Medical student dreams about medical school: The unconscious developmental process of becoming a physician

This paper is a report on a collection of almost four hundred dreams of medical students and postgraduate trainees with the manifest content about medical training. It is a unique dream collection from a defined population that experiences a developmental sequence of observable, reality events. The reality events appear in the manifest content of the dreams along with their symbolic alterations. The dreams are used as a psychodynamic database. The data may illustrate which reality experiences seem psychologically formative, their emotional developmental sequences and their specific emotional content. This is a pilot project exploring whether dream material collected from a discrete task group might give information about a group's emotional adaptation. The dreams seem to show an unconscious developmental process in response to medical training and becoming a physician that unfolds in overlapping stages as trainees learn to master skills and tolerate care-giving responsibility for human life. A progressive, unconscious hero-healer fantasy seems to form. It becomes elaborated in masochistic and then sadistic fantasies. These fantasies are evoked by, and used as a defense against, inevitable but painful anxieties of emotional adaptation to medical education experiences.     

Does globalization affect our dreams? An inquiry into the subject matter of dreaming

Abstract

Does globalization affect our dreaming? This would be the case if dreams, in an increasingly globalized world, showed a decrease in characteristic cultural traits. I maintain however that the specific culture of the dreamer is not relevant in dreams in the first place. Any effect globalization may have on us is therefore not essential to the subject matter of dreaming.

Following Martin Heidegger's philosophical analysis of human existence, dreams are found to deal with emotionally relevant issues of our existence with which we have difficulties to come to terms. Matters of normality which are felt to be matters of course are not a topic in dreams. Consequently, normal cultural features only become a topic for dreaming in some form of negation of their normal function. An impressive dream-report, centering on a denied handshake, serves as an illustration.

In conclusion, it is stated that dreams are concerned with those very individual responses to general human issues which do not comply with the collectively accepted so-called “normal” responses of the specific culture. Our cultural identity is only of very marginal interest in dreams. Dreams spring from and point to the psychoanalytic identity of the dreamer.     

Bearing the unbearable: ancestral transmission through dreams and moving metaphors in the analtyic field

Abstract: This paper explores how untold and unresolved intergenerational trauma may be transmitted through unconscious channels of communication, manifesting in the dreams of descendants. Unwitting carriers for that which was too horrific for their ancestors to bear, descendants may enter analysis through an unconscious need to uncover past secrets, piece together ancestral histories before the keys to comprehending their terrible inheritance die with their forebears. They seek the relational containment of the analytic relationship to provide psychological conditions to bear the unbearable, know the unknowable, speak the unspeakable and redeem the unredeemable. In the case of ‘Rachael’, initial dreams gave rise to what Hobson (1984) called ‘moving metaphors of self’ in the analytic field. Dream imagery, projective and introjective processes in the transference‐countertransference dynamics gradually revealed an unknown ancestral history. I clarify the back and forth process from dream to waking dream thoughts to moving metaphors and differentiate the moving metaphor from a living symbol. I argue that the containment of the analytic relationship nested within the security of the analytic space is a necessary precondition for such healing processes to occur.     

The canary in the mind: on the fate of dreams in psychoanalysis and in contemporary culture

Dreams have been central in the birth and evolution of psychoanalysis. This paper explores the remarkable story of the relationship between dreams and psychoanalysis as a modern version of the long history of dreams in most healing traditions. But psychoanalysis seems to have turned away from dreams as central inspiration in a way parallel to the general culture’s turn away from dreams and the reality of inner life. Yet modern postindustrial culture is transfixed by a version of “dream life” in ways just beginning to be understood (e.g., in the transformation of ancient interest in the inner screen to the external screen). Working with dreams in psychoanalytic psychotherapy was a creative and revolutionary act for our forebears. It is even more so today, in ways that are discussed in this paper.Dr. Paul Lippmann is training and supervising analyst and faculty member at the William Alanson White Institute and faculty member of the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis. He is also Director of the Stockbridge Dream Society.     

