Dreams and the Making of Psychotherapy

by Christopher Skeaff LCSW, PhD

What do you make of your dreams? (How do you understand, interpret, employ, or apply them?) What are you making with your dreams? (In the process of dreaming, what might your mind be creating or recreating?) What are your dreams making of you? (And so what sense of yourself, of others, and of the world might be gained from an exploration of your dream life?)

These are all great questions to ponder and pursue – perhaps especially in the course of one’s own psychotherapy. In this blog post, I want to consider why that’s the case. Why, in other words, do dreams matter to psychotherapy?

Dreams are of special importance to therapy in the first instance because the study of dreams gave psychoanalysis, the originary psychotherapy, its distinctive paradigm (the mind as a compromise born of conflict) and technique (free association). Dreams, in short, played an instrumental part in the making of psychotherapy.

Dreaming as unconscious artistry

In his landmark text The Interpretation of Dreams (1900), Freud offered a theory of dreams and of the unconscious mind, along with an account of how psychoanalysis could work, interpretively and therapeutically, with the elements of an individual’s dream life. Dreams, Freud proposed, are like mysterious works of art that hold personal meaning for their creators. And yet this meaning is puzzling even to the dreamers/creators themselves. Put another way, dreamers, all of us, are more ingenious than we know, fashioning works of self-expression in our sleep, beyond the reach of conscious awareness.

But what sort of unconscious artistry is this? What exactly are we making and communicating when we’re dreaming? According to Freud, dreaming is the individual’s way of thinking about and formulating the objects of their desire. This “artistic” process, he contended, involves making one’s desires into wishes and making one’s wishes known. Or to be more precise, dreams represent in disguised form the fulfillment of wishes. The right kind of interpretation allows us to decode our dreams and become conscious of those wishes.

Dreams, in Freud’s description, are simultaneously private and public. No one else experiences my dream. Nevertheless, I dream it and discuss it in a shared language of images and words. A dream, then, would seem to be a peculiar kind of note-to-self: captivating for the dreamer when he’s dreaming but easily forgotten and poorly understood when he’s awake; a secret message the dreamer tells himself but which must be retold to someone else, a psychoanalyst, if its meaning is to be grasped.

If dreams are primarily self-addressed messages, though, it’s reasonable to wonder why we’d make them so cryptic and so forgettable. Freud’s answer, in a word, is that we’re conflicted.

Secrets we tell (on) ourselves

We’re conflicted about what we want because what we want is very often forbidden. So dreams, Freud tells us, tell the story of forbidden desire and its gratification. It’s for this reason that dreams traffic in wishes (desires likely to be prohibited) rather than simple wants. If we want something, we’ll try to obtain it, whereas a wish implies that something holds us back from directly trying. A wish combines a want and a prohibition: the child who wishes for an ice cream cone has probably had the experience of wanting an ice cream cone and being told “no.” Frustrated in her waking life, the child may, however, find such a wish fulfilled in her dreams, as did Freud’s daughter Anna in a dream about strawberries.

To complicate matters, prohibitions don’t always come from an external source; there are a great many internal prohibitions in the mind itself. Wishing aloud for the death of a parent, for example, is likely to garner shock and reproach from others given social prohibitions against killing. It’s also a sentiment that could be too disturbing to admit even to oneself. In such a circumstance, Freud observed, part of one’s mind must work to prohibit the death-wish, to repress or “censor” it by keeping it out of one's consciousness. Another part of one’s mind, however, remains at work constructing the wish and seeking to give it expression.

Out of such conflict, Freud contended, dreams emerge and cohere as a form of compromise. Psychoanalysts Stephen Mitchell and Margaret Black offer a helpful elaboration of his view:

In sleep, the dynamic force (the defenses) that ordinarily keeps forbidden wishes from gaining access to consciousness is weakened, as in a hypnotic trance. If the wish were simply represented directly in the dream, sleep would likely be disrupted. A compromise is struck between the force that propels the wish into consciousness and the force that blocks access to consciousness. The wish may appear in the dream only in disguised form, an intruder dressed up to look as though he belongs. The true meaning of the dream (the latent dream thoughts) undergoes an elaborate process of distortion that results in the dream as experienced (the manifest content of the dream).

Understood as such, dreams are secrets we tell (on) ourselves. They are simultaneously forms of disguise and disclosure, self-expression and self-defeat.

