MAURICE R. GREEN, MONTAGUE ULLMAN, and EDWARD S. TAUBER
Reprinted from Modern Psychoanalysis, edited by Judd Marmor. Published by Basic Books, Inc. 1968 by Basic Books. Inc.
Dreaming, by and large, in and out of the psychiatric and psychoanalytic literature, has been approached as a different and very special thought process. In psychoanalysis, it has been regarded as a uniquely valuable therapeutic and diagnostic instrument. Freud's earliest psychoanalytic conceptions received great impetus from his investigation of dreams, although they were based, for the most part, on a neurological model of sexual excitation and frustration (Freud, 1899; Amacher, 1965). Much of what Freud formulated is still valid; there is much, however, that no longer holds true in the light of clinical and laboratory research of the last four decades. Nevertheless, the value of the dream as an instrument for probing into the intricacy of the human personality stands unquestioned today.
Literature on the meaning of dreams dates back to 2000 B.C. in Egypt, and to 700 B.C. in Assyria (Boss, 1958). The Chaldeans and other Near Eastern people lent great weight to dreams. In Homer's work and in Biblical writings dreams were regarded very seriously as communications from the Divine. They were used medically in the temples of Aesculapius to promote the ritual healing of sickness, and by Hippocrates to help diagnose diseases. Herophilus, a third-century Greek physician, even recognized that some dreams serve the function of wish-fulfillment (Dodds, 1957). Aristotle suggested that dreams might present a useful course of action that a person had not yet considered in his waking life--an early glimpse of the problem-solving potentiality of some dreams. Dreams have always been considered to have prophetic power, and even today many people use dreams to try to prophesy the winning horse in a race, or the winning number in the numbers racket. Telepathic powers were early ascribed to dreams and recently have become the subject of scientific experiment (Ullman, 1966). Dreams were also considered, even from the days of Aristotle, sometimes to be mere reflections from the waking day, expressing the same cares. hopes, preoccupations, and feelings; and from the Chaldean days to the present some dreams were regarded as foolish, misleading, or meaningless. In the Dark Ages dreams were often regarded as messages from God or the Devil. Freud reviewed much of this history up to 1900 (Freud, 1899).
In this limited space only a few of the significant contributions will be touched on, and not always will the best representation or the original source of the notion be presented. The emphasis will be on recent material and on apparent seeds of further development in the theory of dreaming and the art of dream interpretation.
Freud's self-analysis led to his investigation of his own dreams and childhood memories. His libido theory was based on the ideas he elaborated from these investigations (Tauber and Green, 1959). Although Freud did a richly detailed study of the many varieties of dreams in relation to various contexts, in the end he focused on the infantile sexuality that he believed was concealed and disguised by the manifest dream content. According to Freud, the latent content of the dream was -like the unconscious content of symptomatic behavior, the psychopathology of everyday life, and the communication between the patient and therapist - rich with oral, anal, phallic, and other instinctual strivings. Following the original breakup of Freud's group, Jung and Adler developed approaches to dreams consistent with their theoretical deviations from Freud. Adler's focus on dreams was designed to reveal the content of his theoretical preoccupation with the social and compensatory strivings of the individual (Ullman, 1962). Jung's approach to dreams focused on his concern with the collective unconscious and archaic images (see his latest statement in Man and His Symbols, 1964). Other approaches to dreams reflect the various other psychoanalytic theories and preoccupations.
Heinz Hartmann (1964) and Ernst Kris (1952) emphasized the importance of Freud's late writings on the participation of the ego in dreams and ether unconscious processes-particularly the ego's need for intelligibility and for synthesis. However, it was Erik H Erikson (1954) who made the first important addition to Freud's work within the classical tradition "The Dream Specimen of Psychoanalysis." Here he followed the early lead of Stekel, Maeder, H. Silberer, and Jung in adding to the narrow, mechanistic approach of Freudian orthodoxy a purposive perspective. He said, "... . this dream may reveal more than the basic fact of a disguised wish fulfillment derived from infantile sources; that this dream may, in fact, carry the historical burden of being dreamed in order to be analyzed . . ." (p. 8).
Erikson pleads for more respectful attention to the manifest content of the dream and its verbal report by the patient. He emphasizes the importance of its style of representation which presents the individual's personal time-space and the frame of reference for his defenses and accomplishments. However, in spite of his attention to the verbal, sensory, spatial, temporal, somatic, interpersonal, and affective aspects of the manifest content, he never abandons the more narrow concept of latent dream material. He continues to rely on the classic links of associations and symbols to reveal the latent dream thoughts. Nevertheless, he goes beyond a concern with psychosexual issues and ego defenses to stress the importance of ego identity and a life plan, thus including much of the neo-Freudian contribution. In a more recent book, Insight and Responsibility (1964), Erikson adds a further dimension by assimilating the phenomenological emphasis on immediate subjective experience. He criticizes Hartmann (p. 163) for following Freud in imposing a Cartesian strait jacket on the model of man. He states, "I believe we can undo this strait jacket only by separating from our concept of reality one of its more obscure implications, namely actuality, the world verified in immediate immersion and interaction" (p. 164). He presents a searching analysis of Freud's dream of Count Thun to illustrate the participation of the actual adult ego in the dream. He states, "Dream life encases the most recent dangers to the ego's sense of mastery into the tapestry of previous and distant ones, using personal delusion and private cunning to make one meaningfully patterned past of them all and to bring this past into line with anticipated actuality" (p. 200).
The existentialist approach, best represented by Medard Boss, attempts to transcend the limitations of the various psychoanalytic theories. Boss, in The Analysis of Dreams (1958), addresses himself to the separate and distinct mode of existence that characterizes dreaming. He points out that the person who dreams and recalls his dream is identical to the person who continues to function throughout the waking day. Dreaming characterizes a separate and distinct form of existence for a person as the waking state or nondreaming state of sleep characterizes another distinct form of human existence for the same identity. Boss is sharply critical of both Freud and Jung for what he considers to be their implicit derogation of the manifest content. He points out how the "natural scientific" bias of both of these pioneers led them away from a concern with the dream at the phenomenological level and involved them mainly in a concern with the dream as a disguised form of symbolic expression.
William James, like Medard Boss, respected the phenomenal nature of the dream as a form of existence in itself. He wrote:
The world of dreams is our real world whilst we are sleeping, because our attention then lapses from the sensible world. Conversely when we wake, the attention usually lapses from the dream-world and that becomes unreal. But if a dream haunts us and compels our attention during the day, it is very apt to remain figuring in our consciousness as a sort of sub-universe alongside of the waking world. Most people have probably had dreams which it is hard to imagine not to have been glimpses into an actually existing region of being... (James, 1918, p. 294).
However, James paid very little attention to dreams and dreaming in his writings. It was not until recent years that William James's approach to dreams, similar to that of Boss, became widely shared by many analysts, clinicians, and research workers.
American psychiatrists under the leadership of Adolf Meyer and William A. White eagerly received Freud's contributions to dream theory and the clinical use of dreams in the second decade of this century. But, in spite of this early enthusiasm for Freud's work, there was also keen interest and reception for the later contributions of Adler, Stekel, Jung, and others who deviated from Freud.
Sullivan considered the experience of the dream to be of a different order of experience from that of waking life - in two ways: first, it occurs in a state of sleep and thus poses an impassable barrier to accurate recall in the waking state; and second, dreaming takes place mostly in the parataxic mode of experience, which is a very generalized, oversimplified, and concrete formulation of happenings characterized by their immediate qualities without reference, necessarily, to temporal continuities, causal sequences, or logical syntax. Although Sullivan believed any attempt to translate this into statements that could be made consensually valid by mere intellectual operations was futile and wasteful, he did not minimize the significance of the reported dream. He urged that it be given full attention and weight like any other reported experience. He said, "The psychiatrist reflects back to the person what has seemed to him to be the significant statements, and then sees if it provokes any thought in the mind of the patient" (Sullivan, 1953, p. 337)
Erich Fromm, an early associate of Sullivan in Washington and New York, differs from Sullivan in many respects, including the approach to dreams. Fromm follows H. Silberer, Maeder, Stekel, and others in his use of anagogic, analogical, and metaphorical interpretation. He, too, rejects the limitations of Freud's so-called "laws of the unconscious" as a necessary prerequisite for dream interpretation. Basically, Fromm is concerned with communicating how the imagery of the dream illuminates the patient's struggle to avoid responsibility for himself and his blind tendency to live out life in false solutions, idolatrous pursuits, and evasions while it can, at the same time, reveal his hidden potentialities.
Karen Horney, who was associated with Fromm and Sullivan for a time after breaking away from Freudian orthodoxy, repeatedly emphasized the importance of dreams for developing a patient's awareness of his real self. She said that ". . . in dreams we are closer to the reality of ourselves; that they represent attempts to solve our conflicts, either in a neurotic or in a healthy way; that in them constructive forces can be at work, even at a time when they are hardly visible otherwise" (Horney, 1950, p. 340).
Tauber and Green (1959) proposed a deeper reconsideration of prelogical experience, especially dreaming, in the structure of thinking. They reject the scientific convention of placing concept, ideas, and grammar as central and primary. They assert vigorously that feeling values have a much broader semantic than the content expressed in discursive grammar. They insist that dreaming is not primarily a guardian of sleep; that the doctrine of wish-fulfillment interferes with appreciation of the manifest symbolic activity; that the dream is invaluable for introducing novelty in a patient's conception of himself; and that the dream is rich with details of the analyst-patient relationship, and hence is a uniquely worthy instrument for exploring the transference-countertransference vicissitudes.
