Integrating Dreamwork Into Clinical Practice

Working with dreams in therapy brings many benefits to client and therapist.

Posted May 17, 2018

Most psychologists have had clients work with their dreams in therapy-but all too often this work has to be initiated by the client. Indeed, most psychologists receive no special training with regard to dreams so they do not work as effectively as they could with dreams. The ad hoc handling of dreams in therapy suggest that therapists could improve their practice vis a vis their clients if they received the requisite training in dreamwork. For this to happen however the American Psychological Association needs to require clinical training programs to include coursework on dreams in the clinical curriculum. There also needs to be continuing education/CEU credit coursework on dreams for practicing therapists. Until these educational reforms take place, however, clinical psychologists and mental health workers should begin to more regularly incorporate, however awkwardly, dreamwork into their practices. The potential benefits to clients makes it the ethical thing to do in my view.

The science of dreams has progressed far beyond Freud and Jung’s seminal contributions (and mistakes), but all too many therapists still see dreams within outdated Freudian or Jungian lenses. Dreams not only reflect and facilitate attachment relationships (Freud), they also help to regulate closeness in these relationships. Dreams not only promote emotional and spiritual growth (Jung), they also promote healing via their role in emotional memory consolidation. Dreams not only facilitate insight, they also promote creativity. Dreams not only promote emotional stability, they provide a more accurate record of emotional life than standardized tests or inventories.

Dreamwork in therapy allows a reticent client to bring into therapy fears, emotions, memories, behaviors and hopes he or she may not be able to articulate clearly for the therapist. The therapist should not wait for the client to bring in a dream. Instead the therapist should ask the client to regularly bring in dreams and this invitation should be made in the first meeting/session. The client needs to know that dreams are welcome in the therapeutic setting. If a client says that he never dreams; he should not be contradicted with the claim “We all dream”. Instead the therapist should say “I would still like you to be open to possibly having a dream and bringing that dream into therapy for discussion”. Dreams cannot be forced but they can be welcomed and when welcomed they usually come.

Once a client brings a dream into therapy what do you do with it? What is dreamwork anyway? Like anything else there are several varieties of dreamwork-some of which actually have some experimental scholarship behind them. I do not advocate “dream interpretation”-the dream has many meanings and interpretation is never really completed. However, grasping the central message of a dream is possible and recommended. Freud’s free association technique always yield’s interesting results-especially for the client. If free association feels uncomfortable for the client just ask him or her what each of the images in the dream suggest-what do they make him think of? Take a dream image or event and see what memories it elicits and then follow those memories. Often a central image carries the emotional force of the dream but just as often the obscure little images contain leads that eventuate in breakthrough insights for the client.

Once you have 20 or so dreams from a client have them scored for normative content values and then compare your client’s normative values against standardized norms for his or her age group. For example, using the Hall-Van de Castle norms you might notice that your client departs from population norms with respect to aggression levels or misfortune percent or body image values and so on. You can then use that information in therapy to pursue why those departures from the norms occur. Are they strengths or potential problems for the client and so forth.

Once you start to welcome dreams into your clinical practice you will begin to notice a new kind of therapeutic alliance forming with your client that opens up a wealth of material that can be put in service to that client’s full recovery.

References

Leonard L, Dawson D. The marginalisation of dreams in clinical psychological practice.

Sleep Med Rev. 2018 Apr 22. pii: S1087-0792(18)30029-7. doi: 10.1016/j.smrv.2018.04.002. [Epub ahead of print] Review. PMID: 29759892