Reprinted from The Journal of Nervous and Mental Disease, Volume 129, No 2, August 1959
Whatever the biological function of dreams may be for the human organism, their usefulness to the psychotherapist rests upon one intrinsic quality, namely, their remarkable capacity to integrate past experiential data with current life situations in a manner that discloses more significant information pertaining to current conflicts than is available to the individual at any given moment in the waking state. The question may be formulated in another way: Why is it possible for an individual, while asleep, to experience in the form of dream consciousness all of the forces at work in a current life situation, and to present them with due regard to their relative importance and manner of relatedness, whereas, by contrast, they are experienced in the waking state in a fragmented, partial, or expedient manner?
Three sets of conditions all uniquely pertaining to the sleep state have a bearing on this question. Sleep is characterized by alterations in the physiology of the cortex; the occurrence at times of partial cortical arousal experienced as the dream state; and the absence of communication needs during the sleeping phase of the sleep-waking cycle.
In previous communications (1-4) attention was called to certain physiological considerations and their possible bearing upon our understanding of the formal aspects of dream consciousness. These formal aspects include the employment of concrete means of presentation (predominantly in the form of visual imagery), the sense of immediacy (the dream as an experience in the present), the involuntary quality (the enforced nature of the dream experience), the spatial and temporal distortions, and the transgression of the laws of logic. It was suggested that in the absence of the continuous afferent stimulation characteristic of the waking state, the integrating activity of the central nervous system is qualitatively altered. Stimuli arising during sleep, whether of a somatic or psychological nature, are not identified in their spatial and temporal context. They are not accurately conceptualized. Their manner of integration remains (in the case of physical stimuli) or is reduced to (in the case of psychological stimuli) a sensational level. Two illustrations may clarify this statement. When a physical stimulus is experienced during sleep, it is not experienced accurately for what it is, but the sensory quality does register. A sudden cool breeze, for example, may give rise to images of a violent hurricane or snowstorm. What appears as the exaggerated quality may also be appropriate as an indicator of the relative sleep-disturbing potential of a stimulus suddenly appearing in an otherwise quiescent sensory field. The outside stimulus has now been transformed into a dream image replacing the outside stimulus. As an image, it is in turn experienced sensationally, e.g. as if it were being perceived. By virtue of the existence of reverberating circuits between the cortex and the subcortex, the dream itself is a source of stimuli impinging upon the ascending reticular system in the brain stem raising or lowering its arousal potential.
An analogous situation obtains in the case of psychological stimuli arising during sleep, presumably around memory traces of a recent event. In this case, however, a reduction process occurs. The abstract conceptual elements denoting the experience are reduced to a sensory form. In the case to be presented, the probing activity occurring during the analytic hour was depicted in a dream in imagery involving a peeping Tom peering through a window into the patient's room. The subsequent course of events in relation to the activating system is as outlined. Thus, despite the source of the stimulus (exteroceptive, enteroceptive, or psychological) or the nature of the imagery (simple or complex), the dream functions as a sensory stimulus and as such plays a role through its effect on the arousal center in bringing about either full awakening or the return to a deeper and dreamless sleep.
In two of the papers cited above (1, 2), the theory offered to explain these features -of dream consciousness was based on the Pavlovian concept of the altered relations between the primary and secondary signalling systems during the transitional stages between deep sleep and waking. Pavlov conceived of the primary system as concerned with direct signals of reality whereas the secondary system, built up on the basis of language, enabled the human organism to guide its activity through signals of signals in the form of verbal abstractions. In the transitional state, the primary signalling system assumes dominance over the secondary. Under these circumstances all stimuli, including the conceptualizations associated with past experiences, are integrated at a sensory level and appear to the sleeping individual as direct signals of reality.
