Using Dreams in Psychotherapy

Throughout our waking lives we tend to push into the depths of our minds whatever disturbs or pains us, and to try to live in the shallows. However, nothing psychic is ever finally banished, and what we have repressed returns to haunt us in a variety of ways. One of the aims of psychoanalytic psychotherapy is to retrieve what we have pushed away and to come to understand it, and integrate it into our lives. This can cause new conflict because we both want to know, and resist knowing, about ourselves. At times we’re like frightened children, scared to look at the menacing shape we glimpse in the corner of our dark bedroom, but at the same time absolutely needing to know that it isn’t a bear or a wolf if we are not to be terrorised.

In the face of this resistance to knowing, the problem is to find a way of retrieving what has been so carefully hidden and made unconscious. One of the ways in which a patient’s earliest conflicts come to light is in their relation with their therapist. The therapist, whatever he or she is like in reality, takes on for the patient aspects of the parents who were loved, feared and, at times, hated. It is thus that early sadness, shame, guilt and disappointment can be made conscious and worked through.

As important to my mind is that dreams can be used to reveal our deepest selves and conflicts. More than a hundred years ago Freud, the great father of psychoanalysis, wrote " he Interpretation of Dreams," a book that is still of fundamental importance. In it he analysed his own and his patients’ dreams. He claimed

The interpretation of dreams is the royal road to a knowledge of the unconscious activities of the mind. By analysing dreams we can take a step forward in our understanding of the composition of that most marvellous and most mysterious of all instruments.

Freud privileged dream as revealing the unconscious because he believed, and demonstrated, that in sleep our defences are down, and what we try to repress is able to creep in, albeit usually in disguised form. While few therapists would explore dreams in quite the way Freud did, many share his belief that they put us directly in contact with whatever is troubling us.

Dreams have many functions. We can see dreaming as a different way of thinking in which we try to find solutions for our problems. Sometimes the problems are difficult and the solutions dramatic. Thus the scientist Kekulé, after years of searching, discovered through a dream the molecular structure of benzene. He is reported as saying at a scientific conference, “Let us learn to dream, gentlemen, and then we may perhaps find the truth”. We can also see a dream as a kind of play in which the various characters, representing aspects of ourselves, communicate, not always amiably, with each other. Some dreams allow us to accept parts of ourselves we have long denied. Very often dreams link a current situation with events from our childhood, allowing us to understand our present reactions more clearly.

The following dream illustrates this well. I have disguised details carefully to protect my patient’s confidentiality.

The patient works with children and has just found a new and quite stressful job. She is the oldest child in a large family. Her mother was brought up in an orphanage and knew little love. Before my patient was born there was a series of late miscarriages that presumably reactivated the mother’s mourning for her own mother.
The dream: Two children had been abducted from a children’s playground. The playground is a mother’s nightmare, with toys constructed out of dangerous materials and reminiscent of fairy-tale horrors. In searching for the children my patient has to walk along a wall above a river, clutching a hedge for support. It’s scary. She tells herself that the worst that can happen is that she falls in. At the end of the wall she asks for help and a hand reaches out to her.

We worked on the dream together and recognised that the children’s playground was indeed her intuitive perception of her mother’s nightmare world, filled with loss and grief. At the same time it recalls her preoccupation as a child with horror stories, which can be seen as an attempt to domesticate her mother’s terrifying world. Her search for the lost children, the aborted foetuses, and her mother’s love took her into frightening territory where she might lose her grip and be drowned in feeling. We were able to understand that she was not only responding to the new stressful job as a confident adult, but at a deeper level as a bemused, frightened child, aware at some level of her mother’s preoccupied suffering, symbolised by the prickly support of the hedge to which she clung. What was new was the hand reached out towards her, the hand of me the therapist who might be able to save her from drowning.

By being able to understand that her feelings of fear and inadequacy in the face of her new job were a repetition of her childhood terrors she was able to regain contact with her adult, competent self and recognise that she had little to fear.

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