Clinical Psychology/ Sleep Disorders

 

Eric A. Bell, Psy.D.

 
HomeInsomnia and Sleep DisordersDreaming and NightmaresSleep and Psychiatric DisordersAbout Me and What I Do

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Henri Rousseau "The Dream" 1910

Dreams have fascinated people from many cultures for centuries. Prophecy and religion have placed substantial importance on the meaning of dreams, and these sometimes baffling and mysterious mental processes continue to intrigue many people (including therapists and researchers) to this day.

Sigmund Freud believed that dreams served as the “royal road to the unconscious” and also expressed that each one expressed wish fulfillment.  Since the publication of his groundbreaking work (The Interpretation of Dreams) in the 1900, numerous psychoanalytic papers have been published on this topic.

During the Spring of 1953 rapid eye movement (REM) sleep was discovered and additional research later during that decade linked the psychological process of dreaming to REM sleep.  However, it was also determined that dreams can, and do, arise from non-rapid eye movement (NREM) sleep.

Dreaming is clearly a complex psychological process and is not equivalent to the physiological state of REM sleep.  Some research suggets that dreams do arise from the neural structures governing REM sleep yet other experimental work does not completely support this conclusion.

We do know that sleep laboratory research affords the opportunity to study the mind during sleep, and we also know that many of the most interesting and creative dreams occur when we are dreaming in the home environment. 

The function (or functions) of dreams remains unknown.  It is likely that there are numerous reasons for these unique, private experiences.  Some researchers believe that dreams serve to regulate mood, while others suggest that dreams allow us to commit facts and details to memory.  Still others believe that dreams allow us to review, revise, rehearse and repair our emotional lives.  And, the classic idea is that dreams serve as a safety valve for the expression of forbidden wishes and aggressive impulses.  All of these ideas may be correct - the degree to which they apply to a specific person probably varies. 

Information provided on this page cannot begin to scratch the surface of the marvelous and deeply personal processes of dreaming, and I would encourage the interested to pursue further reading.  There are many books and articles pertaining to this subject ranging from research projects to "dream dictionaries".  I have enjoyed reading many of these.  Van de Castle's "Our Dreaming Mind" is one recommended book because of the depth and scope of material presented.

Some Properties of Dreams

Dream research has been conducted in sleep laboratories for several decades.  One major issue that is agreed upon rests with the notion that the dream is never directly studied; dreaming is a psychological process that occurs during sleep but the dream report occurs during wakefulness.  At this writing, one cannot directly investigate psychological processes during sleep.

It is also understood that we all dream each night, but most of us forget the content of the dream experience.  This inability to recall is striking - how often do we massively forget so many details during our waking life?

Dreams tend to occur during the amount of time they seem to.  In other words, these experiences do not seem to happen in a "split-second". In addition, we tend to dream in color (although some dreams do occur in black-and-white). 

One of the most curious properties of dreaming is our general inability to recognize the dream as a dream when it is taking place.  We simply do not often understand "it's just a dream" when the story unfolds - most of us accept the content of the dream without critical evaluation.

Many dreams actually reflect concerns and ideas of everyday life.  Some are bizarre but many are not.  It is understood that these nocturnal hallucinatory experiences may not be as "crazy" as once considered. 

Dreams and Nightmares

 

Are Dreams Meaningful?

Dreams certainly can be meaningful, but sometimes the content of this experience seems bizarre and completely inconsistent with ourselves.  In order to make sense out of the experience, it is often most helpful to determine what the dream means to the individual.

Several years ago some noted researchers dismissed the functional importance of dreams.  However eloquent this agrument could be, it can always be debated that all mental activity is meaningful - at least to some degree.  The contrary position could also be argued but would represent silly discourse due to human creativity and ingenuity.

Dream Interpretation  has been important to people from many different cultures for centuries.  It is always assumed that the content of dreams is significant to the individual.  Some people remain understandably skeptical about this subject - the validity and reliability of dream interpretation remains open to scrutiny. However, some individuals do benefit from attempting to understand these private mental experiences.  For dream interpretation to be helpful, people often need to write down the content of the dream, describe personal psychological associations with dream images, and then link these associations with current concerns, events and emotions. 

Nightmares

These are terrifying dreams that often awaken the sleeper.  Common themes include being chased or threatened by physical harm.  Nightmares seem to be more common among people who have experienced trauma, and also among those who are emotionally "open", sensitive and vulnerable.  Consistent patterns of psychopathology have not been reported, but clinical experience would suggest that some people with certain personality and anxiety disorders may be prone to markedly negative dream experiences.  Among other groups of people, it is well known that certain types of medications can trigger nightmares.

 

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Fuseli "The Nightmare" 1781

Treatment of Nightmares

Conflict resolution through psychoanalytic psychotherapy was once considered the primary form of treatment for nightmares.  Although emperical research has not clearly emphasized its superiority over other methods, it has probably been helpful to many people throughout the years.

There are other types of treatments for nightmares.  These include relaxation training and systemic desensitization - when using these techniques together, an individual can gradually remain calm (to some degree) when faced with feared dream material.

Image rehearsal therapy has emerged as another treatment for nightmares.  According to this intervention strategy, nightmares are trauma induced and habit sustained.  People with nightmares are encouraged to practice imagery exercises and re-script the dream.  The new dream sequence is rehearsed and practiced during wakefulness.