Four reasons to work with dreams

The following is an excerpt from the first chapter of Leslie Ellis’s book which outlines some of the main reasons modern clinicians should consider working with dreams. 

Why should therapists in clinical practice have a practical understanding of how to work with clients’ dreams? There are many good reasons, now more well-understood than ever, that dream work can deepen and accelerate the process of therapy. Dream researchers have been working for decades amassing evidence that supports the notion that dreams are relevant and helpful to us in many specific ways. But the worlds of dream research and dream therapy rarely overlap, though each could inform and enrich the other. Many clinicians and clinical training programs reject dreamwork as too esoteric or antiquated for modern psychotherapy, but I would argue that an appreciation of the science of dreaming may help to restore dreamwork to its rightful place as an essential aspect of psychotherapy, and a critical part of any therapist’s skill set…. So, why work with dreams?

They point to our most salient emotional concerns.

It may seem that we don’t need dreams to do this, but that we are always well aware of our most pressing emotional concerns. However, human consciousness is not always straightforward or consistent, and people can be very good at unwittingly deceiving themselves. In fact, one of the most popular forms of therapy (cognitive-behavioral therapy or CBT) was founded on the premise that our mind leads us astray and distorts our experience in a number of ways. One example is rationalization, a habit of talking ourselves out of our feelings using ‘rational’ arguments, such as, “I’m not sad that she left; I didn’t really love her anyway.” We can often fool our conscious mind, but such a person may dream of losing something of great value and wake up crying. If they pay attention to their dream, they will realize that they are in fact very sad about the loss of their relationship. Dreams are like that very good friend who is willing to be honest with us even when what they have to say is not easy to hear.

Dreams can also provide therapy clients with a way to introduce important yet deeply personal topics in the course of therapy, subjects they may want to bring up but are reluctant to do so due to fear, embarrassment or cultural norms that discourage personal revelation, even in therapy (Tien, Lin & Chen, 2006). Goelitz (2007), who works with clients preparing for death, found that dream work brought the focus of the session to the deeper emotional concerns rather than the more typical discussions about physical symptoms and treatment. She noted that the dream work helped her clients feel less alone and better prepared for death. She was convinced that these discussions would not have taken place had they not been facilitated by a dream.

Dreams bypass our internal editing process and normal defenses and so are honest representations of our life situation.

Dreams tell the truth, even when such truth is uncomfortable and defended against in everyday awareness. During sleep our prefrontal cortices, responsible for, among other things, rational thought and executive functioning, mostly shut down for the night. During dreaming, our internal editor, and our moral authority also go to sleep. That’s why our dreams can sometimes be bizarre and why normally taboo subject matter such as explicit sexuality and violence can often appear in our dreams. At times, it seems as though our dreaming consciousness is trying to get our attention by delivering its content in the most flamboyant or dramatic way possible. It helps to know that dreams are often metaphorical, not meant to be taken literally. For example, I had a dream that I was eating horseshit and kind of enjoying it even though I was well aware of how disgusting this would seem to the people around me. I laughed to myself when I understood the dream’s message might have to do with a lecture I had listened to a few days’ prior that I found highly entertaining and yet filled with ideas I considered completely far-fetched.  Because I liked the person, I was trying to remain open to their ideas, trying to take in and digest the material, but having trouble doing so. The dream captured the complexity of my feeling about the situation with economy and humor.

There is considerable clinical evidence to suggest that dreams carry emotional truth that is often difficult for the dreamer to assimilate (Ecker & Hulley, 1996). One of the major benefits I have seen in working with dreams is that it can help clients to see and truly experience an unconscious aspect of their personality or behavior that is not congruent with how they see themselves or want to be (Ellis, 2013). For example, a client I will call Michael had a dream that he was walking on a beach and came across a group of people sitting in a circle, and his cousin was there with them smoking a crack pipe. Michael had a strong judgment about this, as smoking crack was something he would never do. But if, as some theories suggest, characters in a dream represent aspects of ourselves, then Michael was like his dream-cousin in some way. In the dream-work he did, I asked him to ‘be’ his cousin on the beach, and when he imagined this, he felt an attraction to the pipe, and then a dawning of awareness that this feeling of addiction was familiar to him as it colored the dynamic of his relationships with the women in his life. He was flooded with shame and a heartfelt desire to change which fueled transformation in his relationship and many other aspects of his life.

