This short article was written for the catalogue of the exhibition, ‘Sleeping and Dreaming’. The exhibition can be seen at the Wellcome Trust London, from 29 November 2007 to 10 March 2008.

 Dreams in Contemporary Psychoanalysis
Daniel Pick

The interpretation of dreams, Freud famously insisted, provides the royal road to the discovery of unconscious psychic life. The characteristic manner of considering the night-life of the mind inside psychoanalytic consulting rooms has shifted markedly over the last century, but is dream interpretation still the ‘royal road’? Some psychoanalysts clearly privilege such content over other material, and use dreams to structure clinical papers—what better way than through the selection of a telling example and the unfolding story of its interpretation? But psychoanalysts today tend to be more alert than in the past to ways in which patients use dreams, alongside other communications, unconsciously, in sessions. These days, the interpretation of dreams is inextricably bound up with consideration of the transference. [ii]

 Summarising—as I do here—a general, contemporary approach to dreams in clinical practice requires the attachment of a health warning. For the psychoanalytic movement is a loose term referring to an extremely varied set of approaches. There are too many schools of thought, national traditions and subdivisions, conflicting techniques and models to enable neat outlines of current practice. The movement has both centrifugal and centripetal tendencies, a variety of regional orthodoxies and debates, each of which evolves in relation to divergent intellectual and clinical developments of psychoanalysis, for instance in North and South America, France or Britain. Thus no thumbnail sketch can do justice to that complexity. Nonetheless, it has become widely assumed, and in a way increasingly obvious, that the process of imparting dreams may itself be heavily loaded with meaning for either or both parties, the dream-giver and the receiver, the patient and the analyst.

 To take an obvious example, the analyst who moves expectantly in the chair as a patient brings a nightmare might inadvertently encourage the provision of such material as ‘gift’, or its withholding as a form of punishment and deprivation. If we think of a state of ‘evenly suspended attention’ as an ideal analytic stance, then excessive zeal for dreams would indeed be a transgression of that stance. How far a patient accurately picks up such unwitting ‘clues’ will vary greatly. In any event, evidence (real or imagined) of the analyst’s particular personal appetites or distastes may have complex and unforeseen consequences. If the analyst is (or is believed to be) primarily interested in the dream work, the patient could feel (consciously or unconsciously) neglected and let down, as though the analysis now proceeds at the expense of the person. Yet of course the patient’s underlying attitude to the proffering of dreams in psychoanalysis may at that precise moment or in general be a significant issue, regardless of the practitioner’s success or failure in maintaining the analytic position. Either way, the mood that surrounds the bringing of dreams merits consideration alongside the actual ‘oneiric’ material.

 One reason we now give extra significance to dreams is because they are seen to contain features of an unconscious ‘drama’ that will also manifest itself in the analysis. Each provides a potential perspective on the other. Aspects of that drama may even be played out in the very session in which the dream is told, with the analyst, as mentioned, taking on, or being assigned, a part. To put this another way, the patient might unconsciously instigate a particular kind of interaction, into which the analyst is also then unconsciously drawn. Sometimes it turns out that the dream beautifully anticipates (or at least gives a supporting picture of) the state of affairs in the analysis, and vice versa.

 Such ‘enactments’, if they do occur, are hopefully subtle rather than gross in form, with the analyst having the wherewithal to notice what is happening, or at least what has happened. Therapeutic benefit may be achieved precisely where such a ‘pull’ is recognised and considered— made ‘food for thought’. Any number of internal obstacles to such recognition and ‘digestion’, in either or both parties may be present. Nonetheless, if there is some tolerance of that less than perfect situation, including within it the analyst’s own inevitable partial failure to maintain an entirely consistent analytic role, this can often be helpful. Thus we strive to catch and stop ourselves becoming (for instance through a different tone of voice or unusual gesture), a reassuring comforter, hostile critic or collusive ‘friend’. We try then to think about this process, asking in what way we have found ourselves ‘pulled’ one way or another, and how far – if at all – the patient unconsciously played a part in bringing about that situation.