Ullman (1958, 1959, 1963) early called attention to the adaptive significance of the dream occurring in an experiential state of inner vigilance and partial arousal. He sees the cyclic variations in depth of sleep during the night as an opportunity for the individual to confront some challenge to the continuity of his habitual way of life wherein cognitive preparation for reinforcing neurotic illness patterns may occur or, on the other hand, preparation for healthy change may take place. Dreaming involves a process of self-confrontation, concerned not with intelligibility and referential meaning of a given aspect of experience, but rather with the felt reactions derivative of that experience. Given a situation involving unknown operating causes, a personal myth is created through the use of familiar and manipulatable imagery. This myth and its expression in imagery has to be understood not in terms of disguise, but rather as a statement of a problem the answer to which is not within the sleeper's awareness, and at the same time as an effort at mastery. In both the dream state and the waking state we construct myths to explain things we do not understand.
Bonime, a student of Karen Horney and Bernard Robbins, wrote a practical guide (1962) to dream interpretation expressed in an interpersonal framework concerned with values, the growth of self-awareness, and a confrontation with the patient of what he is actually about in his everyday living. Bonime, too, eschews Freudian mechanics for a view of dream symbolism as metaphoric referents. He heuristically categorizes the dream content into actions, individuals, surroundings, and feelings.
French and Fromm (1964, pp. 94-95) emphasize the problem-solving tendencies of dreams wherein "wishes and wish-fulfilling fantasies are only parts or phases of a more comprehensive problem-solving effort:" They explain Freud's failure to appreciate the problem-oriented thought processes of dreaming as due to a narrow preoccupation with infantile wishes and a misguided belief in the value of tracing chains of association. They present a sequence of dreams in the course of a psychoanalysis that richly illustrates the step-by-step path in which the patient manifests in his dreams the gradual unfolding and overcoming of his problems in living. The analyst in this case relies on intuition, empathy and "sympathic resonance" to grasp the gestalten of the dream imagery. French says, "What is present in the dream work, on the other hand, is a practical, empathic understanding of interpersonal relations. This kind of understanding does not need syntactical logic" (p.162).
In the past we have had to rely on the questionable validity of a report of a private experience which nonetheless had a limited usefulness. Scientific research must use data that are public and repeatable in order to establish the community of consensus to which scientific knowledge belongs. Publicly, we have had the reported dream; and now we have the observations of the physiology and behavior of the dreamer as he is dreaming, thanks to the EEG monitoring technique discovered by Aserinsky and Kleitman (1953).
Dreaming appears preponderantly in stage one EEG when it is ascending from stage two EEG, usually after at least a short period of stage four EEG (Kleitman, 1963). Dreaming may occur with or without rapid eye movements, referred to as REMs. The presence of REMs is presumably associated with the liveliness of the dream sequence. When the sleeper was both actor and spectator of the dream he was witnessing, he showed more REMs, as well as more small hand movements, than did the sleeper who was only a passive spectator of the dream. Subjects reported dreams more often when the REMs were accompanied by a large increase in the pulse rate. Slow eye movements, referred to as SEMs, are also significantly associated with dreaming. Kamiya said, "SEMs often build up in magnitude and speed . . . into REMs. Also, SEMs do not cease on the onset of REMs. On the contrary, the REM period is really a period of heightened SEM as well as REM" (Kleitman,1963, pp. 98-99).
Roffwarg, Dement, Muzio, and Fisher (1962) described an interesting experiment in which a judge working with the verbal report of a subject's dream could, without knowing the EEG pattern, infer, with a high degree of accuracy, the direction of the eye movements from the movement and spatial patterning occurring in the dream.
Kleitman (1963) considers the REM-EEG cycles associated with dreaming to be only one manifestation of a basic primitive periodicity of rest and activity that occurs in animals and humans alike, even in anencephalous children and in decorticated dogs. In the newborn human this cycle, of 50 to 60-minute duration, represents a coalescence of several periodicities; this cycle increases with age to 60 to 70 minutes in children of nursery school age and 80 to 90 minutes in the adult (Roffwarg, Muzio, and Dement, 1966).
Aserinsky now questions the one-to-one correspondence between REM activity and dreams. He describes bursts of REM activity that occur during a so-called REM period sometimes not accompanied by dreams. A twenty-minute REM stage does not mean a twenty-minute dream.
Studies comparing the waking state with the REM periods (REMPs) show much more similarity than the REMPs have with the other stages of sleep. The auditory-evoked response, AER, simulates the waking state amplitude in contrast to the increased amplitude observed in N-REM sleep (Weitzeman and Kremen, 1965). Also, neocortical cells which initiate corticospinal movements have almost the same threshold (slightly lower) during REMPs as they have during states of quiet wakefulness. In the other stages of sleep the threshold is much higher than during wakefulness. In fact, all the evidence shows that there is a heightened excitability of the sensorymotor cortex in REMPs that is probably general for the entire neocortex as well as the vestibular and bulbar reticular formation during REMPs than during other stages of sleep. Although gross body movements are inhibited during REM periods, studies show that fine body movements, measured by a strain gauge, at the throat, wrist, ankle, upper arm, shoulder, and abdomen, were markedly increased. These fine body movements continued throughout the REMP and were almost completely absent during nonREMPs (Baldridge, Whitman, and Kramer, 1965). Interspersed with these fine movements arc electromyographic recordings which show a reduction, often to zero, of muscle potential. The characteristic low-voltage desynchronized EEG pattern shows, in addition, 2- to 3-second "sawtooth"-shaped waves just prior to or coincident with clusters of eye movements.
Erections occurred during 80 per cent of REM periods, more frequent in the latter part of sleep time. Erections could not be accounted for by bladder pressure, local irritation, or sexual deprivation. Most of the subjects freely expressed erotic feelings in waking life, yet rarely reported any erotic content in the dreams that occurred during the erection-REM cycle. When deprived of REM-erection time, there was a compensatory increase on subsequent nights in both REM time and erection time, but more so with erection time as there were more erections during non-REM sleep (Karacan, 1965).
There were also increases in respiratory rate, systolic pressure, electrical skin resistance, and heart rate.
It seems to many research workers that the REMPs represent a qualitatively different state and process distinct from both sleep and wakefulness rather than a lighter or deeper aspect of the single state of sleep. This view is not universally accepted within the ranks of the experimentalists themselves. The notion of a qualitatively unique state of the organism differing from both the waking and the sleeping state, once introduced by Jouvet and Courjois (1959), was further developed and elaborated by Dement (1964) and Snyder (1963). An opposing point of view, however, has been put forth by Hernandez-Peon (1963, p. 80) based on direct brain stem stimulation by cholinergic substances. He argues that the so-called emergent stage one simply represents the deepest stage of sleep. Thus maintaining a unitary point of view of a sleep-waking continuum, Hernandez-Peon accounts for the electrocortical manifestations of the REM state as due to the spread of inhibition from the rostro-pontine segments of the arousal or vigilance system to the thalamus. The low-voltage pattern of activity is resumed when thalamic spindle-bursts are no longer sent to the cortex. "The rapid eye movements which appear in bursts during the 'desynchronized' stage of sleep can be accounted for by intermittent releases of tonic inhibition acting upon the oculo-motorneurons in the brain stem, as well as upon the motor cortex" (1963, p. 80). This has been one of the most constructive contributions made toward an understanding of the nature of sleep. Hernandez-Peon demonstrated the hypnogenic pathways by placing minute crystals of acetylcholine into the brain, thereby revealing an extensive but well-defined pathway along the neuroaxis subserving sleep. This technique induced first slow sleep (N-REM) with cortical slow waves, sharp waves in the hippocampus and entorhinal cortex, a slight elevation of the arousal threshold, and a moderate diminution of muscle tonus in the nuchal muscles. Within thirty minutes, more or less, REM sleep supervened with characteristic EEG desynchronization, significant increase in arousal threshold, high amplitude theta rhythm in the entorhinal cortex, practically isoelectric electromyogram, and bursts of rapid eye movements. Subsequent studies revealed that the hypnogenic pathway extended from the forebrain down as far as the upper levels of the spinal cord. Furthermore, he demonstrated that the sleep mechanism consists essentially of a powerful inhibition of the mesodiencephalic arousing or vigilance neurons. The sleep-wakefulness continuum is conceptualized as two reciprocally antagonistic neural systems with an intrinsic rhythmic and automatic activity. The dreaming process, conceptually more speculative, has been explained on the basis of selective disinhibition of the corticolimbic system. This formulation attempts to account for the widespread electrical activity occurring in the cortical areas.