The second set of conditions has reference to the temporary quality of dream consciousness. The dream occurs at a time when the cortex is in a state of partial arousal. The consciousness at this time is a transitional one and is unstable in the sense that its resolution has to occur either in the direction of awakening or of returning to sleep. It is the individual's biological environment which controls this state of affairs. Consciousness participates by influencing this environment in a certain way. By a sequential series of images, the individual forms a statement that represents a total assessment of the currently disturbing life situation as well as the defensive mechanisms whereby it can be handled. In so doing he transforms the psychologically disturbing event into an evaluative stimulus which in turn determines whether full arousal has to occur or not. Thus in sleep he is confronted by the biological necessity to depict the experience in a way that enables it to play a role in arriving at one of two entirely different states of being - sleeping or waking. While awake, the individual is not forced to make a decision to alter his state of being in any such total sense.
This formulation suggests the connection between transitional or dream consciousness and the vigilance needs of the organism. With the dissolution of waking consciousness, the individual temporarily suspends his ties to the outer world. Transitional consciousness; linking past data to currently acting stimuli, provides a means of assaying disturbing events in regard to the relative safety or danger associated with continuing sleep. To be effective as a vigilance operation, the dream has to say as much as possible about the disturbing event. Conceptions incorporated into the concrete imagery of the dream integrate many experiential fragments from the life history of the individual, unconnected in time but connected in their relevance to the current problem.
One further condition makes the sweeping interpretive power of the dream possible. This has to do with the absence during sleep of the need to communicate the implications of the threatening event. This makes it relatively safe to experience them. It is only in the waking state that communication through language is possible. Language may appear in the dream, but it does so within the setting of concrete imagery and for the purpose of developing the sensational impact of the imagery. When the dream is recaptured in the waking state, it is as an anomalous fugitive from the sleeping state. To transform it into an instrument for use in the waking state now involves an uphill struggle. Language, in the form of relevant associations, enables the element of communication to come into the picture. What occurs beyond this point in terms of the contribution the dream can make to a deeper level of understanding in waking life is then a function of the nature of the therapist's efforts and the patient's neurosis.
Some of the theoretical points outlined will be considered in relation to the following clinical material.
The patient is a 30 year old woman, married for ten years, with one child of five. She has been in psychoanalytic treatment for three months. Difficulties in many areas of living finally culminated in her decision to seek help. Her complaints were:
1) General feelings of inadequacy and dependency in her marriage. She wants to, but cannot reciprocate the love and support her husband extends to her.
2) Specific sexual difficulties. She has never experienced orgasm and engages in the sexual act in an inert fashion to satisfy her husband.
3) A sense of inadequacy and lack of self-confidence in her work as an interior decorator.
A specific situation actually precipitated her into treatment. A close and enduring friendship with another married woman terminated in a violent and recriminatory manner. The two couples had been intimate friends over a period of many years. The patient had a dependent, anaclitic relationship with this woman and the break was followed by a profound sense of loss, depression, and continual preoccupation with the affair.
Briefly, although she appears to be an individual with many assets, including a generally attractive personality and a lively intelligence, she has, despite good intentions, shown a penchant for getting into difficult personal, situations and always needing a stronger figure to rescue her.
Her initial reactions in treatment might best be described as "protective inadequacy." Her feelings of inadequacy were so expressed as to always contain an apparently logical and therefore compelling invitation to the therapist to step in, give advice, and assume the role of being the sole active agent. To the newness of the treatment situation she added a gratuitous aura of mystery; to the problem of being a novice at dream interpretation she added the further problem of feeling a deep estrangement from her own dreams. One encounters a variety of reactions by patients to the challenge of working on dreams. At one extreme is the "I can do it myself" group. At the other, which includes this patient, we have the "I know it's my dream, but I can't do a thing with it" category.
Two sessions before the hour to be discussed, she presented the following dream.
