Hi Twiggy,
I like your spontaneity in imagining, devising and executing this picture. Although the title suggests a nightmare, we see no pain. We see blood streaked down her face from her eyes and lips. This speaks of illness perhaps. Still we know the blood means potential loss of life, so this is an important signal and gets our full attention.
When we look further, the young woman is in some repose. There’s no suggestion of agony in the posture. In fact she is resting as if sunbathing or even floating as she dreams or is dead. We do not know. The give away is the left hand that is gracefully curved. So this is not something ugly, some crime, rather a look at the risk life inherently brings.
The "zig-zag" composition made by the arms and body moves our eyes to explore the vulnerable figure. The use of a bull’s-eye pattern of lighting hardly allows one to move away from the girl’s head. There is strong motivation that we should see what is there even though we might not like it.
This picture is about looking into the frightening unknown. Again, "life as a journey". A young person should not have to face such a vision so early!
Asher