Configurational approach to manifest dream analysis: Possible acceleration of the patient's communication in psychoanalytic psychotherapy

This paper presents an approach to dream analysis utilizing the manifest content of a number of consecutive dreams from the same patient. Following a review of the literature, it is noted that in once-a-week psychotherapy there is often very little time for exhaustive dream analysis to unravel the buried meanings within the latent dream content. Twenty categories have been established for the configurational analysis, which is applied to the analysis of the first eleven dreams of a patient in psychoanalytic psychotherapy. The authors independently analyzed the patient's dreams using each of the 20 categories with high reliability, then combined their contributions. This data was then compared with the treating analyst's independent clinical observations about the twenty categories.     

Spirituality and Dream Work in Counseling: Clients’ Experiences

The authors suggest that focusing on dreams in counseling may be a useful framework to explore clients’ spiritual values and beliefs. Because little is known about how spirituality and dream work are integrated in practice, the purpose of this article is to document how some counselors and clients work on spirituality and dreams. Responses of clients who focused on dreams from a spiritual perspective are described and discussed. Relevant clinical issues that counselors may encounter are identified. Recommendations are made for counselors who wish to integrate spirituality and dream work in counseling.An earlier version of this article was presented at the Semi-Annual Meeting of the Association of Mormon Counselors and Psychotherapists, Salt Lake City, Utah, April 2004.     

Psychotherapists' dreams about their patients

Abstract This study examines therapists’ dreams about their patients from the Jungian and the relational perspectives. Few clinical and empirical references to this subject are to be found in the literature. In the present study 31 dreams were collected from 22 therapists. Dreams were collected using anonymous self‐report inventory. The research focused on three theoretical research questions: 1. What themes appear in the manifest content of therapists’ dreams about their patients? 2. What contributions are made by Jungian interpretation of therapists’ dreams about their patients? 3. To what extent are masochistic contents present in the manifest content of therapists’ dreams about their patients? The first question was addressed using categorical content analysis of a) themes common to different dreams and b) pre‐determined themes for all dreams. The third research question was addressed using Beck's (1967) ‘Masochistic Dream’ measure. Results: Among the themes common to different dreams were: therapist‐patient role reversal; therapist and/or patient attends and remains in meeting, departs/doesn’t depart; cancellation of therapy session; sexuality between therapist and patient; aggression; presence vs. absence; non‐verbal relationship and communication; time; driving vs. stopping. With regard to pre‐determined themes it was found that in 20 of the 31 dreams, the therapist had a negative experience and was characterized as vulnerable. Likewise it was found that 26 out of 31 dreams took place in either a) a street, a road, a route, a corridor; b) en route to somewhere; c) a therapy room and/or building; d) a house. With regard to the contribution of Jungian interpretations of the dreams it was found that 17 of the dreams had diagnostic and prognostic elements, 4 of which were initial dreams, 9 of them were compensatory dreams and in 14 it was found that the patient represents the shadow of the therapist. With regard to the third question it was found that 18 of the 31 dreams met Beck's (1967) criteria for masochistic dreams. The theoretical discussion examines the findings from a Jungian perspective, with an emphasis on also understanding the dream in terms of its expression of relational aspects of the therapist‐patient relationship. The findings affirm the presence of the ‘wounded healer’ archetypes in therapists’ dreams about their patients. The results of the study indicate that therapists’ dreams about their patients can be a valuable tool for deepening understanding of the therapeutic relationship and process.     

A parapraxis in a dream

When a parapraxis is put on display in a dream, one can only wonder what service the willful mistake is rendering to resourceful dream work. Freud taught us that anything that appears in the manifest content of a dream may well be a disguise or a distortion of a subject that originally made an anxiety-provoking, and hence short-lived, first appearance in latent dream thoughts. Dreams in dreams and jokes in dreams have been examined from this perspective (Mahon 2002a, 2002b), and this paper focuses on the appearance and meaning of a parapraxis in a dream, with the argument that seemingly casual "mistakes" are highlighted in the manifest display to cover up some latent, much more deliberate subject matter.     

