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Almeida Junior: Descanco, (Circa-1882), private collection, Rio de Janeiro (Brazil)
Suggested Strategies to Cope with RISP
Since RISP appears to be such a frightening experience to the vast majority of individuals with the condition and in some cases perturbs significantly day-to-day life, we briefly describe several different strategies that can be used to mitigate its negative effects. We first enumerate different "conventional" medical treatments that have been applied in recent years with varying degrees of success, and then present a "psychological" approach that individuals may adopt in order to cope with RISP.
The medical treatment most commonly used to reduce the frequency of occurrence of RISP or even to stop RISP from occurring is the prescription of tricyclic antidepressants such as imipramine and clomipramine, and such a treatment is not limited to isolated sleep paralysis but is in fact widely used for narcolepsy, whose main symptoms are uncontrolled daytime sleepiness and cataplexy (sudden loss of muscle tone) [58], [59]. As a matter of fact, imipramine is particularly effective in controlling cataplexy [60-62], and maybe significantly more so than in treating RISP [63]. Other treatments include serotoninergic agents such as L-tryptophan with or without amitriptyline [63]. More exotic forms of treatment have been applied, such as magnetic therapy, i.e., the application of weak time-varying electromagnetic fields (EMFs) [Sandyk, 64](in the particular treatment described in [64], AC pulsed picotesla intensity EMFs of 5Hz frequency were applied extracerebrally 1-2 times per week to a single patient), but the fact that episodes of sleep paralysis gradually diminished and abated completely over a period of 3 years in the case of a single patient does not necessarily imply that such a treatment would be successful for a majority of RISP experiencers. However, an interesting suggestion made by Sandyk in [64] is that the resolution of sleep paralysis in this particular patient by AC pulsed applications of EMFs is related to enhancement of melatonin circadian rhythms and to cerebral serotoninergic neurotransmission, as pineal melatonin and monoaminergic neurons are implicated in the induction and maintenance of REM sleep and the pathogenesis of sleep paralysis. This also implies that taking melatonin at appropriate times for a better control of circadian rhythms may -at least- reduce the frequency of RISP episodes. Indeed, as pointed out in [55], jet-lag seems to be a precipitating factor of isolated sleep paralysis, and the beneficial effects of melatonin in mitigating jet-lag by correcting the resulting sleep pattern disturbances are well known. Therefore, a careful administration of melatonin may also have beneficial effects regarding RISP. However, until now we have not yet found any medical source confirming such a hypothesis. Finally, as stated by Dement et al. in [62], "No completely satisfactory treatment is available at the present time." This applies as well to narcolepsy as to RISP. Although we have described several medical approaches for treating RISP and have expressed the hypothesis that melatonin may have beneficial effects, we point out that we are not engaged in rendering medical advice or professional services and that RISP experiencers who have significant difficulties in coping with this condition should consult reputable sleep specialists and/or neurologists.
Since there is at present no proven medical treatment that would reduce the frequency of RISP episodes, let alone eliminate RISP completely, for the vast majority of RISP experiencers, we may envisage various psychological approaches that could lead the experiencers to cope with RISP satisfactorily. At first, one should realize that RISP might occur during most of an individual's life -if not during all his/her own life-, despite him/her leading a reasonable way of life (i.e., regular sleep patterns, mitigation of stress, an appropriate diet, reasonable exercise, etc.). In such a case, with time one can indeed learn to accept RISP as a "normal" part of one's life, and even obtain a better grasp of one's own individuality, by considering the following factors: First, consider the phenomenon as something to be explored. We have seen that RISP is not dangerous in general. The real problem to solve is the intense fear that is felt by most experiencers at the beginning of an episode. The wish to conquer the fear and to explore will lead to a radical psychological change, from a defensive stand to a courageous attitude of outward observation and learning. As an example, let us quote a message posted by a RISP experiencer on an electronic mailing list devoted to the "Awareness during Sleep Paralysis" (or ASP) [65]:
"I just wanted to let you all know about my first ever pleasant ASP! It happened on Saturday night, and I felt all the usual sensations (buzzing, being pushed down/dragged) but wasn't scared and just let it happen. After a while I felt like I was being lifted from the bed, and next thing I knew I was `floating' near the top of my wardrobe. I looked down at my bed and could see that it was unmade, but there was no one in it. I also remember being very excited, and pleased that this was such a non-threatening experience!"
Secondly, When feeling a presence at the beginning or during a RISP episode, try to face it. Stephen LaBerge [14] has suggested that, upon encountering an evil presence during a lucid dream, one should face it and try to transform it, or the unpleasant situation, into something good. There is a "forgiving attitude" in this suggestion, which might result in a transformation of the "evil presence" into something either neutral or outright friendly. Equivalently, a similar course of action can be used when having hypnogogic/hypnopompic hallucinations at the beginning of an episode involving the feeling of an evil presence. Other tactics might be to shout at the presence in order to conquer the fear, or prayers for religiously inclined individuals, which can help build a positive attitude. Finally, when hearing an increasingly loud buzzing sound, and/or feeling increasing pressure on the chest or inside the head, one might state repeatedly to oneself that RISP is not dangerous, so that one may proceed to the (generally more pleasant) next phase of the episode. An interesting approach to cope with RISP that is often used in Japan, where sleep paralysis is prevalent and is named "kanashibari" in Japanese [3], meaning "still-bound", is humor: RISP has been discussed repeatedly on various Japanese television programs, and jokes about RISP are often added to the serious discussions [65a], just as jokes about RISP are also included sometimes in television "durama" (dramas) in Japan.
Thirdly, if these approaches or any other tactics used by a RISP experiencer fail, and if RISP continues to disturb one's daily activities, one can resort to professional psychological counseling with informed psychologists, eventually including also family counseling to inform the family of the experiencer about RISP and its benign, non-threatening character.
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