Freud called “dream-work” the unconscious process of ciphering that shapes the dream and renders its content less disturbing. The main aspects of dream-work include condensation, where distinct elements (themes, ideas, images) coalesce in a single image; displacement, where one image or idea comes to replace another, often more disturbing one; representation, where thoughts are converted into visual images; and secondary revision, where incoherent and illogical elements of the dream are rearranged into a more intelligible narrative.

Interpretation through association

“The task of dream interpretation,” Freud wrote, “is to unravel what the dream-work has woven.” Dream interpretation thus reverses the process of dream formation, moving gradually from manifest to latent content, from disguised surface to hidden secrets. Likewise, as an “unraveling,” the technique of interpretation shifts the work from synthetic to analytic, separating the dream into its component parts.

Freud’s interpretive approach undercuts the popular notion of a dream dictionary of symbols (“water represents fertility”) that would apply universally to anyone and everyone. While the elements of the dream are symbolic, Freud realized, its private, idiosyncratic meaning can only be grasped via a method of association in which the analyst invites the patient (and dreamer) to say whatever comes to mind in relation to the dream. This process entails isolating the elements of the dream’s manifest content and having the patient associate to each. The analyst follows the patient’s associations as they lead in various directions from an element of the dream’s manifest content to the thoughts and feelings that had given rise – via condensation, displacement, etc. – to said element. Ultimately, Freud maintained, the associative paths traced by analyst and patient converge in a dream’s “nodal point,” or latent content.

Consider a dream that Gloria, a psychoanalytic patient (per Mitchell and Black), related to her analyst early on in treatment. In her dream, Gloria was five years old and waiting with anticipation for her father to return home from work. When he arrived it became apparent that he had something disgusting on his shoe, probably dog feces. Gloria remembered feeling a spooky uneasiness about whatever it was that he’d brought into the house. As her treatment progressed, Gloria generated new associations to the dream. She noted, for example, that she was five years old when her brother was born. Gloria also recalled her vague sense at that time of her father’s role in impregnating her mother, and she remembered feeling jealous of how her father had given a baby to her mother rather than her. Further, Gloria recalled many fond memories of her baby dolls along with many painful memories of her early relationship with her brother, whose arrival in the family she experienced as something of a disaster.

From the vantage of Freud’s dream theory, Gloria’s dream might be approached along the following lines. Gloria’s early, erotic attachment to her father is condensed into the image of her waiting excitedly for him to return home from work, her initial curiosity and interest in his penis perhaps displaced onto and symbolized in the dream by his shoe. Gloria’s brother, she likely felt, was a “piece of shit.” His arrival spoiled the loving relationship with her father. Unable to blame her father directly for this event, which upset and enraged her, Gloria viewed it instead as an accident beyond his control. In this manner, the puzzling and eerie manifest content of the dream conceals latent dream content having to do with childhood hopes, fears, and rage. The dream stands as a disguised compromise or composite of her deepest wishes and her defenses against those very wishes, woven together via secondary elaboration into narrative form.

Dreams and the making of psychotherapy

In his work on dreams, Freud delineated a pattern that was to become the paradigm for understanding the unconscious mind more generally. Parapraxes (“slips of the tongue”), neurotic symptoms, and motivated errors – psychic phenomena Freud would take up in other clinical work and writing – all share with dreams the basic form of a “compromise” between desire and defense, expression and prohibition. Here again, impermissible thoughts and feelings gain access to consciousness only in disguised form.   

What’s more, Freud’s method of dream interpretation – free association – was to become a hallmark of psychoanalytic psychotherapy as such. As in dream interpretation, the analysis at the heart of such therapy cannot be reduced to an exercise of telling people what they (or their symptoms) mean. Rather, free association proceeds collaboratively and makes possible an exploration and resolution of the mental conflict specific to each patient. Mitchell and Black explain Freud’s rationale:  

As a strategic device, free association helps the analyst discern the patient’s secrets, the unconscious wishes, while the defenses remain active and can be addressed. By encouraging the patient to report on all fleeting thoughts, the analyst hopes to get the patient to bypass the normal selection process that screens out conflictual content. Yet the patient is fully awake and can be shown that her unintended flow of thoughts contains disguised ideas and feelings that she has been keeping out of awareness.

Analyzing free associations and resistances to free associations affords access to both sides of the patient’s conflict: the secret thoughts and feelings on one side and the defenses against those secret thoughts and feelings on the other. Ultimately, these parameters allow for a therapeutic relationship in which someone can be understood on their own terms, in the process of making, unmaking, and remaking their life.

You don’t have to go this alone. 

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