Psychoanalysis, Sleep and Dreams

“I am on the stage, singing. I forget my part. A foreign looking conductor prompts me. In the wings, a man is looking at me, weeping. He falls in a faint. I rush to him. He looks like my husband. A foreign looking doctor picks him up and says to me: ‘He will sleep now, after which he will feel better.’ I go back to the stage and sing beautifully.”

Later, having acquired more self-confidence she visualized the situation as follows:

“I see a man leading a Jersey cow on a rope. The cow is trying to get under the fence but cannot. Then the cow is changed into a yellow bird which flies away, perches on top of a barn and sings joyfully.”

In the first dream, I am, of course the conductor and the doctor. In the second dream, the cow is an allusion to the patient’s tendency to gain weight. The song-bird is a very obvious symbol.

A series of dreams reported by a stammering patient not only presented the Freudian feature of wish-fulfilment but indicated clearly the patient’s changing attitude and his growing self-confidence, which finally culminated in his complete cure.

One of the first dreams he brought me at the beginning of the treatment read as follows:

“A congressman called Max Sternberg, who looks like me, is on the platform, making a speech. A gang of little Irish boys in the rear starts a disturbance. The audience, unable to hear the speaker, leaves the hall.”

On numberless occasions, small boys prevented him in his dreams from accomplishing his object, and in particular, disturbed him when he was speaking. Later the small boys became less and less aggressive. On one occasion he lead a group of them through a museum and they listened to his explanations without interrupting him.

One night he had the following dream.

“I am near Grand Central and thousands of children are lined on both sides of the avenue to welcome a school principal who is landing from the train. He arrives and they all cheer wildly and I have a feeling that I am that school principal.”

Little boys never disturbed the dreamer after that. He had conquered his regressive tendencies and his speech was improving.

His self-confidence grew to such a point that he had the following dream:

“I was in a room with John and Lionel Barrymore and I rehearsed them for a Shakespearian play. Lionel forgot his part and stopped. I prompted him and declaimed a few lines myself very eloquently. This was accompanied by the thought: Very egotistical-good.”

CHAPTER XIII: RECURRENT DREAMS

His father had died two years before, from arteriosclerosis, and his main complaint had been dizziness, weakness of the legs and depression. To any one but the patient, the psychological connection between his illness and his father’s illness would have been obvious. He, too, saw some connection between the two, only he placed upon that fact a more sinister construction. The heredity bogey was terrifying him. His father had bequeathed his illness to him, and he was to die as his father had died.

It came out in the course of the analysis that he had been from infancy his father’s constant companion, working for him till he was over forty years of age. Although he had always been fond of women, he had never thought of marrying until his father died. After reciting the usual arguments of the average bachelor directed against matrimony, he confessed that he had never had the courage to bring to his home any young woman he liked and who might have become his wife. Fear of his father’s sarcastic remarks set to nought any plans he might have made for a home of his own.

After his father’s death, he went half-heartedly into various business ventures of which his father would have disapproved and he naturally lost his investment. Every time he met with a reverse, he would be tortured by remorse. “This is my father’s money which I have been squandering.” “My father would be furious if he knew what I have done.”

He would then dream that his father stalked past him, cold, indifferent, stern, and he “knew” his father had “come back” to show him his resentment.

The superficial symptoms of the patient’s trouble were easily removed when he acquired enough insight to realize that he had been imitating all of his father’s attitudes and repressing his own ego.

Physical exercise soon restored to his legs the steadiness which they had lost while the patient, imitating his father’s helplessness, would sit in his father’s chair day after day, never taking a walk. A more critical attitude of mind toward the father whom he worshipped, removed gradually the sense of worthlessness which had almost lead him to suicide.

Suicide to him was the road that led back to his father, upon whom he wished to shift his responsibilities, and for whom he wished to work (as a younger man), etc.

The case was much more complicated but the few details of it which I have presented are sufficient to show the close connection which existed between the patient’s most frequent dream and his imaginary neurotic goal.

A homosexual patient always dreamt of her stepmother whom her father married when she, the patient, was only twelve years of age. That marriage was the culmination of a complicated family tragedy, double divorce, unsavoury publicity, bitterness and hostility, puritanical gossip about sex, passion, etc., which made on the child an indelible impression.