 Consider, for instance, a patient prone both to intellectualising and to a ‘stiff upper lip’ approach to life. He brings to his male analyst’s attention a dream about himself as a very young child, accompanying his father to a museum. They get entirely lost in dimly lit galleries full of the most fascinating curios. They stay there until closing time, whereupon the father is shocked to realise that the child had been wet for ages, is cold and hungry, and that neither had apparently noticed this sorry condition as they walked around the exhibits. Having recounted the dream, the patient then immediately busies himself conscientiously with some intriguing ‘historical’ associations. Meanwhile the analyst becomes absorbed in listening to the curious aspects of this back history, before noticing the fast elapsing time, at which point he is finally able to point out to the patient the risk that the very process told in the dream is actually happening in the room. In other words dreams may be relived, may even foretell, something of the dynamics in the very session of which they are a part and to which they are a clue. A situation arises here in which the patient is again at risk of being left hungry, neglected and cold whilst he and the analyst/father  are otherwise engaged, amidst the exhibits.

 Although Freud himself sometimes generalised about dream symbols, the crucial direction of his work was against the idea — prevalent in some nineteenth-century dream books — that particular motifs or stories signified something fixed and given, regardless of the dreamer. His position was that psychoanalytic interpretations of dreams could never be exhausted, nor their theory petrified once and for all. Knowledge of dreams required continuing elaboration and revision.[iii] At the same time Freud consistently argued that the ‘manifest dream’ was but the place from which you began the work, the moving backwards, towards the latent thoughts. His account made extraordinary use of concepts such as condensation and displacement; he saw the dream as a compromise formation, in the face of an internal censor, a ‘text’ that bore witness both to unconscious wishes and to their repression.

 Rather than thinking of this key Freudian principle merely as the fact that there is ‘content’ behind the immediate form, a ‘secret’ revealed through analysis, what most disturbs us is that a process—the unconscious—is disclosed in and through the bizarre transpositions themselves. The dream is ‘worked over’ from the unconscious. The unconscious is evident in such radical transformation. Something cuts across and between the manifest and latent thoughts that cannot be accounted for merely by returning to the forgotten ‘latent’ thought. Freud made this point in a footnote added to a later edition of The Interpretation of Dreams in 1925: ‘At bottom, dreams are nothing other than a particular form of thinking, made possible by the conditions of the state of sleep. It is the dream-work which creates that form, and it alone is the essence of dreaming—the explanation of its peculiar nature’. [iv]

  We are strangers to ourselves in our dreams, and yet the dream is also irreducibly particular to the dreamer. That dream interpretation depends upon—and is only meaningful through—its associations, and the whole clinical context of the particular patient remains the touchstone. Even very short dreams, in Freud’s great book, inevitably generated lengthy analysis, since they were never simply decodable into easily anticipated ‘universal’ meanings. And yet many of those who read and ‘championed’ The Interpretation of Dreams, perhaps most especially in the early twentieth century , fell back on an older ‘dream book’ tradition, pursuing ‘wild’ interpretations, wrapping up the meaning then and there.  In fact, according to Freud’s own lights, not even the proverbial dream of a train passing into a tunnel should be ‘read off’ in advance, assigned the same predictable sexual connotation for every dreamer.

 With the work of Melanie Klein and her circle in inter-war Britain, came a particular emphasis on the view that unconscious fantasy was continually in operation, always shadowing and partially shaping communication. Susan Isaacs, in a now famous contribution of the  1940s emphasised the ubiquity of unconscious phantasy (spelled by psychoanalysts with a ‘ph’ to emphasis this quality) This paper whilst setting out a Kleinian viewpoint also highlighted a feature already contained in Freud’s own thought. Unconscious phantasy, she insisted, was “fully active in the normal, no less than in the neurotic mind“. [v] She went on to describe the analytic task thus:

 The analyst notes the patient's manner and behaviour as he enters and leaves the room, as he greets the analyst or parts from him, and while he is on the couch; including every detail of gesture or tone of voice, pace of speaking, and variations in this, idiosyncratic routine or particular changes in mode of expression, changes of mood, every sign of affect or denial of affect, in their particular nature and intensity and their precise associative context. These, and many other such kinds of detail, taken as a context to the patient's dreams and associations, help to reveal his unconscious phantasies, among other mental facts. The particular situation in the internal life of the patient at the moment gradually becomes clear, as does the relation of his immediate problem to earlier situations. [vi]

All of this can be explored in an analysis with or without the recounting of dreams as such, but can also enrich the way in which they are heard. Perhaps today most of us are less exercised than Freud had been about systematically working through each and every facet of the dream. It might in a given session be just one detail that seems most salient and the manifest as well as the latent content may be found significant—some dreams seem to be more ‘disguised’ than others. But there are also dangers in this looser use of the manifest dream, shorn of Freud’s laborious ‘decipherings’. It can be hard to gauge, when an analyst homes in on some detail of a dream text (or even of the analysand’s affect in recounting it) whether we are in the presence of an ‘overvalued idea’ or of a telling ‘selected fact’ about the patient. [vii]