A somewhat similar neurophysiological state to the REMP has been described by Russian writers and others. It is interesting to see that much more attention has been paid recently to what Pavlov, stimulated by Zeleny, called the "orientational reflex." Many studies, mostly from the USSR, but also from elsewhere, have defined this complex as including: overt receptor-adjusting responses; the EEG arousal pattern; increased activity of the circulatory, respiratory, electrocutaneous, and pupillary responses; physicochemical and muscular processes within sense organs that increase their sensitivity and resolving power; and increased skeletal-muscle tension. Pavlov described a preliminary "arrest reaction" associated, it is now known, with stimulation of the thalamic reticular system, and a later phase, preparing for action, "including tensing of the musculature and the GSR in the palms and soles (apparently due to perspiration, which, as barrow pointed out, facilitates gripping) . . ." (Berlyne, 1963, p. 313). More recently, Sokolov (1963) has described the changes in the EEG in their relationship to the extinction of the orienting reaction.
Where the orienting reaction is extinguished, all the reactions disappear gradually but the EEG background is still active. If, however, the extinction process is continued further, the EEG background tends to be changed by the development of slow waves, indicative of the development of an inhibitory state in the cortex. With the development of this inhibitory background there is a paradoxical restoration and intensification of orienting reactions as revealed by exaltation of alpha-rhythm, a cutaneogalvanic reaction, respiratory changes and vascular reactions, all of which are stably maintained in this transitional state between waking and sleep (Sokolov, 1963, p. 289).
It is also noteworthy that the hippocampal gyrus seems to be necessary for gestalt type memory, although its intactness is not required for repetitive, rote-type learning. In humans, stimulation of the hippocampal gyrus does not cause any significant emotional manifestation.
It has also been shown that during the waking state REM rate is a nonspecific concomitant of attentive activity (Amadeo and Shagass, 1963). No significant differences were found between visual and nonvisual stimuli with respect to the incidence of these eye movements (Shimazano, Ando, Sakamoto, Tanaka, Eguchi, and Nakamura, 1965).
Rechtschaffen has established that visual imagery also occurs during non-REM states in stages two, three, and four, but usually with less detail, vividness, or emotional intensity than dreams reported during REM states. He and his co-workers concluded that "subjects reported unique, discrete manifest images and themes which were repeated in the reports from different EEG stages of sleep. We conclude that on these nights dreams are only a part of a larger body of interrelated sleep mentation" (Rechtschaffen, Vogel, and Shaikun, 1963, p. 547)
It is interesting to note that when subjects were dreaming a dream that they were instructed to dream as a posthypnotic task, the REM time was shortened from the control range of 12.5 to 34.5 minutes to the subjects' range of 2.0 to 9.5 minutes. The REM time was shortened even more by increasing the number of elements given in the posthypnotic dream suggestion. Many subjects dreamt about the suggested topic in every REM period of the night. One explanation may possibly be that scanning of recent and remote memory occurs to a greater extent in sleep not influenced by the guiding security of the hypnotist on whom the dreamer relies for emotional orientation and rapport.
Dream recall is directly related to the closeness of the time of awakening to the occurrence of the REMs. If the dreamer was awakened ten or more minutes after the REMs have stopped, there was complete forgetfulness in twenty-five out of twenty-six cases (Kleitman, 1963). References from the more remote past are much more frequent in dreams that occur toward the end of a night's sleep; rectal temperature is consistently lower during this type of dreaming; recall was better for these later dreams; they were longer in duration, more vivid, more emotionally intense, and were associated with a longer period of REM (Verdone, 1965). Correspondingly, the first few minutes of REMPs early in the night show much more relatively unaltered memory fragments of the preceding day or two than do dreams of the latter part of the night (Fisher, 1965).
The elements and personnel of the experimental situation are also incorporated into dreams directly and indirectly from 68.5 per cent (Whitman, Pierce, Maas, and Baldridge, x962) to 21.9 per cent (Dement, 1963a) of the dreams, especially in the early dreams of the first night in the sequence. Certain kinds of personalities seem to dream more frequently and overtly of the laboratory experimental situation. These have been described as the field-dependent type (Witkin and Lewis, 1964) who have less differentiated personalities, have more trouble recalling their dreams and characterologically rely on defenses of repression and denial. Of this latter group who recalled no dreams at all on half or less of REMP awakenings, there was no difference in their neurophysiological behavior, during REMPs and arousals, from the other subjects (Goodenough, Lewis, Shapiro, Jaret, and Sleser, 1965).
There is some evidence that learning and conditioning can take place during an REMP. Subjects can be trained to discriminate between dreaming-REMPs and nondreaming sleep, and signal this distinction without interrupting their sleep except for a slight arousal response during the actual signaling (Antrobus, Antrobus, and Fisher, 1964). Spoken personal names presented in random order during REMPs were consistently incorporated into the manifest content of the dreams with equal frequency for the neutral names as for the emotionally charged ones. However, they were incorporated with decreasing frequency according to their mode of representation in the following order, respectively: assonance, direct, association, and symbolic representation. This incorporation was not associated with any differences from the usual physiology of REMPs (Berger, 1963).
Memory for the external stimuli (numbers) is better during REM sleep than during non-REM sleep. However, when subjects' eyes were taped open and visual stimuli presented during REMPs, there was no obvious incorporation of this into the manifest dream.
Forgetting of dreams by recallers cannot be explained simply by repression; for if it were due to repression, the recallers could not remember their dreams so readily when awakened during or shortly after a dream. Rechtschaffen (1964) suggests that the fact that "the hippocampus is not functioning during N-REM sleep, or functioning quite differently from the way it does during wakefulness, accounts for much of what we know about the forgetting of dreams" (p. 165).
The tendency to formulate the stages of sleep exclusively along an axis of arousal is misleading since the different sleep stages seem to reflect other possible meanings. Thus, most observers agree that REM sleep reflects maximal inaccessibility of the sleeper if a meaningless stimulus such as a sound stimulus (decibel level) is the test stimulus. Contradictory findings strongly suggest that, although inhibition is maximal during REM sleep, significant stimuli need not be excessive in amplitude and may gain the attention of the sleeper more easily in this stage of sleep than in any other. Recent studies reveal the complexity of the memory patterning during different sleep stages. Evans, Gustafson, O'Connell, Orne, and Shor (1966) have demonstrated that meaningful input during an REM phase of sleep can be recaptured at a later date during REM sleep even though there is amnesia during the waking state for the selective stimulus input introduced during REM sleep. Pending further confirmation of this study, one is tempted to speculate about the nature of memory function along levels of consciousness. Thus one can conceive of memory plateaus consistent with the plateaus of consciousness and speculate that a successful "recall" is a function of the level of consciousness at which the memory material is aimed. Crossing the boundaries makes recall more difficult, but tapping recall from the level at which the information is introduced may facilitate recall. To extend the speculation to schizophrenic episodes which not infrequently emerge from a state of sleep, these episodes seem allied with deep N-REM sleep so that on awakening the sleeper is often confused and disoriented. Abruptness in waking is normally more easily achieved from REM sleep than N-REM sleep. Additionally, somnambulism is characteristically seen in deep N-REM sleep. This resembles the "amnesic"-like quality of individuals in fugues and similar states, where gross conduct may not be too strikingly unusual but yet suggests a memory function that is tied in with highly private and implicit or dissociated processes. These thought processes are not amenable to simple articulation since they no doubt refer back to very early experience. They hint at the possibility that deep N-REM sleep is the repository of ill-defined yet significant autistic mentation for which expectation of conversion to normal dreaming and potential recapture is most improbable. We are tentatively suggesting that there are horizontal planes of memory correlating with horizontal planes of consciousness.
Hence, stage three to four, non-REM sleep is much more significant clinically in that it seems to facilitate "acting out" of the vague implicit confusion of one's individual self - in enuresis, somnambulism, flight terrors, etc. Accessibility to learning during sleep has also become an area of increasing scientific interest, but its successful demonstration or the failure thereof will require an appreciation of what constitutes significant adaptive input as against nonspecific input of greater or lesser amplitude.
The area of memory has likewise acquired renewed interest in view of recent studies of the hippocampus. We suspect that memory patterns may be viable within the framework of a particular level of consciousness, but the transmission of remembered experience from one level of consciousness to another is obviously most difficult unless the time interval in change of state is extremely short. Thus, reporting dream material after one has awakened is notoriously difficult for many people. This is not to imply the time interval is the exclusively salient feature in the capacity for recall.
The relatively greater inaccessibility of the individual in REM sleep as against N-REM sleep revealed in the study of auditory-evoked potentials is convincing since Weitzman has also made similar observations (unpublished) in the monkey. One is tempted to infer that the REM state is similar in many ways to the waking state, not in the least of which is the tendency to focal attention. The dreamer is busy dreaming and inhibition at the first synapse affords relative protection against disturbing sensory input unless it is meaningful.
Observations of sleep talking in the laboratory have been reported by Kamiya (1961) and by Rechtschaffen, Goodenough, and Shapiro (1962). The latter authors confirmed Kamiya's finding that sleep talking occurred predominantly in non-REM periods (86 to 92 per cent). They, too, found non-REM sleep talking associated with gross muscle tensions, artifacts, changes in skin resistance, and occasional alpha-activity indicating a temporary tendency toward arousal. Sleep talking that was observed during REM sleep was found to be correlated with dreams.
Bruxism (nocturnal grinding of the teeth) was also studied with the EEG monitoring technique. It was found that contractions of the jaw muscles occurred much more frequently (20.9 per hr.) during REM sleep than in non-REM sleep (5.3 per hr.). Pilot studies of normal subjects showed that tooth-grinding occurred to a lesser extent but also with the same relationship to stage of sleep. Jouvet (1966) found a similar phenomenon in cats. Normally, this may be due to a spread of activity from the pontile reticular formation to the motor nucleus of the trigeminal nerve (Reding, Rubright; Rechtschaffen, and Daniels, 1964). Enuresis, night terrors, and sleepwalking, however, occur invariably during non-REM sleep.