She felt obscurely then that relations between sexes were something unutterably filthy and while she liked a few boys in her flapper days, she could not master a feeling of disgust whenever their attitude reminded her of the “nasty” things which had wrecked her family.

On the other hand, the pretty young woman whom her father introduced into his home, personified in her thoughts sexual attraction in its most irresistible form, a symbol of sin and bliss. To this day she has love affair after love affair with women, every affair followed by a “nervous breakdown” in which she repents her immorality and experiences terrible remorse. At every stay in a sanitarium, however, dreams of her stepmother, representing veiled and symbolized homosexual situations, obsess her night after night. In one of those dreams she took the place of her father and married the young woman, after which the hostility of the family, manifesting itself in various forms, transformed the pleasant fancy into a painful anxiety dream.

Another patient, tyrannized over by an aunt who had brought her up, would, whenever an emergency arose and she had to take a decision, dream of the severe, forbidding aunt and feel so depressed the next day that she could not accomplish anything and thus postponed the solution of her difficulties.

In certain cases, a recurring dream may bear a strange likeness to a splitting of the personality such as we observed in cases of dual personalities.

The famous Rosegger dream, analysed by Freud and Maeder, should be reanalysed in the light of the statements made in the previous chapters. Rosegger went through a hard mental struggle from which he emerged victorious, but the recurring dream he relates in his book “Waldheimat” tells us much about the trials of a little tailor who managed to make a place for himself in the artistic world but for a long while felt out of place in his new environment.

“I usually enjoy a sound sleep,” Rosegger writes, “but many a night I have no rest. I lead side by side with my life as student and littérateur, the shadow life of a tailor’s apprentice. This I have dragged with me through long years, like a ghost, without being able to get rid of it.... Whenever I dreamed, I was the tailor’s apprentice, ... working without compensation in my master’s workshop.... I felt I did not belong there any more ... and regretted the loss of time in which I could have employed myself more usefully.... How happy I was to wake up after such tedious hours! I resolved that if this insistent dream should come again, I would throw it off and shout: ‘This is only a make believe. I am in bed and wish to sleep.’ Yet the next time I was again in the tailor’s workshop. One night, at last, the master said to me: ‘You have no talent for tailoring. You can go, you are dismissed.’ I was so frightened by this that I awoke.”

Freud compares this dream with a similar dream which pestered him for years and in which he saw himself as a young physician, working in a laboratory, making analyses and unable as yet to earn a regular living. This is his interpretation of it:

“I had as yet no standing and did not know how to make ends meet; but just then it was clear to me that I might have the choice of several women whom I could have married. I was young again in the dream and she was young too, the wife who had shared with me all those years of hardship.

“This betrayed the unconscious dream agent as being one of the insistent gnawing wishes of the aging man. The fight between vanity and self-criticism, waged in other psychic layers, had decided the dream content, but only the deeper rooted wish for youth had made it possible as a dream. Often, awake, we say to ourselves: Everything is all right as it is today and those were hard times, but it was fine at that time. You are still young.”

Maeder, of Zurich, refuses to accept such a simple explanation and offers a more complicated one, burdened, like many psychological interpretations of the Swiss school, with ethical considerations.

“By his own efforts,” Maeder writes, “Rosegger had worked himself up to a high position in life. This has made him proud and vain, two faults which easily disturb mankind, for they cause a man to suffer in the presence of superiors and place him in a parvenu position among the lowly.... Deep down, there takes place, in the sensitive poet, a gradual elaboration, a development of the moral personality.... The long series of tormenting dreams shows us the development of the psychic process which ends in a deep but effective humiliation of the dreamer.... His being sent away, dismissed, symbolizes in my opinion, the overcoming of the pride and vanity of the upstart.”

I agree with Freud on the wish for youth expressed by Rosegger’s dream and fulfilled by way of a regression. But neither Freud, bent on introducing a sexual element into his interpretation, nor Maeder, overfond of moralizing, seem to have realized the tremendous meaning of such a series of dreams, culminating as they did in a changed attitude to life.