This art of psychoanalysis

It is the art of psychoanalysis in the making, a process inventing itself as it goes, that is the subject of this paper. The author articulates succinctly how he conceives of psychoanalysis, and offers a detailed clinical illustration. He suggests that each analysand unconsciously (and ambivalently) is seeking help in dreaming his 'night terrors' (his undreamt and undreamable dreams) and his 'nightmares' (his dreams that are interrupted when the pain of the emotional experience being dreamt exceeds his capacity for dreaming). Undreamable dreams are understood as manifestations of psychotic and psychically foreclosed aspects of the personality; interrupted dreams are viewed as reflections of neurotic and other non-psychotic parts of the personality. The analyst's task is to generate conditions that may allow the analysand-with the analyst's participation-to dream the patient's previously undreamable and interrupted dreams. A significant part of the analyst's participation in the patient's dreaming takes the form of the analyst's reverie experience. In the course of this conjoint work of dreaming in the analytic setting, the analyst may get to know the analysand sufficiently well for the analyst to be able to say something that is true to what is occurring at an unconscious level in the analytic relationship. The analyst's use of language contributes significantly to the possibility that the patient will be able to make use of what the analyst has said for purposes of dreaming his own experience, thereby dreaming himself more fully into existence.     

When does a dream begin to ‘have meaning’? Linguistic constraints and significant moments in the construction of the meaning of a dream

The paper investigates the origin of the meaning of dreams starting with a discussion of psychotic dreams. The author distinguishes the dream as dream from the remembered and the narrated. A two-step dream phenomenology is proposed that both acknowledges the objectivity of the dream and traces the origin of its meaning to its translation into language. Following a review of recent neurobiological theories of dreaming, the paper focuses on certain aspects of the psychoanalytical understanding of the dream phenomenon and in particular on the interpretation of dreams from the perspective of intersubjectivity and phantasy.     

Freud,Bion and Kant: Epistemology and anthropology in The Interpretation of Dreams

This interdisciplinary article takes a philosophical approach to The Interpretation of Dreams, connecting Freud to one of the few philosophers with whom he sometimes identified – Immanuel Kant. It aims to show that Freud's theory of dreams has more in common with Bion's later thoughts on dreaming than is usually recognized. Distinguishing, via a discussion of Kant, between the conflicting ‘epistemological’ and ‘anthropological’ aspects of The Interpretation of Dreams, it shows that one specific contradiction in the book – concerning the relation between dream‐work and waking thought – can be understood in terms of the tension between these conflicting aspects. Freud reaches the explicit conclusion that the dream‐work and waking thought differ from each other absolutely; but the implicit conclusion of The Interpretation of Dreams is quite the opposite. This article argues that the explicit conclusion is the result of the epistemological aspects of the book; the implicit conclusion, which brings Freud much closer to Bion, the result of the anthropological approach. Bringing philosophy and psychoanalysis together this paper thus argues for an interpretation of The Interpretation of Dreams that is in some ways at odds with the standard view of the book, while also suggesting that aspects of Kant's ‘anthropological’ works might legitimately be seen as a precursor of psychoanalysis.     

Dreaming and consciousness

Abstract

Research in the second half of the twentieth century may finally have succeeded in constraining the boundaries of reasonable discussion about dreams and dreaming. Largely owing to physiological discoveries and psychophysiological methods for the representative sampling of human dreamlife, we now have a body of observations that delimits plausible explanations and theories.

For example, we now know that neither REM sleep nor its dreaming is a sporadic, fleeting response to intense psychic needs or peripheral organ states, but rather is an autonomous, cyclically recurring process which consumes relatively much of our sleep, indeed of our lives. We also know that the content of representatively sampled dreams of both adults (Snyder, 1970) and children (Foulkes, 1982) is generally realistic and mundane, rather than fantastic and bizarre. From this finding, and from direct com parisons of representatively sampled laboratory-collected dreams with spon taneously remembered home dreams (e.g. Foulkes. 1979). it has become apparent that the idea of dreaming as being full of strange and discontinuous imagery is a stereotype based on limited acquaintance with our own dreamlife. Specifically, our most ordinarily memorable dreams seem to be those relatively few that are particularly emotionally engaging, particularly unrealistic, or particularly odd in their imagery or thematic sequence. This leads us to underestimate the orderliness of a process that typically functions plausibly and coherently, in a similar if not identical manner to that which we believe (perhaps also stereotypically) characterises our non-dreaming experience.