Dement and Wolpert (1958) found no distortion of time in dreams, but that the time in which the action occurs as reported by the dreamer corresponds more or less precisely to the duration of the REM activity. There is something of a tendency to overestimate short time intervals. Experimentally, it has been shown that this tendency is increased by visual deprivation or by a state of depressed affect. Tauber and Green's inference (1962) based on clinical evidence that color was present in the great majority of dreams was supported by the subsequent EEG study by Kahn, Dement, Fisher, and Barmack (1962).
The percentage of sleeping life that is spent in stage one REM "dreaming activity" decreases as a person grows older, starting with 80 per cent in a thirty-week-old premature infant to only 13 per cent in a hundred-year-old individual.
Rapid eye movements occur when there is no possibility of any visual imagery, such as in premature infants, the newborn, and the congenitally blind, thus indicating that the rapid eye movements are an inherent mechanism whose function is not yet proved and are associated with visual imagery only later on in life when visual experience has taken place.
Dream deprivation usually results in irritability, restlessness, and increased appetite. However, Dement (1963b) has reported instances in humans and animals where dream deprivation seems to have no effect.
It is now well established that Freud's hypothesis that the dream is created specifically in response to external or internal stimuli in order to protect sleep was completely mistaken, Dement (1964, p, 149) reported ". . . In all the recent studies of sleep, there has been no finding which confirms the notion that sleep must be preserved or that there is even any desire or advantage in preserving uninterrupted sleep."
Contrary to the assumption of Freud, Sullivan, and others, the physiology of dreaming has very little, if anything, in common with psychotic states. Children and adults suffering chronic psychoses have the same EEG dreaming patterns that normals do.
The fact that dreaming occurs with such great frequency early in life and gradually diminishes as the individual gets older indicates that possibly dreaming serves a developmental function in the physiological maturation of the human organism. Roffwarg, Muzio, and Dement (1966) have developed a compelling thesis favoring an interpretation of the maturational effects of dreaming sleep.
Since we still do not understand what sleep is, whether it be dreaming sleep or non-REM sleep, and since so far we have a right to assume that all living animals have to have some kind of sleep, and since from a clinician's standpoint disturbances of sleep occupy a serious part of our inquiry into a patient's health, a valid inquiry must include a very broad global sense of the sleep mechanisms in the animal kingdom. It certainly is not self-evident that dreaming sleep could be absent from the life program of any animal alive. If we conceive of dreaming sleep as a reflection of the perceptual motor experience of the waking state, this type of sleep would restate the adaptive pattern appropriate to the particular species.
The questions raised by phylogenetic studies cannot be answered easily unless a more extensive inventory of sleep behavior is made of the whole vertebrate kingdom. There are certain consistent findings in the study of placental mammals and the opossum, a marsupial, which indicate that a generalization concerning the existence of REM sleep is applicable throughout. There are species differences in respect to the precise patterns of REM sleep and the fact that the opossum spends some 80 per cent of its time in sleep, of which 20 to 30 per cent is in REM sleep, has led some investigators (i.e., F. Snyder; 1965) to emphasize the antiquity of this neurophysiological process. But if the opossum is a living fossil among mammals (no monotremes, e.g., the spiny anteater or the duckbill platypus, have been studied), certainly the turtles, which can be traced back in time further than the extinct dinosaurs, reveal no REM sleep, according to Jouvet (1965). The pigeon and the chicken show very short bursts of REM sleep. On the other hand, preliminary studies indicate the presence of eye movements during sleep in two diurnal lizard species. The fact that the latter animals have such highly developed vision and oculomotor organization has suggested that specialized receptor equipment may play a role in the eventual neural mechanisms subserving sleep. How the presence of the neocortex, whose limited beginnings are first noted in reptiles and which reaches its highest development in mammals and particularly in man, is integrated with brain stem mechanisms is still far from clear. Recent studies on the frog (Hobson, 1967) have led some to doubt whether REM sleep occurs at that level of vertebrate phylogeny. So far no studies of sleep in fish have been made and formidable technical problems no doubt have contributed to the hesitation in the exploration of sleep in fish. Furthermore, there are few reliable behavioral studies of fish sleep even though certain tropical marine fish evince states of diminished arousal akin to mammalian sleep.
At any rate the existence of REM sleep in lower mammals, decorticate humans, and infants does not preclude the notion of dreaming sleep under normal circumstances since the dreaming process need in no way be "caused" by the neural mechanisms underlying REM sleep. It is merely that certain neurophysiological states may facilitate other higher neural processes. If one conceives of dreaming sleep as a state consistent with the adaptive challenges of the particular species under consideration, one may suspect that perceptual activity of the animal in the waking state is endogenously "reviewed" during dreaming sleep.
Unexpected findings in the lower end of the vertebrate spectrum need not cast doubt on what is solidly confirmed in other areas. The life span and internal clock mechanisms in the animal kingdom are sufficiently idiosyncratic so that patience in our search is more important than premature attempts to resolve "crucial" questions which are only seemingly crucial because our knowledge is still so scant.
Although the physiology of dreaming is fascinating, raises many questions, and serves as an invaluable instrument for monitoring dreams under experimental conditions, the content of dreams can be approached distinctly and separately as a phenomenon in its own right. The range of this content is as enormous and varied as is the range of thought in everyday waking life, encompassing everything at one time or another - every category of mental experience from simple fragmented sensations to profound, prophetic messages.
Sequences of dreams of patients undergoing psychoanalysis have been reported by French, Offenkrantz, and Rechtschaffen (1963), Jones (1962), and Kramer, Whitman, Baldridge, and Lansky (1965), among others. Kramer et al. compared the dreams that were recalled to the experimenter and later reported to a psychiatrist with those which were also recalled to the experimenter but forgotten for the psychiatrist. These latter dreams were characterized by themes of thinly disguised homogenital relations, denial of need for treatment, fear of being injured by treatment, and compulsive handwashing. Some sequences showed progressive movement in trying out in the dream drama feared longings with anticipated rejection, punishment, and later victory. Other sequences showed different statements of the same problem restated over and over again with little or no progression.
Depressed patients, even when improved on imipramine therapy, showed predominant themes of escape associated with feelings of hopelessness or helplessness. Imipramine decreased the amount of dreaming time and was associated with an increase of hostility expressed in the manifest content.
Edith Sheppard first reported in 1956 (Saul and Sheppard, 1956) a method of studying personal attitudes and defensive postures in dreams under the rubric of ego functions measured by a rating scale applied to the manifest content of dreams. She later assumed that ". . . the manifest dream is excellent for studying the ego activities, especially its unconscious activities" (Sheppard and Saul, 1958, p. 237). Ten categories of ego functions were described: Source, Object, Completion, Participation, Expression, Resolution, Logic, Reality, Body Image, and Interrelationships.
Other studies have correlated hostility in manifest dreams with essential hypertension (Saul and Sheppard, 1956); giving and taking tendencies in manifest dreams with gastrointestinal disorders (Alexander and Wilson, 1935); and exhibitionistic and voyeuristic trends in manifest dreams with skin diseases (Miller, 1948). Gordon (1953) has correlated manifest dreams with TAT stories, and Bolgar (1954) has correlated manifest dreams with Rorschach responses. Sheppard (1963) reported a subsequent study by which manifest dreams were rated independently and blindly from the association given by patients in analysis and which were also rated independently and blindly. The independent ratings correlated highly in five major categories - three of hostility, one of genitality, and one of bodily mutilation. DeMartino's study of mental defectives found that subjects with higher IQ's tended to report more complex and mature dreams than those with lower IQ's. He also found that the dreams could well be utilized in much the same manner as standard projective data (DeMartino, 1954).
Markowitz and Seiderman (1963) reported a fascinating study wherein a professional artist made drawings of dreams reported by children. These drawings were then photostated. The parents of the children were shown the dream pictures of their own child together with those of three other children and asked to comment on all four without being told that one of them was based on their own child's dream. In this pilot study they found that parents are more responsive to their own child's dream than the dreams of other children. The manifest content of the dreams of children seem to express their social reality, e.g., a child who "sugar coats" her hostility to her mother in waking life dreams of pouring hot chocolate over her dying mother.
In recent years, beginning with Piaget (1951), dreaming has come to be seen as part of a general spectrum of thought processes, participating in the development of mental activities from infancy through childhood into adulthood. Just as children's drawings, play, Rorschach responses, and spontaneous stories show a developmental progress from the early years of verbal communication through childhood and adolescence, so do their reported dreams. Likewise, just as spontaneous stories, figure drawings, and Rorschach responses are useful ways of approaching the various problems, difficulties, psychodynamics, and diagnostic issues among patients of all ages, so have dreams been useful in the same way. Like other projective techniques, however, the use of dreams relies heavily on the personal resources and interpretive skill of the therapist. Dreaming, which is ordinarily private, uncommunicated, and often unnoticed by the waking person, is the purest form of projective data that we have; manifesting in the cases of the treatment and the laboratory situation the interpersonal transactions that include both therapist or experimenter and the patient or subject.
