The core of pavor nocturnus is a sense of progressive paralysis. Max Stern connects it with a phase of primary or neurogenic shock which he calls the 'catatonoid reaction'. This phase just precedes full shock and possibly death. It bears some resemblance to the catatonic syndrome and is marked by stupor, muscular rigidity, etc. Excessive stimulation in children leads to shock and the catatonoid reaction is the last defense against full shock and perhaps death.

Pavor nocturnus is the catatonoid reaction occurring in sleep. The stupor (catatonoid blocking of central registration) permits awakening. It is not an anxiety signal but the real traumatic situation itself. The realistic quality of the hallucinations is discussed.

The infantile organism cannot adequately discharge sexual excitement and thus pavor nocturnus is the sexual trauma of childhood. It is connected with the primal scene and infantile masturbation and gives effectiveness to the castration fears. It contains oral elements.