Thus, studies of representatively sampled dreaming have shown that dream imagery itself typically is realistic or plausible (Dorus, Dorus, & Rechtschaffen, 1971). that dream speech typically is both grammatically correct and appropriate to the imagined situation in which it is embedded (Heynick, 1983). that the feelings accompanying dream imagery typically are appropriate to the imagined situations which they accompany (Foulkes, Sullivan, Kerr, & Brown, 1988), and that, overwhelmingly often, dreams progress over time in a continuous rather than a discontinuous way (Foulkes & Schmidt, 1983).

Such data indicate the need to radically revise or replace most older dream theories from the clinical tradition. Given the role that physiologists and physiological methods played in the development of these data, it was perhaps inevitable that dream theories would begin to be framed in reductionist terms. And, since the 19505, there have been many attempts to “explain” dream phenomena through their reduction to neurophysiological processes (e.g. Crick & Mitchison, 1983; Hobson & McCarley, 1977)     

Memory in dreams1

In this paper the author discusses a specific type of dreams encountered in her clinical experience, which in her view provide an opportunity of reconstructing the traumatic emotional events of the patient’s past. In 1900, Freud described a category of dreams – which he called ‘biographical dreams’– that reflect historical infantile experience without the typical defensive function. Many authors agree that some traumatic dreams perform a function of recovery and working through. Bion contributed to the amplification of dream theory by linking it to the theory of thought and emphasizing the element of communication in dreams as well as their defensive aspect. The central hypothesis of this paper is that the predominant aspect of such dreams is the communication of an experience which the dreamer has in the dream but does not understand. It is often possible to reconstruct, and to help the patient to comprehend and make sense of, the emotional truth of the patient’s internal world, which stems from past emotional experience with primary objects. The author includes some clinical examples and references to various psychoanalytic and neuroscientific conceptions of trauma and memory. She discusses a particular clinical approach to such dreams and how the analyst should listen to them.     

THE ONEIRIC AUTOBIOGRAPHY OF GEORGES PEREC

Georges Perec's book La Boutique Obscure (1973; translated into English in 2012) serves as the basis for this paper. The book is a collection of dreams that its author dreamed from May 1968 to August 1972. The present author treats these dreams as chapters in a bizarre autobiography, elaborating Perec's life through a discussion of those dreams and using them as a starting point with which to discuss his views of dream interpretation and the role of dreams in psychoanalysis.     

Telling Dreams and Transference: The Interactional Function of Dreams as Free Associations

Since Freud's Dream Interpretation and his additional writings on the analysis of dreams, the technique of handling a dream report within the analytic session has remained nearly unchanged. It is characterised by dream-centred associations and their interpretation in regard to dream content and to transference. This approach constitutes an alien element within contemporary interactional psychoanalytic technique and tends to provoke resistances in the analytic dialogue. This article stresses the function of dream reporting during the session with respect to the interactional process. It is concluded that sufficient attention should be given to interactional analysis of dream reporting in accordance with the questions: Why does the patient at this point of the process tell a dream, and why does he tell this very dream instead of another?     

The Deaf and Their Problems by Kenneth W. Hodgson

Abstract

This article is an attempt to develop a coherent, unified, and consistent conceptualization of dreaming and dreamtelling in the clinical setting. Dreams told in a therapeutic setting are challenging events: fantastically rich in content, but often overwhelming in their implications for peoples’ relationships. When told in therapy groups, dreams provide additional challenges for all participants. Learning to work with dreams not only enhances understanding of unconscious intrapsychic and group processes, but may also have a strong impact on the therapeutic culture and working relationships in the group. After differentiating dreaming from dreamtelling, I briefly describe three uses of dreams in groups—the classical “informative” and more familiar “formative” uses, and a new perspective that focuses on the “transformative” aspects of a dream told. According to this perspective, a dream told has an interesting past, an important present, and a worthwhile future because of its interpersonal, intersubjective influence on the dreamer–audience relationship.     

