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Table of contents
We must not disclaim the responsibility for our unconscious thoughts as they reveal themselves through dreams. They are truly a part of our personality. But our responsibility is merely psychological; we should not punish people for harbouring in their unconscious the lewd or murderous cravings which the caveman probably gratified in his daily life; nor should we be burdened with a sense of sin because we cannot drive out of our consciousness certain cravings, biologically natural, but socially unjustifiable.
The first prerequisite for a normal mental life is the acceptance of all biological facts. Biology is ignorant of all delicacy. The possible presence of broken glass, coupled with the fact that man lacks hoofs, makes it imperative for man to wear shoes. The man who is unconsolable over the fact that his feet are too tender in their bare state to tread roads, and the man who decides to ignore broken glass and to walk barefoot, are courting mental and physical suffering of the most useless type. Read more Read less. Kindle Cloud Reader Read instantly in your browser.
Not Enabled. No customer reviews. There's a problem loading this menu right now. Learn more about Amazon Prime. Get fast, free delivery with Amazon Prime. Back to top. Second, dreams reported in an experimental context were analyzed by an independent evaluator using a standardized method to quantify changes in dream content Moser method. Single cases are presented.
Preliminary results suggest that psychoanalysis-induced transformation can be assessed in an objective way.
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Can we, as psychoanalysts, initiate a fruitful dialog with neuroscientists and gain additional knowledge of the unconscious, psychoanalysis' specific research object? Throughout his entire life Freud had hoped that new developments in the neurosciences would contribute to exploring psychoanalytic processes from a natural scientific point of view.
Psychoanalysis, sleep and dreams (eBook, ) [leondumoulin.nl]
In many of his historical and theoretical papers the South African neuropsychologist and psychoanalyst Mark Solms substantiates that Freud—due to the standard of neuroscientific methods during his time—turned his back on this vision and defined psychoanalysis as a solely psychological science of the unconscious. Over the past few years, recent developments in the neurosciences, e. The international Society for Neuro-Psychoanalysis was founded in the year contributing to an exchange between both scientific disciplines via regular congresses.
Apparently a growing number of worldwide research groups have begun to realize that the neurosciences and psychoanalysis can benefit from each other in interesting ways. By now the neurosciences are equipped with objective and precise methods of verifying hypotheses about human behavior, while psychoanalysis, based on its rich experience with patients and its unique method of field research has developed a variety of different models in order to conceptualize the multi-layered and complex observations derived from the psychoanalytic situation and to test them by means of its specific form of empirical research—clinical psychoanalytic research.
Psychoanalysis' explanatory models and insights can conversely be of interest to neuroscientists and raise specific research questions see e. Sometimes also empirical studies evoke challenging research questions for both research fields. In the on-going LAC-Depressionstudy see below , for example, one interesting and unexpected finding for both research fields is that a large majority of chronically depressed in long-term psychoanalytic therapy suffered from severe traumatization during childhood. The scientific discourses on the long-term effects of traumatizing experiences can be traced back to the mid 19th century Sachsse et al.
Nevertheless, as is well known, Freud always kept his interest in the neurological basis of psychic functioning, particularly also concerning the topic of trauma. For one, the extremely traumatizing experiences of the Holocaust, which led many survivors to reach out to psychoanalysts in the form of treatment or for an assessment due to reparation claims, compelled a reviewed analysis of the short- and long-term consequences of extreme traumatization. Moreover, the treatment of survivors' children conveyed the insight that traumatic experiences of this enormity also encroach on the lives of the following generations.
The traumatic experience carves itself into the body and directly influences the organic base of psychic functions. Psychic space and the ability to symbolize are destroyed Laub et al. These findings from clinical psychoanalytic research have been pursued by many psychiatric and neurobiological researchers in the last years see following section. In any age traumatization can lead to severe incursions of a person's psychic structures also see Leuzinger-Bohleber, , ; Leuzinger-Bohleber et al.
One of the effects of an acute, severe traumatization is that the affected person is abruptly seized from reality by the traumatic experience: within a dissociated condition he now experiences the reality surrounding him in a completely different way, unreal, fey, separated from all other people, isolated and lonely. Intuitively he realizes that this experience depicts an infraction in his life that he will carry within himself from now on.