There is considerable evidence (Tart, 1965) now that the content of dreaming can be modified by hypnosis, conditioning, learning, and the influence of the therapist, or, in the experimental laboratory situation, by personnel. The fact that dreaming is an inherent, cyclical, physiological activity that functions in everyone throughout his entire lifetime does not prevent dreaming any more than other cyclical, physiological processes from being influenced by the complexity of interpersonal transactions as they occur or develop in the course of one's lifetime. Unfortunately, fruitful perspective on this process has been blurred by attempts to reconcile recent research findings with Freud's concept of instinctual energies (Fisher, 1965). As Grinker (1968) and others have pointed out, thought processes, including dream activity, involve very, little energy compared with other physiological processes, and have much more to do, adaptively and functionally, with the processing of information. Piaget has been uniquely valuable in this respect for pointing up the function of dreaming and play in the growing child as intermediary developmental processes in exercising symbolic skill, and in assimilating new information (Green, ig6ia).
In the light of the fact that dreaming occurs with great regularity in all human beings of all ages regardless of what ails them, one cannot ascribe either the cause or purpose of this regular, cyclic, psychophysiologic process to any varying environmental stimulation, such as current emotional conflicts, unresolved infantile wishes, frustrated instinctual drives, or anticipated environmental dangers. All these variables, as well as many other factors, undoubtedly influence the manifest content of the remembered or reported dreams. However, the psychophysiological pattern continues to occur in its cyclic rhythm regardless of the presence or absence of these variables and without being diminished or increased by them. Dreaming time can be interfered with by drugs, by waking, or by conditioned inhibition of dreaming time. Dream deprivation studies suggest that this cyclic, psychophysiologic process we call dreaming in some way facilitates the integrity or wholeness of the discriminating personality in both feeling secure and in alertly discriminating the various aspects of the environment with appropriate capacity for attention and concentration. However, Kleitman (1963) is averse to ascribing any purpose or adaptive function to dreaming. He likens it to any habit which, when interrupted, shows similar symptoms.
In lieu of more precise, rigorous knowledge at this time, we may speculate that our dreams, however influenced they may be by persons, sounds, stimulations from our immediate or recent environment, do manifest, in some way, idiosyncratic representations of felt importance regarding our personal orientation to our values in our daily living. The type of sleep manifested by dreaming may be the neurophysiologic instrument of greatest importance in the lower animals for their assimilation of orienting experiences in space and time regarding food, drink, and enemies, and in their preparation for adaptive responses. Dreaming in humans may result from the cortical participation in this primitive system and probably manifests the generalization (what Freud called "condensation") and abstraction (what Freud called "displacement") of the components of day-to-day emotional experience of feelings.
Condensation, like generalization, gives a common meaning to several different items. In reference to feelings, a variety of feelings separated from one another in time can be apprehended together in a symbol that draws on something they all have in common. Condensation, therefore, is not a "law" of the unconscious, but simply the assimilation of new feelings to old, manifesting the generalization that is characteristic of all mental processes. The affective stress must be changed or displaced in this process. Freud, of course, considered the manifest dream to be always a disguise. Displacement of affect as a disguise can be considered separately, for it is a common literary device used in the form of irony, pseudo-objectivity, and suggestion, in everyday life or in literature, to cloak an affectionate or hostile feeling. Ella Freeman Sharpe (1951) described other psychoanalytic concepts that have been recognized forms in diction and parody for centuries-simile, metonymy, synecdoche, onomatopoeia, parallels, antitheses, repetition, implied metaphor, and dramatization.
Feelings determine direction in human living by the way in which they indicate, when genuine, what is valuable, important, or interesting to the individual, either within or outside of his awareness. These feelings can function like the sensations of animals as indicators of withdrawal, approach, detour, or highly complex presentations of an emotional position or movement in human relationships.
Piaget, like William James, appreciated this cognitive aspect of feelings. He said, "Interests, pleasures and difficulties, joy and success and disappointment and failure . . . intervene here, as regulations of the action constructed by intelligence" (Piaget, 1951, p. 206).
Many studies have shown that dreaming is paid more attention to and is even facilitated in individuals who place more value on the spectrum of feelings, on the imaginative activity which includes introspection, daydreaming, fantasy, and aesthetic activity (Singer and Schonbar, 1961). Hence, whatever the basis of the physiological necessity of dreaming activity, it remains, besides, an additional resource for those who value the cognitive dimension of feelings for enhancing the quality and extent of their living. Added to this is the cultural facilitation of recall in preliterate societies where the social exchange of dream experiences assumes salience (Eggan, 1949).
Thus, the dream, whatever its raison d'etre, can comprise a tremendous variety of suggestive sensations and images. It can present a confusing kaleidoscopic panorama of fragmented auditory, tactile, kinesthetic, olfactory, or visual images, each of which represents an emotional feeling of some value; or it can present a coherent, complexly elaborated product that may even take on all the qualities of a work of art. The cognitive aspect of the dream may be clear and simple or mysterious and bewildering.
The visual mode predominates for sighted people in dreams as in language and metaphor. Visual imagery is a form of organizing information especially suitable to spatial orientation and guidance. Visual forms are also preferred for fine discrimination, as exemplified by the deviation of a needle pointer on a scale. It is also favored for presenting complex, unfamiliar material, where we frequently use diagrams and illustrations; for material that necessitates relatively simultaneous relational comparisons, such as "before" and "after" pictures; and for material from which a person must make relatively quick selections of information from a much larger supply, as in a table or a graph. It is appropriate, then, that our dreams are predominantly visual for those of us who can see (Geldard, 1960).
In the kaleidoscopic presentations of the dream drama, every person, every object, every element, every quality participates in the affective expressiveness of the totality of the particular event or sequence of dreaming. In this way, the parts of a dream are like the lines in a drawing where each line, each element in the picture, whether it is part of a person or the formation of a cloud or the image of a tree, participates in the total organization of the picture; or as in a poem where the sound, meter, rhythm, as well as the sensations evoked by the words themselves, all make up a single totality of affective experience. Susanne Langer (1953) pointed out that the work of art which corresponds most closely to the process of dreaming in its formal attributes is the cinema, where the individual, seated in a darkened room, forgets himself while participating in all the various roles portrayed on the screen, responding to them and to the scenery and background music as a totality.
The most noteworthy formal characteristic of a dream is that the dreamer is always at the center of it. Places shift, persons act and speak, or change or fade - facts emerge, situations grow, objects come into view with strange importance, ordinary things infinitely valuable or horrible, and they may be superseded by others that are related to them essentially by feeling, not by natural proximity. But the dreamer is always "there," his relation is, so to speak, equidistant from all events. Things may occur around him or unroll before his eyes; he may act or want to act, or suffer or contemplate; but the immediacy of everything in a dream is the same for him.
This aesthetic peculiarity, this relation to things perceived, characterizes the dream mode: it is this that the moving picture takes over, and whereby it creates a virtual present. In its relation to the images, actions, events that constitute the story, the camera is in the place of the dreamer (Langer, 1953, p. 413).
This pervasive immediacy and self-enveloping organization by which every element of the dream is related to every other by feeling rather than by natural, scientific, or other kinds of order characterize the dream mode of experience. This is also true to a lesser extent of powerful and original metaphor. In that case an image evoked bywords or sounds can correlate our knowledge and experience in a way that is different from and complementary to the logical mode of correlation. Of course, dream imagery, like metaphorical expressions, can be profoundly resonant and inexhaustible in implication or it may be shallow and trite. A metaphor such as "the bawdyhouse of fame" (Preminger, 1965, p. 494) makes an immediate impact which could easily be expanded into a sermon on the vanity as well as the human cost of status-striving. There are many dream sequences that could express a similar feeling.
The dream, then, is a product of mental activity, unwitting and spontaneous. Although the content may be influenced by many factors, the dream product can be studied without reducing it to any particular single influence that participated in determining this content. As in the case of any other mental product, it is a formidable research task even to try to comprise all the determinants. The dream can be studied in terms of what it expresses and how it expresses it, and of the basic elements that make up its phenomenal world, however it is represented or determined.
Piaget (1951) has described the development of intelligence in terms of the formation, refinement, modification, and elaboration of intellectual schemas from infancy throughout childhood to adolescence. Dreaming, like all representation of affect, also shows intellectual forms. There seem to be developmental changes in the phenomenal appearance of dreams, too. A recent study of stories that children have made up spontaneously between the ages of two and five describes findings similar to dreams of the same age group (Pitcher and Prelinger, 1963). Roughly summarized, one might say that the presentation of space is gradually more developed, with greater area of space and more imaginative and abstract space being referred to with increasing age. Also, the characters or persons in the dream become more generalized and more like stereotypes with increasing age - in other words, there is a movement from literal, concrete events in a small, narrow space toward more generalized and representational events in a larger, more diversified space as the small child approaches school age.
Many workers have contributed to the now well-known fact that considerable information is taken in through man's perceptual apparatus which can be demonstrated in an experimental situation, but is ordinarily not at all available for recall under any circumstances (see the review by Tauber and Green, 1959). Many of the elements that make up spontaneous drawings or that make up the imagery or speech in a dream can be traced back to perceptions that the subjects were knowingly or unwittingly exposed to in the experience of the past few days. These visual elements, as well as verbal elements, undergo transformations and metamorphoses. These transformations and metamorphoses apparently occur outside of awareness about the same time as the actual perceptual experience itself. This is then "played back," so to speak, and further elaborated, or not, in the dreams of the night.