The rhetorical organisation of dream‐telling

An appreciation of the ways in which clients and patients tell stories in psychotherapy is essential to an understanding of the therapeutic process. This paper reports findings arising from a programme of research into the analysis of patient narratives in psychotherapy sessions and diagnostic interviews. The focus of the current paper is on the analysis of the use of language in patient‐therapist interaction during the recounting in therapy of dream narratives. Dream‐telling follows certain rules of presentation that can be described as a set of specific rhetorical practices. The rhetoric of the dream‐teller reporting a dream is one of emotional distance, reflecting a narrative sequence which lacks a motivational framework. The report needs to be put into context by establishing a dialogue with the listener. The sharing of the dream with another, especially in the psychotherapeutic context, represents the dream‐teller's attempt to reproduce the dream experience. This attempt is made with reference to a responding and commenting other. The function — or dysfunction — of the assumption of hidden, non‐obvious, non‐recognisable wish‐fulfillment scenarios in patients' dreams is discussed. A method of working with dream material derived from narrative research is briefly described: the dramaturgical approach. This approach emphasises collaborative negotiation between client/patient and therapist, and combines the idea of free association with dream reconstruction and embedding the dream in current concerns, desires, and challenges.     

The butterfly dream as ‘creative dream:’ dreaming and subjectivity in Zhuangzi and María Zambrano

The ‘dream of the butterfly,’ which seals the second chapter of the Zhuangzi, is often interpreted as undergirded by the bipolarity of dreaming and awakening or by the elusive interchange of identities between Zhuangzi and the butterfly, dreamer and dreamed. In this paper I argue that the underlying structure of the story may be better interpreted as exhibiting not two, but three stages of development, consistently echoing other tripartite parables in the Zhuangzi. In my reinterpretation I rely on the phenomenology of dreams proposed by the Spanish philosopher María Zambrano, which distinguishes among three states: the primal dream, characterized by atemporality and wholeness; wakefulness, characterized by temporality and analytic thinking; and the creative dream, in which reality discloses itself as a meaningful, holistic unity. I suggest that Zhuangzi’s parable describes a similar self-transformative threefold process culminating in the joyous freedom of a shifting multifaceted subjectivity centered in the timeless pivot of the Dao.     

The neglected object: A history of the concept of dreams in Polish psychiatry and psychology in the interwar period, 1918–1939

The development of the concept of dreams in interwar Polish psychiatry and psychology was influenced by Western European concepts as well as by sociocultural factors of the newly independent state. Few Polish psychiatrists addressed the subject of dreams. They were influenced mainly by Sigmund Freud's psychoanalytic concept of dreams, but also by Alferd Adler's, Carl Gustav Jung's, and Wilhelm Stekel's ideas. Nevertheless, they approached psychoanalysis critically. The most comprehensive concept of dreams in Polish psychiatry was oneiroanalysis by Tadeusz Bilikiewicz. Oneironalysis was a method of dream analysis based on psychoanalysis but it rejected the psychoanalytic method of free associations and challenged psychoanalytic approaches to the interpretation of dream symbols. Polish psychologists were even less interested in dreams than psychiatrists. Problems with dreams, the most elaborate psychological work by Stefan Szuman consisted of an outline of epistemological problems with general theories of dreams and a harsh critique of psychoanalysis. The neglect of the subject of dreams in Polish psychiatric society can be seen as connected with the social and professional reception of psychoanalysis in Poland. Psychoanalysis was met with opposition from conservative scholars and publicists presenting nationalistic and anti-Semitic attitudes. It was also criticized by the biologically oriented majority of psychiatrists of the Polish Psychiatric Association. In the case of psychology, the most influential Polish psychological school, Lvov-Warsaw School, promoted Brentanian intentionalism, introspection, and psychology of consciousness, therefore, leading to psychologists' reluctance to explore unconscious states like dreams.     

The Other in Dreams

After examining the identity issues in Freud's Irma dream, Erik Erikson (1954) concludes that workable dream solutions may be not only ego-syntonic but also ethno-syntonic. Dreams may therefore open a window onto private, unconscious perceptions of the especially significant others upon whom we depend for security and satisfaction. The author examines a number of dream texts from this angle. Through these examples, he illustrates the way in which dreams may depict a person's sense of unconscious connection and responsibility to family, to community, and, in special cases, to one's nation. Dream life may thus illuminate a person's unconscious citizenship.