Dreams can bring a new and wider perspective on a situation that is stuck or static.

History provides many good examples of how a dream can bring a creative new perspective. The person who invented and patented the first lock-stitch sewing machine solved the main challenges to developing a reliable machine because a dream pointed to the solution that had long eluded him. Elias Howe, who eventually became the second-wealthiest man in the U.S., came up with the novel idea of putting the hole in the ‘wrong’ end of the needle from a dream of a spear fight between warring native tribes. In the dream, some of the warriors’ spears punctured the fabric of the tents, snagged loops of thread, and pulled them back through with the tips of their spears. Dreams are the sources of many great inventions, including the periodic table and Einstein’s theory of relativity. For someone who has studied a subject deeply but who has become stuck in a fixed way of looking at the problem, dreams can bring the fresh creative inspiration that was elusive. Sometimes ‘sleeping on it’ can bring unexpected and creative answers. For a thorough treatment of dream creativity, see Barrett (2001).

Dreams are embodied and present us with an internally-generated world that is detailed and appears very real to all of our senses. This total immersion brings us in touch with the magical quality of dreaming. A dream is a richly detailed world that is experienced as entirely real while the person is dreaming it. Even for those who experience lucid dreaming and become aware they are dreaming while in the midst of it, the experience feels very real. This aspect of dreams is what makes them so compelling, and such a useful tool in therapy for assisting clients in stepping out of their ordinary way of experiencing or seeing things. A dream can bring a broader perspective, a new way of seeing, a shift from ordinary consciousness, or habitual ideas, a step toward change.

Dreams provide diagnostic information and can be indicators of clinical progress.

There are many ways that dreams can provide diagnostic information about clients, although the subject is a complex one because dreams can be cryptic. According to Sacks (1996) dreams are, “directly or distortedly, reflections of current states of body and mind.” Neurological disorders can alter dreaming processes in quite specific ways, and these can vary from person to person. Sacks gives the example of a patient with an occipital angioma who knew that if his dreams turned from their usual black and white to red, he was about to have a seizure. Some other examples Sacks offered are loss of visual imagery in dreams as a possible precursor to Alzheimer’s, and recovery dreams presaging remission from multiple sclerosis. Sacks hypothesized that the dreaming mind is more sensitive than the waking mind to subtle changes in the body, and so appears prescient because it picks up subtle early cues.

In some cases, this premonitory aspect of dreaming can even be life-saving. Taylor (2009) offered the example of a woman from a dream group that met regularly who dreamt of a purse of rotting meat. The dream was so disturbing to her and the other group members, the woman felt unsettled enough to have a diagnostic pap smear which turned out to be negative. She insisted on further testing which revealed she had a particularly aggressive form of uterine cancer that would have killed her had she not caught it in time. At the time of the dream she had no symptoms and was about to go on a trip – she credits the dream and the dreamwork for saving her life.

Not only can dreams be indicative of potential health changes for better or worse, but they can also be used to track clinical progress. Tracking shifts or progress via dreams can be an easier task for therapists than using a dream to make an initial diagnosis because it is often easier to spot an incremental change in the pattern of dreaming than to decipher something completely new. It takes some time to get to know the unique world of each dreamer, and paying attention to a series of dreams will make it clearer when something significant has changed. For example, in my research into the nature and treatment of recurrent PTSD nightmares (Ellis, 2016), specific kinds of changes in dreams that had been recurring repeatedly, sometimes for years, appeared to coincide with trauma recovery. This observation is supported by research that sampled 94 trauma survivors and found the closer their nightmares were to replicating the actual trauma event, the higher their level of related distress. For trauma therapists who track dreams, the progression from concrete to less realistic, more imaginative dreaming can be seen as a sign of clinical progress.

Posted by Leslie Ellis