"Milt [husband] and I and two others were in the dream. He and I were watching someone shinny up a tall pole, a flag pole. When he got to the top, he lay down and relaxed. Milt asked, 'Do you think we ought to try?' I said, 'You go first.' He did. Then I did. We were both relaxing on top and watching the others go down. One got down by jumping. I started to feel very uneasy. I said to Milt, 'You'd better go first.' He slid down halfway and jumped the rest of the way. He said, 'Okay, you choose your way.' I was frightened but found that I made my way down easier than the others by grabbing the circumference of the pole and sliding all the way down."
Her initial response was, "This makes absolutely no sense to me." When efforts to pursue the dream directly failed, the therapist raised the tentative speculation that perhaps some of the symbols expressed in the dream might be related to matters of a sexual nature.
A grudging admission brought up the next impasse, verbalized along the familiar lines, "So where does that get us?" Still in the dark as to why she had the dream at this particular time, and what it meant, the therapist continued his questioning. The next one apparently reached its mark. I asked her what she had been doing and thinking just before she had fallen asleep. She suddenly remembered that she reluctantly had had intercourse with her husband. The feelings of distress in connection with this, which she had formerly dealt with in a general way, now had to be spelled out in relation to a specific recent experience. These included all of the feelings associated with her contradictory state of inner resistiveness and outer compliance. She felt hypocritical, guilty, inadequate, and annoyed. The important point, however, was that this particular question punctured the amnestic facade that enabled her to look only in the therapist's direction for help with the dream. Behind the conscious and, as far as it went, honest conviction that she was cooperative in working on the dream, she was at the same time engaged in a series of fencing, hiding, shielding, and withholding operations. To have continued in these neurotic defensive maneuvers in the face of this direct question would have involved her in the act of consciously lying. This she was not prepared to do. We are not concerned here with the meaning of the dream, but rather with the following sequence of events.
First, the patient's efforts to cope with the problem of dream interpretation followed a path that was consistent with her life-long anaclitic pattern of relatedness. She was structuring the therapist as the Delphic Oracle, to whom she could come for the interpretation.
Second, therapeutic intervention disclosed both the source and manner of her own participation in the joint task of dream interpretation.
By error, the patient came exactly one hour too late for her next appointment and could not be seen. The hour she did come was one which she had had up to two weeks before, when it had been changed to the preceding hour. She had forgotten about the change, despite the fact that the week before she had come at the new time. She was very chagrined and troubled by her mistake.
In the next hour, she presented the following dream and up to a point seemed to interpret it correctly. She had had this dream on the night following her last therapeutic session.
"The setting is a school or college, with tall buildings around a campus. The atmosphere is rural or suburban. There is a young man trying to see into a window. He is a peeping Tom, but not exactly. There is a man and a woman there, I'm not sure, but they may have been making love. The man was going through a very precarious situation. He was walking on a ledge as he was trying to look in. The woman came to the window and was very indignant. The man came close to falling off the building and breaking his neck. Then the scene changed. I was in a locker room. I had gone swimming. It was a very involved, complicated place. I was looking for my locker and a dressing room. I had the feeling I was going to find it."
Her own interpretation established the following connections.
1) She felt that the dream referred to the probing activity of the previous hour.
2) She felt it had to do specifically with the sexual material.
3) She recognized the element of danger. She could not relate it to the therapist, but only to the sense of danger she felt at those critical moments when she feared a catastrophic break-up of her marriage.
Beyond this, any further direct interpretative work on the dream was impossible for her. However, other associations occurred during the hour which she didn't fully understand. Their occurrence revealed a partial, fragmentary grasp of their relationship to the dream.
1) She recalled an earlier dream at the time of her pregnancy - one which had as its theme being incarcerated in a place where she was being taught how to be a doormat and was finally rescued by her husband.
2) She recalled this as the only dream prior to the present one which she felt she had interpreted. She herself at the time thought it had to do with her pregnancy and that having a child would make a doormat out of her.
3) For the past few months the patient has again been trying to become pregnant. She is still ambivalent about it, but less so.
4) She spoke about her great dependency on her husband and his role as rescuer in her life. He had initially opposed her coming to treatment and had attempted to act the role of psychiatrist to her.
