Author(s): J. Carey Jackson, MD

Date Authored: December 5, 2013

This gentleman has been out of prison for 30 or more years. He has never mentioned sleep difficulties as an issue, nor his near nightly nightmares. Here he tosses them off as if it is a given that he lives with terror of “those people” (now a world away) coming to get him and that he revisits this nightly in his sleep which is often disturbed because of it. The manner in which he has learned to accept this and manage it, and consider it part of his life, can suggest to the clinician that it is not an issue. On the contrary it is a powerful source of distress. To not expect or look for and find relief from this suffering is a very sad reality. I am often struck by how many aging torture survivors never bother to mention their disturbed sleep and nightmares since they have accommodated this reality for so long.