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The Dream

A Psychodynamically Informative Instrument

Received March 8, 2001; revised June 24, 2001; accepted July 3, 2001. From the Psychoanalytic Institute and the Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York. Address correspondence to Dr. Glucksman, 68 Marchant Road, West Redding, CT 06896.

The dream is a unique psychodynamically informative instrument for evaluating the subjective correlates of brain activity during REM sleep. These include feelings, percepts, memories, wishes, fantasies, impulses, conflicts, and defenses, as well as images of self and others. Dream analysis can be used in a variety of clinical settings to assist in diagnostic assessment, psychodynamic formulation, evaluation of clinical change, and the management of medically ill patients. Dreams may serve as the initial indicators of transference, resistance, impending crisis, acting-out, conflict resolution, and decision-making. A clinically functional categorization of dreams can facilitate an understanding of psychopathology, psychodynamics, personality structure, and various components of the psychotherapeutic process. Examples of different types of dreams are provided to illustrate their relevance and use in various clinical situations.

Key Words: Psychodynamic Psychotherapy • REM Sleep • Dreams