Why Your Nightcap Could Torpedo Your Expensive Trauma Therapy

glass on bed

It is pretty common for trauma survivors to look to alcohol to take the edge off at the end of a rough day.  Most days are challenging when you have DID.  Some days it feels like 5 pm by noon.  Or earlier.

A small glass of wine or a single bottle of brew seems quite minor when you consider the other ways to unwind, such as sleep meds (mostly highly addictive), non-prescribed drugs, or self-harm.  It can seem that as long as you don’t go overboard, a little alcohol couldn’t possibly be that bad for you.

It might not be the worst thing you could do, but it could erode much of the benefit from of your last therapy session.

How does that happen?

Phase I of trauma therapy is all about stabilization: building emotional regulation, learning new coping strategies, and developing smooth system communication.  Phase II is processing trauma memories, and phase III is crafting a satisfying life that isn’t oriented around the past and the symptoms of DID.

Trauma therapy has a strong learning component in every phase, but particularly in phase I, which is actually present throughout all 3 treatment phases.  It is only a separate stage in theory.  Every therapist uses and helps clients refine their phase I strategies during trauma treatment.


That nightcap (a small glass of wine, a shot, or a beer) will be metabolized by your liver overnight.  The process will produce ketones, and those need to be metabolized.  The degradation of that nightcap while you sleep will rob you of some of your REM sleep a few hours after it leaves your stomach.  REM (rapid eye movement) sleep is predominant in the 2nd half of your night of sleep.  The disruptive effects of ketone metabolism on REM sleep is why you are more likely to awaken in the early hours of the morning after drinking alcohol. Reducing REM sleep is also a trigger for night terrors; these are the times that you awake screaming and shaking while still asleep but don’t remember anything.  It wasn’t a nightmare; it was a night terror.  All the terror of your past, but without all the story line.  If you thought that a part was not giving you access to your dream, you might not be correctly looking at what was happening unless you understand sleep terrors.

REM sleep is when the brain focuses more on processing the emotional content of the past day, but also when it endeavors to connect information about your emotional learning for the past few days.  There are some trauma therapists that think that dissociation creates difficulty with pathways in the brain that use REM sleep for this purpose.  We do know that almost 90% of trauma survivors with any diagnosis have some degree of sleep problems.

Poor sleep during this stage of sleep makes it harder to knit together newly learned information into emotional growth, and poor sleep due to alcohol will make it even harder to process emotional content.  Content you may have paid for with your HSA dollars or actual greenbacks.  Great therapists are more frequently cash-only.


Eroding learning is never anyone’s intent.  Not at those prices.

So if you are wondering why you aren’t making as much progress as you had hoped, take a look at what else you are doing day AND night that could be unintentionally torpedoing your best efforts and your therapist’s efforts.  If you aren’t getting enough sleep or enough quality sleep, that might be one contributor to your sense of being stuck in treatment.

For more information on sleep and DID, read  Could Getting Better Sleep Decrease Your Response to Trauma Triggers?  and Three Common Sleep Issues for Trauma Survivors (and an effective treatment for nightmares!) .

breathing trauma

Published by Cathy Collyer

I am a licensed occupational therapist and a licensed massage therapist, in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment, with a focus on sensory processing issues and treating the consequences of complex trauma. I am the author of four books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training Your Child With Low Muscle Tone". Over the years I have lectured about trauma treatment and pediatric development.

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