Nothing will be as it was before. These psychoanalytic insights on the psychodynamics and genesis of traumatization are generally based on psychoanalysts' intense work with individual patients seeking relief from their psychic or psychosomatic problems. Such an event impacts the subject in the form of an external, massive stressor and changes the structural features which have been formed in part by genetics, prenatal and early childhood attachment, and experiences in the outside reality. This impact is identified as a threat by the brain and therefore quickly leads to a somatic stress reaction accompanied by severe psychic reactions cf.
Sachsse and Roth, ; Reinhold and Markowitsch, Among others, DSM-IV lists the following symptoms for PTSD: intense fear, helplessness or horror, recurrent and intrusive distressing recollections of the event, persistent avoidance of stimuli associated with the trauma, as well as persistent symptoms of increased arousal. The causes for traumatising situations are e. What consequences do these different approaches have for the treatment of traumatized individuals?
From a psychoanalytic point of view today, in cases of traumatic experiences the natural stimulus barrier is interrupted by unforeseen, extreme experiences, usually linked to a threat to life or mortal fear. The ego is exposed to an extreme feeling of powerlessness and inability to control or manage the situation and is therefore flooded with panic and extreme physiological reactions. The flooding of the ego leads to a psychic and physiological state of shock.
The traumatic experience also destroys the empathic shield of the internalized primary object, the confidence in the constant presence of good objects, and the expectancy of human empathy. In trauma the inner, good object, the negotiator between self and surroundings becomes mute Hoppe, ; Cohen, The feeling of continuity and the basic sense of one's own life are lost. At the same time psychiatric and neuroscientific findings on the brain function of traumatized patients may be relevant even for psychotherapists, as we try to illustrate in this paper.
Hence in our introduction we try to bridge the gap between psychoanalytic and neuroscientific findings on trauma. In the next section we apply this knowledge to an on-going study by simultaneously examining chronically depressed patients with EEG and fMRI during their psychoanalytic treatment. Our example of a single case study will illustrate in the last section how a change of manifest dream contents, as they are portrayed in psychoanalytic sessions, can be contrasted by changes in the contexts of dreams in the sleep laboratory.
Only then does trauma in its enclosed, psychic existence become accessible to therapeutic work: the unutterable horror is linked to visualizations, metaphors and eventually to verbalizations. Therefore the changes of dreams during psychoanalysis with severely traumatized patients could indicate that a symbolization process of the trauma has taken place—and thus indicating significant transformations in the inner world of the patient.
In this paper we would like to report on an attempt to measure such transformation processes in the manifest dreams of chronic depressed analysands not only by clinical psychoanalytic observations but also by a theory-guided content analysis of dreams developed by Moser and von Zeppelin that is accepted by the non-psychoanalytic academic community.
In dream research dreaming is described as a thought-process in which our inner system is engaged in processing information Dewan, Inner cognitive models are constantly being modified in coordination with what is perceived. In contrast to dreaming reactions to our environment are immediate during the waking state, thus enabling information consolidation into memory only limited by capacity restrictions of the system itself.
The dream searches for solutions or rather best possible adaptations for these dream complexes. These introjects are closely related to triggering stimuli from the outside world and structurally similar to stored situations of the complex. The searched for solution of the complex is governed by the need for security and the wish for involvement, i. Wishes within these complexes are links between self- and object-models and RIGs i.
Conflictuous complexes are areas of bundled wishes, RIGs and self- and object-models with a repetitive character, thus creating areas of unbound affective information. Affects within such an area are inter-connected by k-lines, which are blocked and therefore cannot be located. In order to solve these conflictuous complexes it is necessary to retrieve this affective information into a relational reality in order to make them come alive and locatable cf.
Figure 1. This is attempted in dreams, their function being the search for a solution of the complex. This search for a solution within a dream again is governed by the above-mentioned security-principle and involvement-principle. The following illustration may serve as an elucidation of this model. Memory Model of conflictuous complexes according to Moser and von Zeppelin Eric Kandel is convinced that psychoanalysis must apply these new methods in order to prove neurobiologically the sustainability of its results Kandel, and verbal accounts otherwise it will vanish from the world of science and only be remembered as a historical relic, a memory attesting to Sigmund Freud's enlightening spirit in the 20th century.
