Bringing dreams back into therapy
Dreams were once an important part of therapy, just as once they were an important part of everyday life and a topic of conversation at the breakfast table.
According to research by Schredl et al., more than 60 % of patients bring dreams to psychotherapy, no matter what form of therapy is used. Yet, most therapists are uncomfortable working with dreams (Leonard and Dawson 2018). Despite their discomfort, more than 60% of therapists, including humanistic and cognitive-behavioral therapists, find dreamwork to be helpful for their clients (Schredl M 2000). Perhaps clients intuitively know it is helpful to talk about their dreams. Rather than our clients, it may be us, as therapists, who are uncomfortable about their value or unclear how to use dreams in therapy.
In considering dreams, the therapist must be mindful of the patient’s needs and the kind of therapy being attempted. Dreams in clients seen in purely supportive treatment, especially those with more severe pathology, should be examined from the point of view of strengthening and maintaining the ego, not from exploring unconscious material. Thus, the use of free association or amplification should be limited in those clients.
When therapy is more insight-oriented, fuller dream exploration is more appropriate. The fact that a patient brings a dream to therapy may suggest that they might benefit from dream work. If a patient in ego-based therapy, like cognitive behavioral therapy, brings a dream to therapy, it may indicate that they are unconsciously seeking a more insight-oriented approach.
Tips for dream exploration:
The most important client we treat is ourselves. The most important tip is to work with your own dreams, learn to remember them, record them, explore them. The following suggestions apply to your personal dreamwork as well as your work with clients.
1. Acknowledge the dream as an important contribution to therapy. Many of the ideas described in the chapter “Befriending your dreams” are appropriate here, especially that of writing down or recording your dreams.
2. Ask the client to describe the dream in as much detail as possible.
3. Do not interrupt the description, except for brief clarification.
4. Ask the client what thoughts they have about the dream.
5. Ask the client to describe the feelings they were having in the dream.
6. Ask the patient if the dream seems to be related to any recent events. This is an exploration of what would be called, in Freudian terms, day residue.
7. Ask the patient about associations to specific dream elements (events, situations, people, feelings). Explore dream elements neutrally, without a preconceived idea of the meaning of the dream. Pay special attention to details that seem odd as those are often important.
8. If people appear, ask the client about the characteristics or traits of each person. Figures that are important in a dreamer’s life, like parents and spouses, frequently recur in dreams. Figures that had minor roles in a client’s life, like a high school friend, may represent traits associated with that person.
9. Examine the emotions that the dream brought up; was it happy, sad, peaceful, or nightmarish.
10. Consider the possible relationship of the dream to the therapeutic situation. A therapist is an important figure in a person’s life and may appear in dreams, and issues about therapy may express themselves in the dream. Resistance can also express itself in dreams. Jung, Freud, Kirsch and others (Kirsch 1990) have noted that patients can focus on long, tedious and pointless dreams as a way of avoiding therapeutic issues. This is rare and would be difficult for an inexperienced therapist to recognize.
11. Consider amplification of dream elements. Amplification concerns the recognition of mythical and collective material in the dream and can be strengthened by images or associations from outside the dream. Amplification is especially important in big dreams and dreams with archetypal elements.
12. Examine the: 1) setting, 2) plot, and 3) key turning points in the story. These can represent important conflictual issues in the patient’s life. The plot and characters point to conflicts and their expression in the life of the patient.
13. It is usually natural for clients to view a dream externally as if the dream figures were representations of characters in the patient’s life. The mother in a dream, for instance, will be experienced as if she were the patient’s actual mother instead of the internal representation of the mother within the client. Explore this external stance toward the dream by discussing the relationship with the mother.
14. Invite the client to view the dream internally. The mother in a dream, for instance, may not be a depiction of the real mother but of the internalized mother image, the mother archetype. The internal and the external are often linked. The personal external elements of the mother call up the archetypal collective elements. Internal and external elements may express themselves together in a dream.
15. Similarly, consider the dream ego, not only as a reflection of the person himself but also as a personification of some particular aspect of the person. For instance, in the dream of the crab/lizard that begins the Introduction, the dream ego (the image of the dreamer in the dream) is not the person himself, but that aspect of the person that fears and wishes to control the unconscious.
16. Imagine the events of the dream as internal rather than external. This is especially important with negative aspects of a dream. Death of the dream ego usually does not portend physical death, but rather a death of some personified aspect or attitude of the dreamer. This can be very reassuring to the client.
17. When possible, relate the current dream to the past dreams of the patient. Important patterns may emerge, and growth and change may be evident to therapist and patient when past dreams are explored in relation to current dreams.
18. RELAX. Dream exploration should be fun for you and the client. As Jung emphasized, there are no right or wrong answers, multiple ideas and interpretations can be entertained, multiple interpretations can be correct. Remember the story from the discussion of dreams in Judaism. Two dozen dream interpreters can interpret a dream differently, yet all of them may offer valuable insights.
19. Consider the outcome of the discussion and interpretation of the dream. Did it “connect” with the client and seem meaningful to him or her? Do subsequent dreams and discussions seem to confirm the dream interpretation? Did the dream and its interpretation expand the client’s self-awareness?
20. Remember that dream interpretation can be challenging, especially if a therapist has minimal experience with this kind of work. Seek the wisdom of supervisors or colleagues to help with dream work. Ongoing practice will increase comfort in working with dreams.