The study of verbal utterances or phonic-like forms in dream states shows that the characteristic experiential and presentational mode of symbol formation and organization prevails even when verbal instead of pictorial forms are used. Werner and Kaplan did a careful analysis of "dream speech" collected by Kraepelin over many years and found that ". . . connotations are still diffuse and interwoven; subjective and objective domains are not sharply distinguished; logical connections are not articulated; vehicles are immersed in affective-sensory-motor states and are typically personal, idiomatic, concrete, and relatively labile in character" (Werner and Kaplan, 1963, p. 244). There is frequently a continuous transformation and metamorphosis of one mode of expression into another-bodily states, postural attitudes, gestures, images change into verbal conceptions and concrete images and vice versa-images quickly express the same notion in verbal form, postural attitude, and bodily states in an almost kaleidoscopic manner. Sometimes it is more ordered and can even be as well organized, we all know, as a theatrical presentation. Freud himself remarked on how well the pictorial and concrete use of many words makes it easy for the dream to represent these words in images, e.g., "superfluous" appearing as an image of water overflowing; "manipulated" appearing as a handshake. The reverse kind of transformation also occurs. Werner and Kaplan (1963) describe the following examples from Kraepelin's collection: the conception "let yourself go" occurred in "dream speech" as "take off the mental shirt collar"; the conception "body and spirit meeting in man" yielded the words "the mushrooms and the angels find each other."
Similar studies, better known, have been made of visual transformations. Fisher (1960) has reviewed much of the current literature. Flavell and Draguns (1957) particularly focused on a historical perspective to microgenesis (the sequence of phenomena taking place between the presentation or occurrence of a stimulus and the formation of a stabilized cognitive response). A recent study of tachistoscopic responses including dreams and drawings revealed a much greater variety and individuality than previous studies. The drawings included "visual after-images; tightly drawn images; loosely organized free floating imagery; and blanks . . . . graphic products are not unlike verbal products . . ." (Corman, Escalona, and Reiser, 1964). Almost 90 per cent of the subjects presented elements of the experimental situation in their dreams. The drawings were rich with imagery suggestive of danger, physical threat, and efforts to forestall some unknown disaster. Conflict areas and adaptive coping techniques were clearly evident, apparently triggered by the situation of the experiment. Diagnostic categories of personalities seem to correlate with certain expressive tendencies here as in other projective data. Subjects of a predominantly hysterical personality showed greater variety of forms; greater freedom to use the entire space of the paper in drawing; more frequent alteration in live quality; and subliminal transformations of the perceptual elements. Obsessive-compulsive persons, in contrast, showed constriction and perseveration. They produced repetitive geometric forms which sometimes became representational, a consistent subject content, constricted use of the space available, and a greater tendency to detail. The authors suggest that the altered state of consciousness produced by the experimental situation - lying still in a darkened room exposed to brief flashes of light and instructed by the authority to "draw whatever images you see" - certainly evokes strong feelings which must play some part in the form and content of the imagery produced.
This altered state of consciousness is characterized by an absence or marked diminution of the usual waking alertness and attention to the variable requirements of the external world. Janet, Breuer, Freud, and others considered this altered state of consciousness to be one particularly vulnerable to trauma, conflict, illness, fatigue, or other stress, following which the unity of the mind is interrupted and a part of it is dissociated. This was early referred to as the hypnoid state because of its similarity to the state of heightened suggestibility and vulnerability of the hypnotic state. This hypnoid state is normally entered into preliminary to sleep. It is also one in which daydreaming and "mind-wandering" may occur. Because of its inadequacy for critical appraisal and intentional productivity, this state of mind is most likely to experience its content in the presentational and expcriential form of symbolization rather than the discursive and referential. This state of mind is deliberately striven for by the shaman who needs to produce a trance, by the priest-doctors of the temple of Aesculapius, by the artist seeking inspiration from within, and by the psychoanalyst who seeks free association from his patient lying on a couch.
The evidence that the laboratory situation enters into so many dreams of subjects, together with the evidence for subthreshold perception presented by Fisher and Paul (1959) and Klein (1959), among others, makes it overwhelmingly clear that the person of the psychoanalyst, together with the entire situation in which the patient encounters him, must at times enter into the dreams of every patient whether overtly or in disguised form. The reverse, no doubt, also holds true. Thus both patient and doctor take in much more of each other than either one is aware of, and this information may be teased out of defensive and counterdefensive operations during their mutual search for truth in the patient's world of experience.
It is apparent from the foregoing that we can no longer approach the problem of dreaming with an exclusively psychological bias or with an oversimplified biological one. The range of our interests has to be extended to include, in addition to the psychological and clinical dimensions, at least two others - the psychophysiological and the social.
Much of this ground has already been covered, and it remains to suggest an over-all hypothesis whereby dreaming becomes integrated into the general adaptive capacities of the organism. We can assume that a physiological mechanism anatomically located in the brain stem enables the organism to reflect periodically on some aspect of its existence and to do this under conditions where the brain, though active, is active in a way that differs from waking consciousness. A number of derivative postulates follow from this general statement.
1. The formal characteristics of the dream have to be understood as a consequence of the altered brain milieu occurring at the time. These formal characteristics include the use of a sensory mode of expression, the sense of immediacy, and the involuntary quality of the dreamer's participation. Under conditions in which there is a relative exclusion of afferent information, cognitive processes move in an autistic and hallucinatory direction. These hallucinatory and autistic processes, whether occurring in states of sensory deprivation or while dreaming, occur because there are, at these times, only two behavioral directions open to the organism. It can seek to overcome the deficit state by achieving a higher state of arousal-one that would establish a waking organism-environment equilibrium; or it can respond in an opposite way by attempting to minimize any arousal impact of the environment. Cognition and behavior are turned about, so to speak, in their relationship to subcortical centers governing arousal and are now in the service of altering an arousal state in one direction or another. In the ordinary course of waking events, a sufficient state of arousal is maintained by everyday sensory stimulation to serve as a necessary precondition for the thought processes guiding activity in the waking state. During sleep, the important thought processes guiding activity do not lead to the actual behavior engaged in by the subject, but become manifest in the periodic alterations in an internal state, the heightened states of arousal characteristic of ascending stage one REM dreaming sleep. Thinking, under such conditions, has the unique qualities that we associate with dreaming; it is thinking in a sensory mode.
2. The possibility of manipulating through the products of an activated cortical state the unstable equilibrium existing during the REM state (unstable in the sense that it can be terminated by strong emotions generated in the dream or by an aversive signal) suggests that the organism learns how to use this state in the service of vigilance needs. Vigilance is here used in its symbolic reference to possible threats or interference with the value systems of the organism rather than in its reference to any physical threat to bodily integrity. Reticular activation is responsive to sensory stimulation, as the now classic studies of Magoun (1952) have shown. Dell (1958) has proposed reintroducing the term vigilance to refer to the nonspecific changes in the arousal system in response to internal and external stimulation. He uses it in the sense that Head (1926) does, with no reference whatsoever to conscious experience. The nonspecific arousal state is one of vigilance and affords a basic mechanism for the translation of a bodily need into behavior. Heightened levels of activity and specificity in the sensory and motor fields that characterize vigilance operations in the waking state are replaced by heightened cortical activation during the dreaming state.
3. In line with this hypothesis, the train of events presumably occurring at the time cortical activation occurs in the REh1 state would begin with an affective residue of the day's experience, translated into a visual metaphor. This would undergo further development as the vigilance needs impelled a longitudinal exploration of the significant connections of the present theme to past periods of life and a horizontal exploration to test its impact on current growth potential and defensive operations. Current feelings reappearing in the dream mode evoke orienting responses, forcing on the organism a reshuffling of value systems to assimilate the intrusive affects. A new equilibrium is arrived at reflecting either positive growth or an effort at maintaining the status quo.
Since alterations in the arousal system come about involuntarily, and since this system is responsive to stimuli along a spectrum of sensory intensity, it follows that the quality of thinking evoked under these circumstances would have certain specific characteristics:
1. It would more appropriately occur in a sensory rather than a discursive mode.
2. Its behavioral effect would be a central one (influence on arousal level) rather than an external one (motor adjustment).
3. The way in which this mode of thinking is experienced would reflect the involuntary and unconscious purposes toward which it is being deployed.
4. Although the whole range of an individual's past experience may be potentially available for use in this manner, the actual material that comes into focus tends to be limited and derivative of a recent event. Such an event may have been tangential to the waking purposes of the individual, but nevertheless touches on less understood and therefore less mastered but yet significant aspects of one's life experience.
5. The essentially involuntary quality of this sensory level of thinking establishes it as an instrument for the conscious reflection of derivatives of past experience in their unmastered and involuntary aspects.
6. Once a life situation is grasped and portrayed in this way, the subsequent development is itself determined by the dynamic quality of the resultant images. Each image is, in a sense, an emotional vector; and the principles governing their interaction and final outcome might be referred to as the principles of dynamic visual metaphor, and probably conform to similar principles in the aesthetics of architecture, painting, and poetry.
