Working on dreams, from neuroscience to psychotherapy

Res Psychother. 2021 Aug 12;24(2):540. doi: 10.4081/ripppo.2021.540.

Abstract

Within the current clinical practice, the debate on the use of dream is still very topical. In this article, the author suggests to address this question with a notable scientific and cultural openness that embraces either the psychoanalytic approach (classical, modern and intersubjective), and the neurophysiological assumptions and both clinical research and cognitive hypotheses. The utility of dream - in the clinical work with patients - is supported by the author with extensive bibliographic references and personal clinical insights, drawn from his experience as a psychotherapist. Results: From an analysis of recent literature on this topic, the dream assumes a very different function and position in the clinical practice: from 'via regia to the unconscious' of Freudian theories - an expression of repressed infantile wishes of libidinal or aggressive drive nature - it becomes the very fulcrum of the analysis, a fundamental capacity to be developed, a necessary and decisive element for the patient's transformation. The dream can also be use with the function of thinking and mentalization, of problem solving, of adaptation, as well as an indicator of the relationship with the therapist in the analytic dialogue or of dissociated aspects of the self. Finally, the author proposes a challenging reading of the clinical relevance of dream: through listening to the dream, the clinician can help the patient to stand in the spaces of his own self in a more open and fluid way and therefore to know himself better, to regulate his affects, to think and to integrate oneself. A dream which is not interpreted is like a letter which is not read (Babylonian Talmud, tractate Berakhòt, folio 55a) A man is shown [a dream] only from the thoughts of his heart (Babylonian Talmud, tractate Berakhòt, folio 55b).

Keywords: Dream; clinical work; interpretation; psychoanalysis.