I drift off to sleep and suddenly I am standing in a whitewashed and undefined landscape, gazing up at a group of massive ivory houses, all of them unfalteringly perfect in their twinkling windows and midnight black shudders. A deafening voice commands me to move the houses somewhere else, the instructions unclear. I can hear an insistent clock ticking and I am suddenly consumed by a sense of urgency. I desperately look for help but there is nobody here except myself and the voice screaming at me to move the houses. I know this is a dream; I think I’ve been here before. I can’t wake up and the screaming is too much. I need to move the houses quickly. I pick the heavy houses up over my head and move them one by one, my bones breaking from the weight, but I am unable to stop until either the screaming ceases or I wake up. I turn back to move another house but I wake up abruptly, short of breath and exhausted. Noticing it is almost time for work, I get up and put on my uniform, smoothing out the wrinkles and already pushing the dream out of my mind. “It was just a dream.” This dream is one of my many recurring nightmares I experience. With a history of unfortunate circumstances, including exposure to stress-inducing environments and recently acquired PTSD resulting from sexual assault by a fellow U.S. Army soldier, the development of insomnia and bad dreams is inevitable. Although I have sought a variety of professional help, none has proven effective so far.
Advancements in psychological science propose that dreams are the key to discovering deeply rooted damage in trauma patients. Studies show that dreams are not just irrelevant and random fragments of imagery, but are in fact connected to reality and the conscious mind. Often, people who are suffering high levels of stress or are coping with trauma experience altered sleeping patterns and emotionally heightened dreams. These dreams can be lucid, nightmarish, bizarre, or simply memorable. Many dismiss their dreams and don’t pay attention to the content, but ignoring them is ignoring the opportunity for dreams to act out their natural purpose for self-reflection and awareness. Based on case studies and research, psychoanalysis in the form of dream analysis can function as an effective method of trauma healing, as it offers a way to sort through suppressed emotions and identify causes for emotional associations, and thus supplies the patient with healthy coping skills.
Different theories on the purpose behind dreams include: memory recall; threat simulation as an evolutionary defense mechanism that trains human minds to practice survival without true life risk; affective networking; and the idea that dreams provoke moods and emotions and can adjust emotional reactions to presented contents. Sigmund Freud, the father of psychoanalysis, was a psychologist and scholar who believed dreams are images manifested for wish fulfillment, as well as a means for stimulus mastery. Psychologist Joshua Levy explains the advancement of these early dream theories, specifically by a later scientist Ferenczi, who studied Freud’s work: “every dream, even an unpleasurable one, is an attempt at a better mastery and settling of traumatic experiences...” (qtd. in Levy and Finnegan 14). Many others have discussed the relationship between patients’ dreams and underlying trauma (Levy and Finnegan 14).
In order to understand the significance of dreams and the science behind psychoanalysis, it is crucial to understand the biology of the brain and the sleeping process. Scientists are actively studying these processes in conjunction with theories of psychoanalysis, such as the Frankfurt fMRI/EEG Depression Study (FRED) described in Gennady Blanket and Eric A. Fertuck’s “Review of trauma, dream, and psychic change in psychoanalysis: A dialog between psychoanalysis and the neurosciences.” Blanket and Fertuck document the observations of brain activity analysis through MRI scans in order to gauge whether psychoanalysis, or dream work, led to the change in the memory-emotion relationship through memory recollection, looking to detect lasting neurobiological changes in the brain function of mainly chronically depressed patients. To give some insight into what happens on a biological level during sleep, it is important to note first that there are a variety of sleep stages, and the stage in which dreaming occurs is called Rapid Eye Movement (REM). REM is considered the most important stage of the sleep cycle because that is when the body is re-energized. REM sleep begins when signals from an area of the brain called the pons travel to a brain region called the thalamus where humans process sensory stimuli, and then to the cerebral cortex (“Brain Basics: Understanding Sleep”). The cerebral cortex is the layer of the brain that is responsible for learning, thinking, and organizing (“Brain Basics”). Signals are also sent to nerves, where they shut off neurons in the spinal cord and can cause temporary paralysis of muscles or muscle spasms and movement (“Brain Basics”). Although dreaming is manifested in a state of unconsciousness, parts of the brain active for conscious purposes are shown to be active during sleep. Therefore, dreaming functions as a connection between the subconscious and the conscious mind. For example, parts of the brain that store memories and process emotions are highly active. According to the National Institute of Neurological Disorders and Stroke, “researchers now know that sleep is an active and dynamic state that greatly influences our waking hours, and they realize that we must understand sleep to fully understand the brain. Innovative techniques, such as brain imaging, can now help researchers understand how different brain regions function during sleep” (“Brain Basics”). Dreams are created through the signals from memory recall, emotional processing, and behavior learning. Thus, people react in dreams as they would in real life because the same predetermined response behaviors that are channeled in conscious situations are being channeled here. This conjoined consciousness in dreams and dream content implies that dreams are a product of memory fragments, emotional and behavioral responses, and are triggered by emotionally heightened events in waking life.