Field workers in anthropology have interested themselves in dreams from the point of view of the role dreams play in a particular culture, the light they shed on the customs and traditional beliefs, their connection with the prevailing myths, and their role in cultural continuity. Since dreams are dreamed by particular individuals in a culture, the question arises as to how and in what manner the unsolved problems of the particular individual are related to the unsolved problems that characterize the particular cultural setting. In any given culture there are problems and limitations to human development that are linked to currently inappropriate or inadequate institutions or mythic beliefs in the historical development of that culture. Individuals within the culture may be totally or partially unaware of the inappropriateness or inadequacy of these beliefs and institutions for the problems and limitations they encounter. Dreams have been useful to anthropologists and other behavioral scientists concerned with these institutions and myths.
Dreams of preliterate peoples reflect fragments of the prevailing mythology in a manner that is readily detectable to an outside observer. However they may be manipulated by the individual dreamer, the fact remains that the myth exists as an entity apart from himself, and one that is consciously or unconsciously assumed as real. These socially sanctioned foci of belief come to life in the dream as sources of support or as sources of anxiety, depending on the underlying nature of the immediate conflict. Historically, we may delineate three evolutionary stages in this approach to the study of the interrelationship of dream and myth. The first stage saw the introduction of speculative hypotheses on the connection between myth and dream by nineteenth-century philosophers such as Comte and Hartmann, by psychoanalytic writers starting with Freud (Freud and Oppenheim, 1911), and further developed by Abraham (1909) and others. The second stage witnessed the emergence of ambidextrous scholars such as Rivers (1923), earlier, and Roheim (1952), Devereux (1957), and others, more recently, who were knowledgeable in both psychoanalysis and anthropology and who sought and found confirmatory evidence in their field studies, of classical psychoanalytic tenets. Current trends, characterizing stage three, reflect a radically different approach to the problem shown by an emphasis on manifest content and by the introduction of quantitative measures in the assessment of dreams and culture. The approach has become more open and exploratory and less concerned with the validation of a priori psychoanalytic concepts (cf. S. G. Lee, 1958, on social influences in Zulu dreaming; the studies of Yir Yoront dreams by David M. Schneider and R. Lauristan Sharp; the study of the Caribbean by E. A. Weinstein, 1962; and the study of dreams from Hopi informants by Dorothy Eggan, 1949, 1952 and 1961). Eggan provides many clear examples both of the general cultural referents of the dream and the specific dynamic interaction between manifest content and the Hopi myth and folklore. On the question of the general cultural referents of the dream Eggan writes (1961. p. 552): "The answer to the question of whether dreams can be used cross-culturally lies in part in the degree to which dreams can be considered both a projection of the personality and the reflection of the culture. On these points there is much affirmative evidence, both experimental and ethnographic."
Bourguignon (1954, P. 268), in a study of Haitian dreams, comes to somewhat similar conclusions: "Dreams furthermore act as channels for the development of idiosyncratic modes of worship and lend support to whatever mythology exists, which itself is largely based on anecdotal material about the gods. This mythological material, in turn, furnishes the basis for dream interpretation and for the manner in which dreams are experienced."
When we come to explore the relationship of myth and dreaming within the framework of our own existence, there are points of similarity and difference to the situation prevailing in primitive cultures. It is the same insofar as myths exist and gain expression in the content of dreaming. It is different in that, in contrast to the relative ease with which myth can be discerned in primitive society, the discovery of myth in our own milieu involves the effort of taking a look at our own insides - a feat even more difficult for a society than for an individual. Sapir (1929), Kluckhorn and Murray (1953), Opler (1956), and others have called attention to the cultural patterning that plays so large a part in our lives. We are subjected to this cultural patterning before we are aware either that it is occurring, or aware of anything about the nature of the patterning. As humans, we find ourselves in the self-conscious and often difficult position of having to take a second look at a rather fragile and vulnerable product which is not by any means completely of our own making. The overt difficulties, the symptomatology of illness at a manifest social level are receiving more and more attention. The covert influences remain to be uncovered and understood in their influence on the individual.
Although psychoanalytic writings shed light on the mechanism of unconscious processes - namely, how the individual copes with forces influencing his behavior and which are not understood by him - there is a great deal of confusion, disagreement, and ignorance about the source and nature of these unconscious factors. It is in relation to this problem that concern with social myth assumes importance. Here we have a reservoir for what is collectively unknown or unconscious, and one that in some manner articulates with what is personally unknown or unconscious.
With regard to the dream, our main emphasis as therapists has always been on the characterologic and personal conflictual referents of the symbols. Each dream element, however, expresses not only the personal and subjective, but also a historical and social referent which actually exists or did exist. When a woman dreams of a reference to her own sexual organs as a head of lettuce (Ullman, 1960) encased in the empty shell of a cantaloupe situated on the shelf of a supermarket, she is saying something about her own personal sexual problems and at the same time making a statement about an aspect of social life. The personal referents arouse our interest. The social referents are generally not pursued to any great degree.
The personal referents may be analyzed in relation to the following variables: involvement occurs in a situation of incipient sexual activity, apart from her own will and intent, and at the instigation of her husband; affective concomitants of irritation, compulsion, guilt, and constraint; and resolution through pseudo-acquiescence and preparatory sexual activity involving the use of a diaphragm. Here we see the disunity between behavior, affect, and symbolic expression.
The important point, however, is that, although the factors predisposing this individual to this disunified reaction are imbedded in her own genetic development, they can emerge only in the presence of existing social referents that can be used or misused for the purpose of rationalization. These social referents are:
1. We live in a society where the capacities of individuals are sometimes treated as objects divorced from the person: labor, brains, beauty, talent, sex.
2. These separated capacities are bought and sold.
3. The exchange value and laws of the marketplace tend to automatize and impersonalize the transaction.
4. There exists in the nature of the external referent a detachment or separation of the individual from the commodity he needs or uses. His real relation to the commodity is obscured and his relationship to it is determined by its manifest elements - the object exists as something apart from himself which may or may not be purchased.
These external or social referents reflect significant aspects of the social structure. They assume importance when one considers that insight is not knowledge alone, but knowledge combined with the ability to change behavior. A new equilibrium through insight cannot be achieved unless and until it can be experienced in activity.
It is, of course, a relatively easier task to expose a neurotic mechanism than to change it. The difficulty of effecting the change, the working through, the struggle against resistance, is one that involves not only the exploration of how these mechanisms articulate with other dynamic aspects of the personality, but, of equal and perhaps greater importance, how this trend "pays off" - that is, the pragmatic value created by the sociopathologic environment bathing and nurturing the trend. The individual is pulled back not only by the weight of his own past experience, but also by the external reinforcement that is ever on hand in the surrounding social milieu.
The view presented differs essentially from the classical Freudian position insofar as it considers the source of unconscious motivating influences as linked to specific experiences in a given social and cultural milieu and not as originating in the biological nature of man, or as due to man's inherent vulnerability because of his extreme dependence on symbolic processes. Furthermore, it assumes no a priori identification of unconscious processes as intrinsically of potentially troublesome. This point of view is in line with Fromm's notion of a social unconscious, one that is something currently recreated for each individual as he participates in the cultural matrix long before there is any clear registration in awareness of the nature of the acculturating process. It is essentially a unitary view of man's nature and predicated on the view that where pathology exists in the psychic sphere, as well as in the physical sphere, our first task is to gain an accurate knowledge of the exact nature of the noxious agents at work. When functional alterations in consciousness occur, as in states of dreaming, the key to their understanding lies not in such dualistic concepts as the return of the repressed and the corollary concepts of wish fulfillment and disguise, but in the basic notion that an individual is struggling to express under conditions of altered brain function the totality of factors, some known, some unknown, governing his reactions to a specific life experience. While dreaming, no less that while awake, we are dealing with the same unitary structure, capable of the same logical incisiveness, but functioning under different conditions of afferent input, internal organization, and behavioral effect. We are dealing not with a fragmentation or compartmentalization of the psyche, but rather with the relative dominance of a concrete and experiential mode of expression over an abstract and referential mode.
However, there is much of Freud's contribution that still stands; for example, day-residue dreams, especially those in the early part of the night, contain much material from the previous day or two which, at the same time, express deeper feelings of a more problematic nature that the dreamer is not aware of in his daily waking life. Unresolved feelings linked to memories of early childhood are expressed in dreams, but they occur toward the later part of sleep. Spoken words in dreams are sometimes repetitions of actual spoken words from waking life. Freud's insight into the defensive aspect of minimizing and forgetting dreams holds true, although most failure of dream recall can no longer be ascribed to repression. Affects in dreams are much less altered or distorted than ideational material, as Freud noted. Also, Freud emphasized the fact that throughout sleep we know we are dreaming and can exercise our preconscious wishes to observe and enjoy our dreams, or to wake up for some particular condition. However, there is no convincing evidence that dreaming protects sleep from interruption, even REM sleep. Nor is there any evidence that infantile sexual wishes are a necessary, if not sufficient, condition for dreaming to take place.
