Dreams and Psychotherapy, Then and Now
By Christopher Skeaff, LCSW, PhD
Psychoanalysis, we might say, started with a dream. While vacationing in the summer of 1895, Freud first arrived at what he believed to be a compelling interpretation of one of his dreams, the now-famous dream of “Irma’s injection.” In a letter relating the experience to his friend Wilhelm Fliess, Freud wrote, “Do you suppose that someday one will read on a marble tablet on this house: ‘Here, on July 24, 1895, the secret of the dream revealed itself to Dr. Sigm. Freud.’”
For Freud, the secret in question wasn’t just the meaning of this particular dream; it was the secret that dreams as a phenomenon held for understanding the human mind more generally. Ultimately, through his work on dreams, Freud delineated a picture of the mind as a compromise born of roiling struggle, and he devised a collaborative method of analyzing such mental conflict. What began with dreams as an interpretive project continued, in Freud’s own work and beyond, as a therapeutic treatment of psychiatric symptoms. Dreams, in short, played an integral part in the making of psychotherapy.
That was then, but what about now? How does the relationship between dreams and psychotherapy stand today? In this post, I’ll briefly discuss how some contemporary practitioners have developed Freud’s initial approach to dreams by foregrounding, among other things, the lived experience of the dreamer and the diverse modes of listening to dreams.
Living in a dream
Arguably, Freud gives short shrift to the dreaming experience insofar as his dream theory regards the “manifest content” of dreams, the drama played out in the dream, as an epiphenomenon of hidden dream thoughts. Freud’s theory thereby underplays key elements of dreaming, including the experience of being inside the drama of the dream.
As psychoanalyst Frank Summers underscores in his article “To Live in a Dream,” dreams “tend to be dramaturgical,” with the dreamer simultaneously protagonist (as well as writer and director) and audience. “During the experience of dreaming,” Summers explains, “the dreamer lives in the dream. That is why there is not only believability to the dream, but also a unique quality not replicable in waking life.”
When viewed chiefly as a collection of symbols to be decoded, the dream material is prized for the hidden thoughts it might represent. The therapist will, accordingly, treat a patient’s associations – the thoughts, words, and images that come to mind in relation to the dream – as keys to deciphering some deeper meaning. For Summers, this traditional clinical emphasis on associations risks trivializing the experiential depth and affective intensity of dreams, with all their space-, time-, and logic-defying weirdness. Dreams, he argues, are more than just cryptic messages; they are sui generis ways of experiencing the world. To approach dreams on their own terms, then, requires the therapist to maintain and invite curiosity about what it was like to be in the dream.
Consider some clinical illustrations. George, a 50-year-old cishet man, sought treatment for help with acute depression. The therapy came to focus on how miserable he felt in his work life as a financial manager, despite his professional success. Initially, George downplayed the significance of money and status; such conventional markers of success weren’t, he insisted, central to his self-esteem. As the therapy progressed, however, George began to realize that the satisfaction he derived from his social position was so considerable that he couldn’t risk losing it. George feared that in giving up the unhappiness of his current work life, he would wind up feeling aimless and insignificant. He felt trapped.
At one point in the treatment, George dreamed about a typically staid male colleague showing up at a social function in drag, garishly made-up and flamboyantly dressed. If focused primarily on symbolic content, George’s therapist might have been tempted to interpret the dream in terms of an unconscious wish to be a woman or gay. Instead, the therapist began by asking George what it was like to be in the dream. George replied that he felt deeply envious of the colleague’s self-confidence in revealing who he really was. George admired that his colleague “didn’t care what others thought” and he affirmed, “I want to be like that.” To truly be “like” his colleague, George added, he would have to leave his current job.
In recounting the dream, George felt the intensity of his envy, a new feeling for him. And yet he located the importance of the dream more in the experience of utter dependence on others’ approval. George confessed that acknowledging such dependence made him feel “weak.” Ultimately, the dreamt envy made George aware of how much he yearned to be free from others’ judgments and how powerless he felt to free himself from their gaze. So the dream contributed more than symbolic content; it connected George with the intensity of his longing for a new life.
Another patient, Charles, also achieved a deeper and more textured emotional understanding of his predicament by exploring his dream life in treatment. Charles had been enmeshed with his mother for most of his life, propping her up emotionally and often finding himself recruited into the role of surrogate spouse. As his therapy progressed, he became increasingly aware of the emotional price he was paying in the maternal relationship. He began to make attempts to distance himself from his mother and felt intense guilt as a result. It was in this context that he dreamed his parents and siblings had traveled to Europe without him.
Not much came to mind when pondering the dream’s meaning. But when his therapist asked Charles what it was like to be in the dream, he immediately responded, “lonely.” Charles had begun the session exploring his grief at needing to separate from his mother. As he talked more about his experience in the dream, a dim sense of loneliness intensified into painful feelings of isolation and abandonment until, eventually, Charles noticed that he felt “all alone in the world.”
At that point, Charles associated to other periods in his life when he’d attempted to gain independence from his mother’s influence only to plunge into such despair that he would resume the old relationship with her. That despair, he now felt, was fueled by a loss of orientation, a worldlessness, that he was anxious to allay with her continued involvement. Charles was struck by how his use of his mother was exploitative in its own way: he needed her to avoid the panic of loneliness.
This dream and others that followed during Charles’s treatment made palpable for him a kind of terror underlying the anxiety about separating from his mother. In classical fashion, Charles’s therapist would often have him associate to the elements of a dream and would track his associative paths as clues to the dream’s meaning. Notably, though, Charles’s associations proved most valuable after he had felt the experience of living in the dream dramas. When Charles recalled lonely moments in his life, the thoughts, images, and memories were saturated with affective meaning because he recalled them from a place “inside” the despair of isolation.
Dreams connected each patient with affects – George’s envy and longing, Charles’s dread and despair – that they hadn’t been able to fully experience in waking life. Life in the dream thus revealed to each patient certain potentials they had not otherwise known. With Summers, then, we could see the dream as a distinct “way of being in the world that allows for a different form of living, a different way of existing, than is possible in any other mode of consciousness.”
Attending to these experiential dimensions of dreaming does not entail a rejection of Freud’s classical model of dream interpretation so much as a broadening and deepening of what it means to work therapeutically with dreams. Interpreting, in the sense of decoding meaning, is one among many orientations therapists and patients might adopt in relation to dream life.
Dream conversations
In his book Nocturnes: On Listening to Dreams, Paul Lippmann develops the notion of dream “conversations” so as to position the therapist as an interlocutor and listener – and not exclusively an interpreter – of a patient’s dreams. For Lippmann, the idea of conversation encompasses a variety of responses to a dream, including “appreciation, aesthetic discussion, spending adequate time with dream associations, elaborations and amplifications, each interwoven with some question or reaction or elaboration from the dream listener, if he or she cares to.” The point, as with Summers, is not to supplant interpretation or the search for meaning but to “help create the conditions from which interpretations will show themselves if they wish.”
Partly owing to the success of Freud’s groundbreaking efforts, the project of interpreting dreams has become freighted with such significance that many people find themselves in the grip of rather rigid ideas about how they “should” be making sense and use of dream life. Following Lippmann, present-day therapists would do better to cultivate a freedom in the responsiveness to our patients’ dreams, a “more mobile reaction” in which the listener (therapist) “is able to feel, think, react in any way, in any direction, guided by increasing familiarity with the story and ways of the dreamer.” From there, a multifaceted dream conversation can begin in which the dream’s secrets – be they hidden meaning, dormant potential, or novel ways of being and feeling – might reveal themselves.
You don’t have to go this alone.
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