Troubled dreaming, a consistent symptom of stress seen in PTSD patients, is an intentional message communicating that the mind is struggling to be in a healthy state. Post-traumatic stress disorder (PTSD) is a lasting condition acquired following a traumatic experience that usually requires treatment from a professional. The disorder is most common with war veterans, sexual assault patients, and rape victims. Extreme stress can also create similar conditions to PTSD. Symptoms include nightmares and insomnia, depression, mental and physical distress, avoidance, isolation, extreme change in behaviors, and sensitivity to stress stimuli. Recovery is difficult because PTSD, while typically acquired from an isolated event, can trigger emotional distress in other areas of life, including past trauma. Healing generally can take years or even a lifetime. People often cope by not coping, simply moving on with their lives and attempting to deal with the symptoms as a part of everyday life. Because of this, troubled dreaming is even more common due to the suppression of emotions and the significance of memories.
Even with professional help, bad dreams throughout treatment processes often don’t subside because they aren’t being acknowledged outside of being a side effect. Therefore, the natural purpose of emotional transference of dreams is being rendered useless without analysis. Trauma and stress are heavy burdens on the mind and show in behaviors, either voluntary or involuntary. It seems that human behaviors are driven by one of two things: either ingrained instinct or emotion. It can be said even that ingrained instinct is itself driven by innate emotive responses. Often people associate emotions with active feelings and labels; a person will feel angry, sad, happy, scared, etc. during an experience and will reflect on those feelings as they experience them. However, emotions are dynamic and in most cases people are feeling multiple ones at the same time and as such cannot actively process all of them simultaneously while they are focusing on other things. The human attention span is selective and must prioritize to function properly. In certain cases, a person will not realize they felt a certain way about something because they were too occupied by dealing with their situation. In such cases, they are involuntarily processing these emotions and will create subconscious associations and may reflect on these emotions later or purposefully not at all, depending on the nature of the emotions. That is why sometimes people do not realize they have been feeling stressed until physical symptoms develop. In a dream state, the mind may manifest stored or subdued emotions. People typically do not see dreams as having such a purpose, but rather view them as nonsensical and insignificant to their health. Bad dreams or nightmares are instead labeled as side effects, which allows the problem to get shrugged off and dismissed, when in actuality dreams play a very real purpose as the human body’s ingrained method for coping with stress based experiences.
Dreams in the form of nightmares can elicit negative emotional response because they are connected to deep emotional distress that patients suppress or are unaware of. Emotions presented in dreams are typically reflective of emotive behaviors in life situations. Soudabeh Givrad, author of “Dream theory and science: A review” in the Journal of Psychoanalytic Inquiry, discusses the manifestation of nightmares and contextually negative dreams as a byproduct of stress, anxiety, and other psychopathological symptoms seen in PTSD cases and trauma victims (Givrad 209). The hyperarousal of emotions can be both triggers for memory disturbances that relate to trauma and consequences of memory disturbance. When a bad memory is activated, it manifests itself in other ways to avoid active suppression, commonly through nightmares and behaviors. This defensive reaction, a result of environmental stimuli, triggers traumatic memories that are usually left fragmented or disguised (Givrad 210). Those who suffer from PTSD have flashbacks, chronically disturbed sleep, and hyperactivity in response to such stimuli.