What the therapist does with a reported dream usually reflects the style with which he treats any other reported experience that the patient brings. In the classical psychoanalytic style he would wait for the patient's free association to the elements of the dream and ask questions or direct his verbal reports to the end of having the patient "discover" his infantile sexuality and aggression, and eventually his castration anxiety, primal scene, Oedipal complex, and so on. Needless to say, the literature reveals that the Jungian analyst, the Adlerian analyst, and other disciples of various psychoanalytic theories will respond in such a way as to elicit from the patient the material that will, in the course of time, be more and more expressed in the language and terms of their theory since that is the frame of reference with which the analyst himself is ordering his own experience. However, as Clara Thompson (1950) showed, nearly all the well-known psychoanalytic theories have a valuable contribution to make and need not be mutually exclusive. In fact, there is much to be gained from appreciating the contribution that each makes to the understanding of human behavior and mental illness, and it remains for current workers to see in what context and under what circumstances each contribution has its special values and limitations.
Nonetheless, it is important to have at least a heuristic framework within which a therapist can order his responses to the patient's dreams. It seems useful within the clinical setting to order the communication of dreams and other transactions to four main categories: educational or problem-solving; emergency-coping; comfort-seeking; and simply or playfully expressive and sharing for its own sake. In regard to the last-mentioned category, it is interesting to note that the word "dream" is an Anglo-Saxon noun having a primary meaning in Old English of "melody, joy, or gladness." The Swedish form "dröm" has a direct subassumption of idleness and vacuity. In old Frisian, "dram" also means "(shout of) joy."
Most of the dreaming reported by patients and published in psychoanalytic literature before and after Freud, including contributions of the neo-Freudian, have to do primarily with the problematic aspect of human relationships. This, then, is the first task of the therapist in the beginning of his treatment of any patient: that is, to use the reported dreams, his observations of the patient, his personal response to the patient, and all the usual clinical information to try, at least, to arrive at a tentative formulation of the most significant problems that life has been proposing for this patient and the choices and attempted solutions that the patient has made in the face of these problems.
As Freud observed, and many others have confirmed, the first dream or first few dreams that the patient reports more clearly express his significant interpersonal difficulties than most dreams that are reported later in treatment. However, although the patient may communicate more to the therapist at this point, via his dreams, than in other aspects of his communication, he is frequently much less receptive at this time to interpretations of this material. Without entering into the controversial problem of the timing of interpretations, it can be simply stated that the therapist endeavors to gauge the patient's receptivity and to order his own style of presentation to what the patient can most usefully receive. As one does not speak intimately to strangers (although in some circles it now seems fashionable to describe one's sexual and analytic intimacies at cocktail parties and discotheques), so the analyst must speak within the limits of the patient-therapist relationship as it exists at that point in its development. In some cases there is an early and deep rapport; in others, the therapist must work over a long period of time to develop such a rapport. In America, particularly, this endeavor may be complicated by the widespread habit of pseudointimacy wherein the patient and analyst may collaborate in a type of language and gestural display that tokens intimacy without actually contributing to it.
Bonime (1962) has pointed out how the dialogue between the analyst and patient concerned with interpreting a dream can become a kind of subtle clever filibuster that goes on and on without paying attention to the task at hand. Of course, these kinds of resistance also occur in the transactions between analyst and patient that do not involve dreams, but it is still useful to look at them again, including the well-known dodge of changing the subject immediately after in interpretation is made. Cynicism, of course, is a time-worn defense against responsibility; and so is the indistinct blurring of communication so that the patient's sentence that seems to have started out being meaningful ends up in a vague, drifting note with the implicit implication that the analyst is supposed to know exactly what it means. Then, of course, there are all the devices described by Stephen Potter, in the "one-upmanship" type of evasion, in trying to score on the analyst by being "one up" in one way or another. Another type of resistance that also applies to dream analysis is the intense dedication that the patient expresses, wittingly or unwittingly, to his "sick self." And, of course, there is the frequent use of the device of overwhelming the analyst with the abundance of dreams and their minute detail, or trying to sidetrack the whole focus by inappropriate documentation. Then, there is the very common escape into a preoccupation with theoretical dynamics or, even more blatantly, the verbal jargon of psychoanalysis. The more naive patient with a less sophisticated repertoire may simply avoid the issues by an overenthusiastic acceptance that undoes the whole communication at the same time that he appears to be cooperating so eagerly. Artificial exaggeration of feelings, helplessness, and the "flight into health" are also familiar ways of dodging.
The analyst can avoid many of these resistances by taking pains to avoid certain familiar pitfalls himself. He must avoid a mutual obsessional preoccupation with trivial and irrelevant material, thus unwittingly collaborating with the resistance of the patient. He should not practice a detached avoidance of emotional engagement with the patient. He should not neglect the patient's genuine, though futile, efforts to make sense while floundering about. The analyst must actively intervene when he sees the patient is genuinely floundering and give him some information that will help him get his bearings.
Transference, one of Freud's most important discoveries, must be considered in this context. The analyst must be careful not to arbitrarily assign himself to all the transference problems that the patient experiences or to the various roles that authority figures and others play in the patient's dreams. As a rule of thumb, patients from the well-to-do middle classes tend to see the analyst more often symbolized by a member of the service professions than by a frightening authority figure. For example, the figure representing the analyst that frequently occurs in dreams is the train conductor, the bus driver, the taxi driver, the barber, the doorman, the headwaiter, or the beautician. Finally, it is important to state that working with dreams can be genuinely frustrating and difficult for both patient and analyst without being a reflection on the sincerity and dedication of either partner to the therapeutic enterprise. It is a mistake to misinterpret every difficulty and frustration in the course of analytic work as a conscious or unconscious "resistance" to analysis.
Although the dream is a created product by the dreamer and reflects the dreamer's personality, culture, language, and current style as much as any other product that he might create, the dream does not especially lend itself to the purpose of creating a work of art for the community to which the patient belongs. By the very privacy of the dreaming process and its exclusion from the waking life of historical continuity and communality, the activity of dreaming is handicapped for such creative production. Poems and scientific discoveries arising in dreams (Coleridge, Kekule, Poincare, and others) are a testimony to the enormous creative power of the dreamers rather than a manifestation of a special capacity for dreaming to do this kind of creating. There may, however, be some individuals who dare to show more of their creative capacities during their sleeping life in dreams than they can show or exhibit in their waking life. But this is merely another example that the dream reveals more of the dreamer, sometimes, than any other expressions he can make in waking life. Nevertheless, it is very unusual among artists, writers, musicians, and philosophers to produce any significant work in their dreams.
As for the clinical use of dreams in the treatment of infants, children, juveniles, and adolescents, this varies according to developmental level. With very young children from two to five, reported dreams have much more to do with the immediate problems they are coping with in everyday life. Also, in the very early years dreams are not distinguished from waking life. A three-year-old once reported an experience that happened during the night involving her parents and her five-year-old sister, and she was quite annoyed and stubbornly insisted that they had participated in this experience with her, when they said they knew nothing about it and told her that she had been dreaming. In this way she learned what the word "dreaming" meant. Children's play at this age with their dolls and other toys is much more revealing of the interpersonal transactions of the family life in which they participate than their dreams. This may be true because of the limitations of their verbal conceptualization and formulation for communication. For example, a two-and-a-half-year-old little girl reported dreams of riding in a bus, playing in a playground, and other samples of everyday waking activity that she was currently enthusiastic about. However, in her doll play, with very few words, she showed the mother doll taking the pants off the father doll and putting them on herself; and in another scene showed the mother doll trying to flush herself down the toilet. From four to five, children tend to dream more of animals in a way that represents aspects of human beings, just as the animals do in the animal stories that are read to children, and the cartoons that are shown to children, and in the children's lore over the years. There are the good animals and the bad animals, and the stingy animals and the generous animals, and the timid animals and the brave animals, and so on. From five to seven, according to the Ames study in New Haven (1964), most children experience a great increase in the frequency of nightmares with many dreams of being chased by bad animals or bad people; activity with fire, water, and earth; fighting and punishment dreams; and they are beginning to examine the differences and similarities between the dreams they have during sleep and the fantasies of their waking imagination.
Like any other transaction there are many levels to the communication and interpretation of a dream. It is difficult to make clear outside the clinical context why one interpretation is preferred to another at any particular time. This becomes more clear in the sequential dream analysis reported by authors such as French, Offenkrantz, and Rechtschaffen (1963).
Considering the complex intricacy of this experience and all of the richness inherent in it at any given moment, it is remarkable and puzzling that our imagery is actually successful in evoking similar feelings in other persons. But it is only puzzling when one is confused by the myth of the isolated, gloriously unique individual. Man is not creative out of his separation from nature and other persons; that is the path to insanity and sterility. Man is creative out of his vital participation in nature and the lives of others. "Interpersonal" refers to an existential aspect of man, not a mere social qualification. When we see people participating in the same reality, then it is not puzzling that their unique personal experience of a poem or a dream is both in agreement with and different from that of others. It is at this point that the movement of the creative process from its subliminal depths of unnoticed participation, and from the private revery of sleep, has achieved its fullness in the shared interpersonal experience" (Green, 1961a, pp. 726-740).
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 The question of other determinants involved in the choice of the visual mode is further explored in the section Psychophysiological Considerations.
 We may note an interesting point of contrast between Freud and Fromm. In the case of the former, appearance was taken for essence in his interpretation of the social scene and in his use of it in the development of a psychological system. For Fromm, the appearance provided clues to what was socially unknown but not unknowable, a point of view which ultimately led to his concept of the social unconscious.