘hear’ without actual sound waves hitting the ear,” Wamsley says. From this perspective, it is not at all surprising that people report feeling pain in dreams.
While the experience of pain, both in wakefulness and sleep, is thought to be produced by the brain, it’s a gray area that no one yet fully understands. According to Baird, experts refer to this as the “hard problem” of consciousness. “It is thought, and our recent research is in line with this idea, that the neural activity associated with the feeling or experience of pain in dreams can be identical to or at least highly similar to the neural activity associated with the feeling of pain during wakefulness,” Baird says. The key difference between the two, he points out, is that in the dream you don’t actually stub your toe and therefore there is no physical damage (unlike if you stubbed your toe while you were awake).
But why do some people have such vivid dreams, including those in which they experience pain, and others hardly remember dreaming at all? Wamsley says no one knows exactly why some dreams are more vivid than others but there are some factors that influence the dream experience, including time of night, sleep stage, and sleep history. Dreams later in the night, more toward morning, and those during rapid eye movement (REM) sleep tend to be more vivid. Dreams during recovery sleep following a period of sleep deprivation can also be especially intense. “These factors might be tied together, indicating that periods of sleep when there is a greater amount of activation in the cerebral cortex are associated with more vivid dreams,” Wamsley says.
For me, the recurring experience of feeling pain during my nightmares (which sometimes carries over after I wake up) has created a sense of anxiety and dread. There are nights when my mind races and I feel a tightness in my chest. I’m panicked about what will unfold when I do fall asleep. This dream also plagues me, on and off, while I’m awake.
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Gardner Eeden, author of the book Lucid: Awake in the World and the Dream, has written widely about how recurrent dreams can affect our emotional health, in his own experience and for those he’s spoken to about the topic. “Dream experience can definitely make your body experience valid reactions. Ever wake up from a nightmare and your heart is racing or you're sweating?” he asks—those physical sensations, he argues, can vary from person to person.
The pain I feel when I hit the floor in my dream is extremely intense and very lifelike. It starts as an agonizing impact and continues to throb until I wake up in complete distress. Sometimes, I can still feel the throbbing sensation in my forehead for about a half hour after I wake up. The mental anguish of experiencing an attack and the confusion of sustaining a dream injury that persists upon waking is more upsetting than the pain itself.
Cognitive behavioral therapy (CBT), a common type of talk therapy, has shown promising results in treating chronic nightmares, Baird says. For example, imagery rehearsal therapy (IRT), a cognitive-behavioral treatment in which you reimagine your nightmares with different, less frightening outcomes, can alleviate various forms of nightmares and associated distress.
Outside of a clinical setting—and similar to IRT—Eeden suggests employing a technique that has worked for him and others: taking control of the experience through lucid dreaming techniques. In a lucid dream, you are aware that you are dreaming and can manipulate and change your environment. “Picture yourself in the dark house but make it light. Something reaches out. Catch it, smack it, yell at it. Imagine what it might really be and give it a face. Don't tumble. Stand firm and confront it. Change it. Convince yourself it has no power over you,” Eeden says.
While the experience of pain, both inside and outside of the dream state, is likely all in my head, I’m relieved to know that my emotional and physical reactions are valid and real. It’s also comforting to know there are others who are figuring out ways to combat this as well. Pain is universally an uncomfortable and upsetting experience. I just wish mine didn’t come intertwined with Stephen King-worthy images.
This article originally appeared on VICE US.