In society it will be marginalized even though to this day it is, according to Eric Kandel, the most exciting and complex theory of the human spirit. Although many scientific theoretical and philosophical arguments could be imposed against this point of view, Kandel's assessment is surely correct in the sense that proving the sustainability of psychoanalysis and psychoanalytic therapies with neurobiological tests such as fMRI or EEGs would immediately enhance the acceptance of psychoanalytic procedures within the world of medicine. Keeping this in mind, we perceived the opportunity of an institutional cooperation with the Max Planck Institute for Brain Research in Frankfurt, a.
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The already tested methods of the Hanse-Neuropsychoanalysis Study are implemented here in combination with our sleep-dream-research. Therefore, at the moment, we can only give an account of our attempts to combine psychoanalytic and neuroscientific methods within this study by presenting a single case study, which will be illustrated in the following section. In the last sequences of this paper we also would like to illustrate our attempt to combine clinical and extra-clinical experimental research in the LAC depression study in another single case study.
Marianne Leuzinger-Bohleber has reported the changes of dreams of a severely traumatized, chronic depressed patient as one indicator for therapeutic changes from a clinical perspective in another paper Leuzinger-Bohleber, The same patient, part of a subsample of the chronic depressed patients recruited in the LAC depression study, was willing to spend the necessary nights in the sleep laboratory of the Sigmund-Freud-Institute since investigating his severe sleeping disturbances was of clinical importance. The patient's thus elicited EEG data indeed showed pathological sleep patterns so that he had to be referred to a medical expert for sleep disturbances.
The dreams obtained in psychoanalytic treatment were analyzed and evaluated by the clinician in the psychoanalytical treatment as the analysand spontaneously reported them see p. What makes them different is to whom a dream is told—a total stranger or a clinician with whom you have a close relationship. The aim here was to test if changes found in clinical dreams dream type A with a psychoanalytic evaluation method 1 can be found in laboratory dreams dream type B with the Moser method method 2 as well, which would be indicative for a great robustness of the effect changes in dreams.
This very ambitious project currently conducted at the Sigmund-Freud-Institut SFI and BIC Brain Imaging Center in cooperation with the MPIH Frankfurt Max-Planck-Institute for brain research 8 seeks to examine changes of brain functions in chronic depressed patients after long-term therapies aiming to find multi-modal-neurobiological changes in the course of psychotherapies.
When looking at depression from the angle of brain-physiology, some interesting findings have been put forth: for instance that depression is related to a neurotransmitter disorder, or a frontal lobe dysfunction cf. Caspi et al. But despite all these findings, no specific brain-physiological marker for depression has yet been found. It is therefore justified to address the research question of whether changes in the course of therapy have brain-physiological correlates, which we are currently investigating in FRED.
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Generally speaking, psychotherapists—especially psychoanalysts—work with what can be remembered and with recurring—usually dysfunctional—behaviors and experiences. The assumption is that this has precipitation within the brain, like synapse configuration, priming, axonal budding and more, giving ground to the hypotheses of FRED. This constitutes the neuro-psychoanalytic aspect of the FRED-study of which some preliminary results will be given in the following.
States of Consciousness
Another aspect of change relevant for the study is that of clinical change found in dreams in the course of psychotherapy. The analysis of dreams with the specific method of Moser and von Zeppelin —as will be outlined—enables the comparison of empirically elicited findings with clinically reported ones from the therapist. The FRED-Study investigates the hypotheses that 1 psychotherapy is a process of change in encoding conditions of memory and 2 change in memory encoding will precipitate change in brain activation patterns detectable in fMRI scanning.
We hypothesized that changes in memory processing during the psychotherapy will impact the processing of trauma related memories. In the FRED study we aimed at highlighting changes in memory processing during the psychotherapy scanning depressed patients during a recognition task involving stimuli related to an underlying conflict, at the beginning of the psychotherapy and 7 and 15 months later.
Our predictions for the session effects are as follows: Healthy control subjects without any treatment show no significant session effects, and the activation patterns remain constant over time. In successfully treated psychotherapy subjects, the patterns of activation are changing from Time 1 to Time 3, therefore producing significant session effects in statistical terms. For this investigation, chronically depressed patients were recruited with whom an Operationalized-Psychodynamic-Diagnostics-Interview OPD-Interview; OPD-Task Force, concentrating on axis II relational and a dream-interview see Figure 2 below were conducted in a first diagnostic phase.
From these two interviews the stimuli for the fMRI-scanning are created individually for each patient because they are considered to be good triggers to elicit memory of an underlying conflict.