When Your Patients Have Recurrent Dreams


People of all ages occasionally report recurrent dreams, and there is an established association between negative dreams and daytime anxiety.




People of all ages occasionally report recurrent dreams, and there is an established association between negative dreams and daytime anxiety or worries. While disturbing dreams and terrifying or intense nightmares may be associated with serious daytime fears, anxiety disorders, or PTSD, negative dreams or dreams that could be described as mild nightmares are far more commonly reported.

These types of dreams do not necessarily fall into the category of being terrifying. According to researchers, negative recurrent dreams are far more common than positive recurrent dreams, and may be related to unmet psychological needs.1

Recurrent dream content

The content and themes of recurring dreams tend to be similar among men and women, and among people ranging in age and life situations. Several research studies report that dreaming about falling is one of the most commonly reported recurrent dreams. Being pursued or attacked, typically by a monster or an unidentified evil being, is also relatively common. Taking an exam or failing an exam is a frequently reported theme in recurrent dreams, even among adults.2

Most people who report recurring dreams tend to remember negative dreams, and individuals tend to have a recurrent negative theme, such as being chased, rather than several different negative themes.

These moderately negative dreams are very common experiences, and having occasional recurring negative dreams is not associated with any psychological or psychiatric condition.

Research has found that negative recurring dreams are more common when people have psychological needs that are not satisfied during waking hours. The feeling of having unsatisfied psychological needs affects almost everyone, and sometimes, a persistent feeling lasts for just a finite period of time.

Psychological needs that manifest in dreams

The content of nightmares has been considered related to interpersonal conflict, threats and failure,3 while the psychological needs most closely identified with recurrent negative dreams are have been categorized as autonomy, relatedness, and competence.1 Failure is the feared consequence of a lack of competence, and this theme is most clearly identified in the repeated dream that involves taking a test or failing a test.

Children, in particular, may feel that they are plagued with a lack of autonomy, and children experience bad dreams and nightmares more than adults do. In fact, adults recall and report their own childhood nightmares and bad dreams more often than they recall and report bad dreams that happen during adulthood, suggesting that the lack of autonomy that is an inherent part of childhood may manifest with negative dreams. It is difficult for researchers to identify a specific theme of dreams that is related to a lack of autonomy, and the expression of this need could be complex or variable when manifested in dream form.

Interpersonal conflict and threats are an extreme lack of relatedness with others, and people who have this unsatisfied psychological report increased negative dreams or nightmares that may follow those themes.

The content of a dream is usually not a reliable indicator of the specific waking experience that may serve as the trigger for the dream. But negative dreams in general can be a manifestation of negative feelings during waking. The individual who us experiencing the negative dream may or may not be able to identify the specific cause of the dream, despite the fact that effects of the psychological need linger into the sleeping state.


1. Weinstein N, Campbell R, Vansteenkiste M. Linking psychological need experiences to daily and recurring dreams. Motiv Emot. 2018;42:50-63.

2. Schredl M, Göritz AS. Nightmare Themes: An Online Study of Most Recent Nightmares and Childhood Nightmares. J Clin Sleep Med. 2018;14:465-471.

3. Gauchat A, Séguin JR, McSween-Cadieux E, Zadra A. The content of recurrent dreams in young adolescents. Conscious Cogn. 2015;37:103-111.

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