"Insomnia is a dizzying lucidity that could transform Heaven itself into a place of torture".
With these words, Emil cioran neither "The inconvenience of being born" describes insomnia. Anyone who has spent at least one sleepless night in their life, trapped in the perverse mechanism of trying to sleep, resulting in being more and more awake, understands the meaning of the aforementioned phrase.
If we exclude the presence of some organic pathologies, such as neurological, cardiovascular diseases, digestive disorders, acute chronic pains etc., the inability to sleep although there is a deep physiological need, it has purely psychological origins.
I used the word "origins" wrongly because in most cases of insomnia that lasts over time (ie the one defined as chronic and not transient), the reason why you don't sleep has nothing to do with why you are started not sleeping.
In fact, it may happen that, following any psychic or organic event (very clear to us), one begins to find it difficult to fall asleep or one begins to experience frequent nocturnal awakenings, and that, with the passage of time, even despite the resolution of the initial cause, a new mechanism is established: the fear of not sleeping.
50% of insomniacs are afraid of not sleeping (but not fully aware of it).
The subjects affected by this disorder (because it is a real disorder) declare in fact that they have no particular thoughts or problems to deal with, but that they begin to feel an underlying tension as the evening falls, sometimes a real anxiety, at the same time. idea of having to go to bed, aware of the long and tormented night ahead of them. Once ready to sleep, the brain "turns on" instead of turning off, thoughts crowd, muscles tense rather than relax, you enter a state of psycho-physical agitation in which every attempt made to be able to let go and sleep is transformed in a further cause of tension. This spiral can reach dramatic peaks, with hours and hours of nocturnal wakefulness, which only towards the early morning is interrupted by a sleep achieved by exhaustion.
The consequences are obvious: if you are forced to get up anyway, the day will be long and tiring, if you can sleep late the following morning, day and night will slowly be reversed. At this point, the use of specific drugs to sleep is frequent, sometimes apparently decisive, sometimes only temporarily (there are not rare cases in which, despite the sleeping pills, the hours of sleep are still small). If 50% of insomniacs have difficulty falling asleep, a good 30% fall asleep easily, but wake up in the middle of the night unable to go back to sleep. This type of insomnia is not based, like the previous one, on the fear of not sleeping, but on a different mechanism. In fact, these subjects report in the night their way of managing the reality typical of their diurnal life: a constant control of reality through thought. In fact, awakening comes suddenly, like the turning on of a light bulb, accompanied by a flow of thoughts regarding one's working day or the problems usually faced in the waking hours. The mind appears unable to stop organizing, controlling, managing, planning and so, what apparently may seem functional in everyday life, becomes a dangerous nocturnal mechanism.
In fact, everything that works, if taken to exasperation, becomes invalidating, even a good organizational capacity! In these cases, those affected spend the rest of the night thinking, burdened with anxiety about the next day, afraid of not making it and not having sufficient strength. They can get to have real panic attacks, feeling overwhelmed by a reality no longer under their control and consequently magnifying future events to be faced. Also in this case the use of drugs, mostly anxiolytics, is frequent. But even in these situations it is never a decisive therapeutic act, but a tampon that momentarily calms, but makes it increasingly incapable of acting differently. The remaining 20% of insomniacs know why they don't sleep. The night can be scary for various reasons and thus turns into a narrow and sinister place where you would never want to land. The fall of darkness brings to mind sometimes frightening thoughts, not only in children (certainly the most affected) but also in adults. The fear of death, of thieves, of the earthquake, of ghosts, of one's thoughts, of one's physical symptoms, etc. find their peak in the darkness of the night.
In these cases we are witnessing real attempts to transform night into day, in which the subjects who suffer from it they try to put off going to bed more and more, trying to get stunned in front of the TV and thus be able to collapse without lucidity in one's bed or, sometimes, even reaching the point of not being able to go there anymore. The result, even in this case, is obvious: nights on the sofa, with the light on, the television in the background and the following morning a sore and tired body. The use of drugs is rarer in these situations. In fact, the subjects, being more aware of why they do not sleep, deem useless the use of drugs that “would not take away my fear anyway”.
In all three cases described above we are therefore faced with specific pathological mechanisms that prevent the affected subject, despite the efforts and attempts made, from finding rest in sleep. It is interesting at this point to underline (before giving hope to sleepless readers!) How the rules of what is called "sleep hygiene" (ie those behavioral rules that should physiologically favor a good sleep) are not only not decisive in these situations, but in some cases they can even aggravate the traits. In fact, we are witnessing real almost obsessive stiffenings on schedules, foods, ritualized habits undertaken before going to bed, which instead of favoring sleep block it even more.
The work of good therapy for the problems described so far, it focuses precisely on unlocking the rigid and redundant mechanisms that trap the subject in his forced nocturnal wakefulness. Brief strategic psychotherapy has developed specific treatment protocols for the different types of insomnia, leading in the vast majority of cases to breakouts of the pathology right from the first treatment sessions.
The patient is guided, through small tasks, sometimes apparently bizarre or illogical, of which he is not always made aware of the mechanism to sail the sea without the knowledge of the sky, or to deceive the mind in the search for sleep, so that what hinders him can be overridden, since, quoting Dumas, " sleep is a capricious divinity, and just when it is invoked ... it makes you wait".
Dr. Federica Cagnoni (Official Psychologist-Psychotherapist of the Strategic Therapy Center)