Traditional methods for trauma therapy and PTSD healing are therapist counseling, sexual victim-specific psychologists, group therapy, family intervention, and prescribed medicines for symptoms, including anxiety and depression. While these listed methods sometimes have positive effects, they can also be unsuccessful in the scope of long-term healing. These types of therapy require the patient to “open up” immediately to a professional or group, which is not appealing for most people who are actively isolating themselves and suppressing memories. It can be frustrating and result in long silences or departure from a session. Traditional methods also do not actively address the dreams of the victims, instead focusing on remaining positive and moving forward. Medication likewise does not heal a patient, but rather only temporarily alleviates symptoms of deep distress.
Every professional method for healing I have sought so far has been unsuccessful. Across the board, all the sessions have key components in common. Upon entering, the counselor/therapist/mediator bids me to choose a seat to sit in, and I ask, “Any of them?” as I eye the various choices usually including a couch, folding chair, swivel chair, and the consistent rickety chair in the corner. The next common questions are “So what would you like to talk about today?” and “What is bothering you?” These are frustrating questions because part of the reason I am there in the first place is to figure out what is bothering me. I don’t know how to talk about the assault and subsequent turmoil; I can’t pinpoint exactly what is bothering me about it; and I can’t really connect the dots for the counselor because I can’t even do that for myself yet. Thus, it would follow that I don’t know how to start the conversation off either. Because I don’t know how to answer the questions, there is almost always a long silence, the kind that makes you not want to swallow too hard because it’s too noisy and you don’t know where to look (enter fidgeting habits). More times than not the counselor will choose to focus on how my day went, picking apart aspects of the day to analyze, which I find unsatisfying; we don’t address anything deeper than my annoyance at a snobby customer that I encountered that day, which does not correlate with deeper disturbance due to assault or any kind of trauma. Another counselor, after a particularly long silence in which he made no effort to start a conversation, once said “Well it’s your hour so if you don’t want to talk we can just sit here.” Another counselor said, “We don’t have to talk about the assault and if we do I don’t need to hear details or specifics. In fact, I would prefer not to discuss it.” Perhaps these methods work on others, but for those who struggle with identifying emotions within themselves and talking about their trauma may find that these methods do not work well at all. A person who doesn’t allow themselves to dwell on “negativity” may not be able to acknowledge openly the thoughts they suppress for someone else, at least not forthright.
Dream interpretation, however, can be the most effective counseling option for some because it offers a gateway for communication between the patient and analyst. Once dream content analysis is underway, both the patient and the analyst can connect emotions and memories to the dream through transference and countertransference. From there, sessions can begin to dig deeper and target the roots of the issues manifested in dreams. David Jenkins, in “Assessing dream work: Conceptualizing dream work as an intervention in dream life,” presents the study of dream work as a mostly patient-driven analysis. The patient also interprets the dreams and builds the dreamer’s ability to analyze freely with an open mind. Usually patients are unable to initiate analysis on their own, due to other psychological symptoms, and require a starting point (Jenkins 126). Recalling dreams is a manageable task for the patient and acts as an opportune opening. Through the analysis process, a sense of awareness and self-interpretation is developed and the patient is supplied with lasting coping skills to recognize behaviors and symptoms as emotional cues and act accordingly, possibly choosing to refrain from harmful behaviors. Bessel Van Der Kolk, researcher and author of “The Biological Response to Psychic Trauma: Mechanisms And Treatment of Intrusion And Numbing,” indicates that learning to express the memories and feelings related to the traumatic event through dream analysis can “restore some of the psychophysiological and immunological aptitude to trauma patients” (Van Der Kolk 203).
