Insomnia occupies a peculiar threshold position within the depth-psychology corpus: it is simultaneously a symptom, a messenger, and a site of psychological confrontation. The literature treats it along at least three distinct axes. First, the mythopoeic register, represented most forcefully by James Hillman, reads sleeplessness as an encounter with the Nycian brood — the offspring of Night whose visitations demand discriminating attention rather than pharmaceutical suppression. Second, the neurobiological-addictions register, pursued by Brower and Sugden, identifies insomnia as a universal withdrawal symptom crossing all DSM-IV substance categories and a robust predictor of relapse, linking it to dopaminergic dysregulation and hippocampal plasticity. Third, the grief-and-loss register, developed by O'Connor, situates insomnia as a dysregulatory consequence of bereavement, where classical biological sleep pressure is redistributed or depleted in ways that pathologize the marital bed as a grief cue. Jung's own corpus registers the term only indexically, placing insomnia adjacent to inspiration and instinct — a marginal but suggestive co-location. Janet's hysterical patient, terrorized by the thought of permanent sleeplessness, dramatizes an early clinical encounter with sleep-anxiety that anticipates contemporary CBT-i formulations. Across these registers the tension is consistent: is insomnia resistance to unconscious process, or is it itself an unconscious communication demanding response?
In the library
12 passages
we sleep less in later years because our tasks change. If once we were to be sheltered by Night herself, now we must learn from her offspring. Phantoms of Fate, Death, Despair, Blame, Revenge, and Desire won't let you rest.
Hillman reframes late-life insomnia as a mythologically mandated encounter with the children of Nyx, arguing that wakefulness is not pathology but a form of nocturnal education that sleeping pills and incontinence pads allow us to evade.
Hillman, James, The Force of Character: And the Lasting Life, 1999thesis
Insomnia per se is listed across all substance withdrawal disorders, although sleep disturbance for some substances (cocaine and amphetamines) also includes hypersomnia or unpleasant, vivid dreams. Accordingly, we define insomnia as a universal withdrawal symptom.
Brower establishes insomnia as the single symptom common to every DSM-IV substance withdrawal category, providing the empirical foundation for his universal relapse-risk hypothesis.
Brower, Kirk J., Sleep disturbance as a universal risk factor for relapse in addictions to psychoactive substances, 2010thesis
the insomnia that often comes with grief certainly doesn't help. The period following the death of a loved one is a perfect storm that dysregulates all the systems that control
O'Connor frames grief-related insomnia as a systemic dysregulation, situating it as a compounding factor that makes the present moment unbearable for the bereaved.
O'Connor, Mary-Frances, The grieving brain the surprising science of how we learn, 2022thesis
she certainly could not sleep, because each time she started going off to sleep the thought came that she certainly would not be able to sleep, she would never be able to sleep until she was dead; then she promptly woke up again.
Jung's early clinical case documents a self-reinforcing catastrophic cognition about sleeplessness in a hysterical patient, prefiguring cognitive-behavioral models of insomnia maintenance.
Without the natural pressure of sleep that comes at the end of the day (because that internal biological impetus was used up while he was in his chair), he would lie in bed awake, feeling sad and lonely, reinforcing the association between their bed and grief.
O'Connor illustrates how conditioned grief-associations with the marital bed perpetuate insomnia by depleting homeostatic sleep pressure before retiring, demonstrating the behavioral-associative mechanism of grief-insomnia.
O'Connor, Mary-Frances, The grieving brain the surprising science of how we learn, 2022supporting
persons who are recovering from an addiction to any psychoactive substance and have a sleep disturbance are at an increased risk of relapse compared to those without a sleep disturbance. In other words, sleep disturbance is a universal risk factor for relapse.
Brower formally articulates his central hypothesis that sleep disturbance, including insomnia, constitutes a universal and transdiagnostic predictor of relapse across all categories of substance addiction.
Brower, Kirk J., Sleep disturbance as a universal risk factor for relapse in addictions to psychoactive substances, 2010supporting
Cognitive behavioral therapy-insomnia (CBT-i) is emerging as the first-line therapy for insomnia. A randomized control pilot study (N = 22) showed CBT-I improved insomnia among U.S. Veterans, but it did not reduce their alcohol-drinking behaviors.
Sugden situates CBT-i as the emerging gold-standard treatment for SUD-related insomnia while noting the dissociation between sleep improvement and drinking reduction, signaling a gap in current therapeutic translation.
Sugden, Steven G, Strengthening Neuroplasticity in Substance Use Recovery Through Lifestyle Intervention, 2023supporting
One possibility is that insomnia is linked to co-occurring psychiatric disorders that worsen the course of substance dependence, particularly mood disorders, anxiety disorders, and attention deficit disorder, which all have well-described sleep disturbances.
Brower canvasses mechanistic hypotheses connecting insomnia to relapse, foregrounding comorbid psychiatric conditions as potential mediating pathways.
Brower, Kirk J., Sleep disturbance as a universal risk factor for relapse in addictions to psychoactive substances, 2010supporting
There were no significant differences in effort economy, insomnia and anxiety.
Giménez-Meseguer reports that high-intensity interval training produced no significant between-group improvements in insomnia among SUD patients, suggesting exercise's limits as a standalone intervention for this symptom.
Giménez-Meseguer, Jorge, The Benefits of Physical Exercise on Mental Disorders and Quality of Life in Substance Use Disorders Patients. Systematic Review and Meta-Analysis, 2020supporting
the individual 'cannot go to sleep and cannot wake up' (Bion, 1962, p. 7), i.e. he cannot differentiate between being asleep and being awake, perceiving and hallucinating, external reality and internal reality.
Ogden invokes Bion's formulation of the incapacity to sleep or wake as a metaphor for the most primitive failure of psychological differentiation, implicitly connecting insomnia to the collapse of the boundary between dream and waking reality.
Ogden, Thomas, This Art of Psychoanalysis: Dreaming Undreamt Dreams and Interrupted Cries, 2004aside
Jung's index places insomnia in proximity to inspirations and instincts, a bare but suggestive co-location indicating the term's marginal yet present status within his structural psychology.
Jung, Carl Gustav, The Structure and Dynamics of the Psyche, 1960aside
Insomnia, inattention and fatigue symptoms of women with premenstrual dysphoric disorder
Lin references insomnia as part of a symptomatic cluster in women with PMDD and comorbid ADHD, situating it within a hormonal and attentional dysregulation framework.
Lin, Pai-Cheng, Comorbid Attention Deficit Hyperactivity Disorder in Women with Premenstrual Dysphoric Disorder, 2024aside