by Nina

Paul Weston and his new therapist from “In Treatment”

There I was on Saturday night, doing that thing where you talk out loud to a fictional character on your TV screen. But, really, Paul Weston in Season 3 of “In Treatment” was asking his new therapist for another Ambien prescription. And when he told her that he’d been taking Ambien every night for over a year, I just lost it. I said, “That’s addiction, not a solution! You need to help him wean himself off the pills!” But his therapist wouldn’t listen to me. And then Paul told her that even with the pills he didn’t sleep through the night, but always woke from a nightmare after several hours, and then had trouble going back to sleep, often taking another Ambien to get himself through the second part of the night. He was worried that he might have Parkinson’s Disease. But even though I begged her to offer him an alternative, in the end his therapist wrote him another prescription and said he could come back and talk to her if he wished, so besides the pills all she had to offer him was long-term talk therapy.

Then on Sunday morning I was doing it again because I read an article in the NY Times “Sleep Medication: Mother’s New Little Helper” (see here) about mothers who can’t sleep because they are too stressed out about all the little things they had to do, and instead spend hours in the middle of the night fretting over their “To Do” lists. Both the author of the article and the women themselves seemed to think the only options these women had were sleeping pills or lack of sleep. “Conscious relaxation!” I shouted to the author and the women in the article, but to no avail. It is just part of being a mom these days, they claimed. Some of them even talked about how useful it was to have time to themselves in the middle of the night, when they could get even more work done. 

It’s a good thing I can rant in this post today! I do think sleeping pills can be useful on a short-term basis to get you through a short, difficult spell, but they are not a long-term solution because they do not solve the underlying problems (and you do, in fact, become addicted after just two weeks). If you read my first post on chronic stress (see here) you will know that what’s keeping both Paul and the women in the NY Times article from sleeping well is chronic stress. And a different solution to their insomnia could be practicing yoga stress management techniques. So what would I prescribe for Paul Weston?

During the afternoon or evening, Paul should practice calming yoga poses, such as restorative poses, supported forward bends or supported inversions (such as Legs Up the Wall Pose). Seated meditation is another good option for this time of day. If Paul can do Savavana or yoga nidra without falling asleep, these practices would also be effective, but taking a nap won’t be effective. The idea is for him to switch his nervous system from chronic stress to the relaxation response, providing him with time in a state of conscious relaxation. (See here for info on the difference between conscious relaxation and sleep.)

Then when Paul is in bed trying to fall asleep, I’d recommend either yogic breath awareness (or extending the exhalation) or a self-guided Savasana (such as progressive physical relaxation of different body parts) so that when he falls asleep he will be more relaxed (and will hopefully sleep deeper and longer). Even though he has important things to worry about, the key is to keep his mind on neutral subjects when he is going to sleep (he can always do his worrying the next day!). 

Finally, if Paul wakes in the middle of the night, rather than getting up and turning on the light to read a book, work on the computer, or watch TV (these activities are mildly stimulating), I’d recommend that Paul stay in bed in the dark, and again do a yogic breath practice or a self-guided Savasana. There is a good chance this will help him get back to sleep again. Granted, worrying is very tempting; in the middle of the night it feels like important work. But like any other practice, moving the mind away from worry to a more neutral subject gets easier and easier with experience. 

“Paul,” I’d say, “I’ve been there, too. And these are all practices that have helped me learn to sleep better, even during stressful times.”

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