Admittedly even Freud’s more detective-like method in working backwards from the dream was also open to the criticism that the particular route of association was arbitrary, the method unfalsifiable and potentially whimsical, but critics of the Freudian approach to dreams have often underestimated the patient’s own active contribution to the forming of interpretation, and its evaluation. Critics who equate psychoanalysis with hypnosis would presumably also see patients’ reports of the moving or troubling experience of psychoanalytic understanding of dreams as a form of suggestion or manipulation. While this is quite possible, and has been the subject of continuing theoretical debate and part of the enduring ‘problematic’ of psychoanalysis from the very start of its history—there is much more to the story of the interpretation of dreams, or the potential mutative effects of psychoanalysis, than that.[viii] Those of us who have experienced this at first hand, as patients and as analysts, may choose to respond that ‘the proof of the pudding is in the eating’, but sceptics will probably not be satisfied with such a retort, nor by the disclaimer that patients are rarely just the plaything of the analyst’s interpretative zeal or hermeneutic whim. Nonetheless, room for doubt often remains, as to whose desire is operative at a given moment, the patient’s or the analyst’s. Neither party, of course, is a psychological monolith. We think in terms of ‘parts’, ‘agencies’, ‘objects’, ‘organisations’ within the mind, and of continuing ‘projections’ into and ‘introjections’ of the other. So how we locate desires and anxieties is always a complex intra-psychic as well as an inter-personal matter. Proper psychoanalytic consideration of that complexity will always require fine grain evidence of sessions, rather than oracular announcements about dreams, still less general pronouncements about a patient’s ‘character’. As the French psychoanalyst, J B Pontalis puts it: “it is not the dream’s contents but the subject’s ’use’ of it that reveals his true pathology".’ [ix]

In psychoanalysis, the use of the dream is to be understood as part of a transference situation. Transference, like countertransference, once seen as obstacles to analysis, even failures of analysis, are now seen as important instruments within the ‘talking cure’. The psychoanalyst Hanna Segal also makes this point about the need to grasp the unconscious function of dreams in situ, and she underlines the transformation that has occurred in attitudes to dreams and to technique since Freud’s original discovery that our repressed unconscious expresses itself in dreams:

Nowadays, when we understand much more about the importance of the transference and the developing relationship between the patient and the analyst, we are also concerned with the function of the dream. Why does the patient have this dream and tell it to us in a particular way at a particular time? In that way the dream is treated like any other material. The other thing that has happened since Freud is that we differentiate much more between the time and type of dream, and we consider what dynamic psychic function it performs.[x]

Freud had himself recognised that dreams involve psychic ‘work’ and that psychoanalysis itself is a constant work in progress. Perhaps it should be no surprise that the labour and conflict that produce the ‘compromise’ of the dream and of the session turns out to have surprising affinities. Of course there is work and work; dreams and sessions are not all of a piece: some serve more creative, productive and communicative functions than others. Some dreams appear not to establish a liaison between the unconscious phantasy and our conscious mind, but on the contrary, to be aimed at evacuation. Certain ‘day dreams’ can be seen as examples of that, retreats from psychic engagement, repositories into which unwanted content is ‘binned’. Other dreams, as the Swiss psychoanalyst, Jean-Michel Quinodoz, evocatively suggests, ‘turn over a page’, marking—and perhaps in turn bringing about—real psychic change.[xi] It is also striking how patients have periods in analysis when dreams are copiously available or strikingly absent. This contemporary emphasis on the variable quality of the ‘work’ of the dream and of the analysis builds on Freud, who had already illuminated so many different kinds of psychic task, amongst which we find ‘dream work’ and ‘the work of mourning’. He once defined the aim of psychoanalysis as helping the patient to love and to work. We now focus on the joint employment of patient and analyst: how does the patient collaborate, collude or come into conflict with the endeavour ? How does this change—if at all—moment by moment? The analyst labours to monitor his or her own input, perhaps to wonder how his own personal anxieties or narcissism, aggression or envy interfere, or to ask whether these qualities are projected by or into the patient. This is not to say—at least not in the tradition in which I trained—that the aim would be to communicate such self-‘monitoring’ to the patient in the form of a confessional—the analyst crucially remains as far as possible ‘abstinent’. We aim to ‘work through’, recognising also, as best we can, that neither the analyst’s nor the analysand’s ego is master in its own house­.