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The Role of Dream Analysis in Psychiatry

Why do we dream

According to Freud, when we dream the ego and the defence mechanisms are weaker, the unconscious is more vulnerable. Hence, dreams are a gateway (or a peephole) in to the workings of the unconscious. Freud divides the dream in to what he terms the Manifest Content and the Latent Content. The manifest content is the details of the dream we remember such as the objects, the storyline, the places, people, events etc.

The manifest content works as a disguise to conceal the hidden meaning (the latent content) from us. To work as an effective disguise, the latent content must be completely distorted and buried within layer of symbolism. This may explain why dreams are often surreal and make so little sense to us.

It is the latent content (the hidden meaning) which the psychiatrist attempts to uncover when discussing the dream with the patient. Freud claims that it is important that the psychiatrist considers timing when coming forward with suggested meanings of the dream. The meaning is hidden precisely because it is something the individual does not feel comfortable to acknowledge.

If a psychiatrist puts forward an interpretation too soon, the patient may fight against accepting it. Therefore the psychiatrist must try to wait for the moment where the patient seems to want to grasp the deeper meaning and is on the verge of making the discovery themselves. Then, when they offer a suggested interpretation the patient is more likely to be open to considering it, rather that fighting to keep the meaning hidden.

Wish Fulfilment

For Freud, dreams are essentially an opportunity for wish fulfilment. Unlike daydreams, the wishes we explore in dreams are desires that we daren't admit to ourselves. This is why the true meaning - i.e. the wish - is disguised behind layers of surreal symbolism (the latent content). Such wishes, that are uncomfortable to admit, tend to stem from sexual or aggressive drives. The wish may conflict with our morals or the ideal of our self that we strive towards.

Although we do not want to admit that such an urge exists within us, nevertheless it is an impulse that must find expression in some form of outlet. Therefore, if it causes us emotional discomfort or we try to repress it, then it will seek expression in a means that is disguised from us.

Unlike the dream dictionaries, which imply a universal code of dream symbols, psychiatry treats the symbols in dreams as personal. We use symbols and imagery that are significant to us, and are in some way linked to the hidden meaning i.e. we unconsciously devise our own code. Therefore the key to revealing the latent content is to understand the personal associations that dreamer makes concerning the manifest content.

The psychiatrist works with the manifest content and discusses it with the patient so that they may try and 'crack the code' together and discover the true meaning of the dream.

Cracking the Code

Some obvious associations we make - that help to decipher the symbolism we adopt in dreams - are based on the sounds of words. Words that sound the same may replace one another in our dream code.

For instance cue and queue. A word that is a significant part of the latent content of the dream, may appear as something that sounds similar. Not only do we draw upon similar sounding words to represent one another in dreams, but often we use opposites. For instance up and down, in and out, black and white.

The symbols we use in dreams are often fully loaded and probably trigger many ideas when we discuss them. This is acceptable and shouldn't be off-putting. Often a dream image may represent more than one word as if it compacted with numerous meanings.

Each association should be recorded as they all might be significant to the interpretation of the dream. As you may have experienced, dreams often draw upon things we have recently experienced. For instance, scenes from films may appear in a dream, or ideas and images from recent conversations you've had. These things usually appear with a slight difference or distortion. If possible, it is useful to try and pinpoint the way they differ from reality.

For example, if you dream about a scene from a film you've seen recently, but one of the actors seems to resemble someone you actually know, this might signal that you are comparing the person to the actor (or the role they play in the film). Since a dream tends to be an expression of wish-fulfilment, it is often the case that the wish itself is directed to a more acceptable target.

For instance, the wish may involve an attraction to someone which you do not want to admit to yourself because on some level it is forbidden, embarrassing or potentially damaging. This could be for many reasons - the person is uninterested or unavailable, they are a close friend or a partner of a close friend, you are already attached or married, you thought you disliked them etc. In such a case, the attraction may become the latent content of a dream, and could disguise itself by adopting a different target that is less distressing.

The notion of repetition is a strong signal in psychiatry that points to an inner struggle. If something is troubling us - something that we perhaps find unsettling to thing about - then it will continue to preoccupy us, as if it is seeking release. This applies to conversation i.e. we may keep drawing conversation back to a certain topic, which implies that there is something troubling us about this topic, we are preoccupied with it on some level, and need to talk it out. It also applies to dreams. If we experience the same dream more than once, this tells us that this is an issue that has not yet been resolved and so it will continue to appear in the latent content of our dreams.

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