Joshua Levy’s psychoanalysis of a patient named Anne in a six-year case study exemplifies the dream analysis process and its role in trauma healing. Levy documented their sessions on dream interpretation and psychoanalytical discussion along with his internal reflections on the patient. The documentation serves to demonstrate the role of dreams in the psychoanalytic process while coping with trauma. Anne suffered the effects of an abusive family in various forms, ranging from sexual promiscuity to severe depression. Levy encouraged the recall of her dreams during their sessions in order to better understand the connections of Anne’s subconscious and conscious through deep analysis of the “multiple layers of communication” (Levy and Finnegan 18). By reviewing the finer details of her dreams, the roots of Anne’s deep-seated problems were identified and therefore made aware to her conscious world. This allowed for personal insight into motivators for destructive actions and led to the prevention of such behaviors related to stress coping. Not only did the dreams themselves prove important to Anne’s six-year journey to healthy coping, but her reactions to the dream analysis gave her the power to think independently and be more attentive to her behaviors and stimuli.
Like any trauma healing method, there is no guarantee for success with dream analysis. There are many factors involved in dream interpretation, including the nature of the trauma, severity of the symptoms, personality of the patient, countertransference from the analyst, and patient cooperation. An example of documented failed attempts at psychoanalysis are shown in the journal of Lia Pistiner De Cortiñas, a psychoanalyst interested in recording the educational benefits of failure in such case studies. One patient she describes, named Ana, “felt lost” (De Cortiñas 535) and unsure of how to emotionally grasp her traumatic past or present. She had no means to face her own pain. The psychoanalysis was a failure because the analyst, Lia, was unable to establish a mindful relationship or interest in the patient due to an intrusion in countertransference. Lia essentially got caught up in Ana’s “atmosphere”, a lost and ambiguous tension that created a barrier of unproductivity or desire to deeply analyze the dreams or even thoughts (De Cortiñas 535). Ana herself would miss sessions and cease to “exist” in her inactive interaction with the exterior world (De Cortiñas 535). The case study and the reflection on its failures heavily relies on the concepts of emotional transformations, their lack, and the mental barriers hindering communication between the patient and the analyst. Lia was able to analyze her own countertransference, recognizing that her disinterest in the patient resulted from the draining atmosphere Ana possessed. This mental fogginess was a lack of emotional relation to reality. While Lia could overcome this once outside of her presence, Ana could not escape it (De Cortiñas 535). This case study is an example of just a few of the factors that can go wrong in the analysis process and thus result in failure, thwarting healing. Yet, similar risk of failure can be said for any counseling method, as they all encompass a variety of different elements with a variety of people, all of whom are unique in how they cope with stress and trauma. No method is a guarantee, dream analysis or otherwise.
Post-traumatic stress disorder is a dangerous condition that can cause illnesses and mental deterioration if left untreated. Unfortunately, there are no treatment methods that can promise successful healing. What psychoanalysis offers is not a guaranteed recovery, but a chance for healing that has proven to be effective through case studies and research. The dream analysis process isn’t intended solely to heal a patient, as most other methods do, but also to create independent coping skills so that, in the event of relapse, the patient is equipped to recognize cues to emotional duress and can take actions practiced during psychoanalysis. The main and most important tool psychoanalysis provides is the awareness of connections between emotions and behaviors. Dreams explicitly function as natural indications of mental states. If a person has recurring headaches that can’t be suppressed, that person would be concerned about a more serious health problem that could be triggering those headaches. Principally, lucid, nightmarish, and troubled dreams act much the same way as headaches and, if analyzed properly, can illuminate the source(s) of the mental problems. Dream interpretation may not work for everyone, but it is proven to work effectively, even more so than other methods in many cases. PTSD and trauma victims should be made aware of this method for healing and coping so that they can decide if it is a good fit for them. Many veterans and victims who are struggling with their current methods deserve to have an informed choice on current options: it may be the difference between mental deterioration and good health or, in some cases, life and death.
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