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May 6, 1957. PAVOR NOCTURNUS. Melitta Sperling, M.D.
Dr. Sperling differentiates three types of pavor nocturnus in children: first, the psychotic form characterized by hypermotility, hallucinations, and retrograde amnesia, which is considered to be limited to childhood. There is an insidious onset and progressive development into puberty, at which time serious character disorders, perversions, or psychotic states become manifest. Second, the traumatic form which is considered to be a traumatic neurosis of childhood from which later neurotic, particularly phobic, psychosomatic, or psychotic manifestations develop. The onset is sudden, often dramatic, following the last trauma in a series of narcissistic injuries. The aggression provoked by the trauma is turned against the ego, frequently leading to somatic conversions. To the acutely traumatized child, sleep itself assumed the meaning of a traumatic situation, and in some cases a phobia. Imminent permanent loss of object relationships is the danger in such cases. Waking up, as representing a termination of the traumatic situation in the dream, is a belated mastery of the trauma. The third type is a neurosis, having its origin in the Oedipus, and it is phenomenologically and dynamically similar to or perhaps identical with the nightmare of the adult. It occurs episodically and the anxious child awakens fully with a vivid recall of the nightmare which may become a lasting memory.