Based on the associative data as well as my knowledge of the patient, I felt that the dream dealt with a whole array of material, not clearly perceived consciously, but all related to and following upon the first effective tampering with her dependent structure.
Fundamentally, the dream revealed a wealth of information concerning the situation between the patient and the therapist. The patient believed herself to be in a state of frank, open, and direct communication with the therapist. The real situation was otherwise. The therapist was on the outside and desperately trying to get a look in, an action which was resisted and warded off. The man with her in the room was also the therapist on the basis of previous hints of erotic transference and the absence of any expression of erotic feeling toward her husband. It was as if the therapist, having succeeded in exposing her negative feelings toward her husband, might now discover her positive feelings in fantasy form toward the therapist. This constituted a source of danger to her because it would leave her without that inner sense of independence and aloofness which existed as her only compensation for the self-enslavement she structured for herself. In view of her remarkable dissociative abilities, however, the danger was not yet directed at herself, but toward the therapist. This was so because, as symbolized by her not coming to the preceding hour, she was still capable of warding him off, and - in effect - throwing him off the ledge. Her faith in her neurotic solutions emerged in the ending of the dream in which she is seeking a locker and had the inner certainty that she will find it, even though it was a bit more complicated than she had expected. The women's locker room was a way of flaunting her feelings of safety from men. Here she could dress with no peeping Tom to look in on her.
The situation was somewhat analogous to the state of affairs existing at the time of her pregnancy. Here again, an outside agency, this time in the form of a child, threatened her dependency pattern and necessitated a rescue in the form of shifting the new responsibilities over to her husband. She had some identity in her relationship with her husband whereas, without him, she would be an anonymous doormat. At the point where the treatment, by virtue of her erotic fantasies toward the therapist, threatened this relationship, she symbolically sacrificed the therapist.
This dream has been presented in order to illustrate more clearly the following theoretical points.
1) The dream, in its connection with its vigilance function, is concerned with reality events that upset the equilibrium of the individual. In this instance, the vigilance needs are aroused by a threat to the psychological structure following upon the interchange during the first hour.
2) The recency of this experience as well as its disturbing quality accounts for its reappearance during sleep.
3) The experience gains expression in the dream in the form of concrete imagery.
4) The developing imagery expresses relevant historical connections to the current threat as well as the upsetting impact of the threat.
5) The imagery further depicts the strength of the neurotic defensive countermeasures summoned into action by the therapeutic inroad. This has reference to the ending of the dream where the patient is devising a situation of safety for herself.
8) In this instance, the total sequence of events did not form a sufficient stimulus to result in arousal. Deeper sleep was resumed, accompanied by a dissolution of the dream.
Some of the characteristics of the dream have been explored in relation to the conditions prevailing during sleep.
Attention was drawn to the possible role of neurophysiological changes during sleep in accounting for the concrete level of dream presentations, the role of the reticular activating system in determining the direction and resolution of the transitional dream consciousness, and the relation of the dream to the problems of psychological vigilance during sleep.
Clinical material was presented to illustrate the theoretical points under discussion.
The dream appears to be man's unique means of coping with his biological environment when, as in sleep, that is all that exists for him, just as waking consciousness is the unique instrument for achieving mastery over man's social environment when that dominates the scene.
1. ULLMAN, M. Physiological determinants of the dream process. J. Nerv. & Ment. Dis., 124: 45-48, 1956.
2. ULLMAN, M. Dreams and arousal. Am. J. Psychotherapy, 12: 222-242, 1958.
3. ULLMAN, M. Hypotheses on the biological roots of the dream. J. Clin. & Exper. Psychopath., 19: 128-133, 1958.
4. ULLMAN, M. The dream process. Am. J. Psychotherapy, l2: 671-690, 1958.
 Department of Psychiatry, New York University College of Medicine, 550 First Avenue, New York, N. Y.