I have shown in another book, “Psychoanalysis and Behavior,” that in cases of dual personalities, the second personality is always one that leads a simpler, less arduous life, fraught with lesser responsibilities, than the normal life led by the first personality. The Rev. Ansel Bourne, being tired and needing rest, was transformed for several weeks into A. Brown, a fruit dealer in a small town far away from his home. Miss Beauchamp, prim, overconsciencious, repressed, became the irresponsible Sallie, devoid of manners or taste. The Rev. Thomas Carson Hanna, overworked and a spiritual disciplinarian, woke up from a fit of unconsciousness a newborn baby, helpless and in-organized.

Rosegger, rising from manual to intellectual labour, compelled to adapt himself to the mannerisms of a different world, and to adopt a new set of social habits and customs for which his bringing up in a proletarian home had not prepared him, compelled also to ransack his brain constantly for new ideas to express or for new forms in which to clothe old ideas, may have at times regretted unconsciously the simpler life of a tailor, less rich in egotistical satisfactions but more comfortable intellectually and requiring infinitely less ingenuity.

And some of the remarks which he appends to his dream, confirm my suspicions.

What does he say of his awakening? “I felt as if I had just newly recovered this idylically sweet life of mine, peaceful, poetical, spiritualized, in which so often I had realized human happiness to the uttermost.”

Undoubtedly he had for a long while failed to enjoy it and unconsciously planned to escape from it through a regression to his former estate.

Several lines further down the page we find this statement which is, I think, absolutely conclusive proof of what his mental attitude had been and of the crisis he had lived through.

“I no longer dream of my tailoring days which in their way were so jolly in their simplicity and without demands.”

Rosegger’s dream is one of those morbid manifestations which enable us to follow a neurotic struggle going on within the organism, a struggle for adaptation to life, a struggle of which the subject is consciously ignorant, because he has burnt his bridges and has repressed the most fleeting thought of a possible change.

Rosegger must have smarted under the demands of his new life, but it was out of the question for him to do anything else. The conflict, however, played itself off in his dreams, offering a solution of a regressive type. When, years later, the tailor’s adaptation to the life of a writer was completed, his master dismissed him. The dream solution was no longer needed.

Recurring dreams often give us valuable indications of physical trouble which should be investigated and remedied at once. Even in ancient times, the relation between recurring dreams of physical disability and some physical disability setting in at a later date had been noticed. In those days, however, the interpretation of such dreams was that the vision was a warning sent by the gods, or that the vision was responsible for the subsequent trouble. We read for instance of a man who dreamt that he had a stone leg. A few days later paralysis set in.

In discussing dental dreams I have pointed out the importance of having the denture examined for possible pus pockets.

Dreams of animals gnawing at some organ may indicate a cancer developing in that region. Dreams of exhaustion from climbing hills often denote heart disease.

H. Addington Bruce had for several months had the same dream: a cat was clawing at his throat. Examination of the throat revealed a small growth which required immediate surgical intervention. The cat never came back.

CHAPTER XIV: DAY DREAMS

A day dreamer who consulted me during the war would imagine himself, while walking along the streets, enlisting, taking a tearful farewell from his relatives and friends and accomplishing deeds of valour which made him famous; after which he would be so affected by his greatness that tears would roll down his cheeks. Or the dream would end tragically and he would die and then again a cascade of tears would be let loose at the thought of all the grief his demise would cause. The result was that day after day he would suddenly “wake up” in some public place, his face wet with tears, annoyed and embarrassed by the attention which his appearance would attract.

Those day dreams constituted in spite of their sad cast a fulfilment of his egotistical cravings. Even death was not too high a price to pay for the importance he acquired in his dream, a psychological fancy which is often found at the bottom of some sensational forms of suicide.

The anxiety day dream is the form of compensation sought by many neurotics, weak in body and frequently taken advantage of by more vigorous and ruthless persons.

It also plays at times the same part as masochistic nightmares, filling as it does, the body with glycogen and a sense of power.

I have heard patients suffering from a sense of real or imaginary inferiority tell me of their obsessive anger finding relief in scenes which they made, while walking along the streets or when sleepless of nights, to some absent person whom they held responsible for their troubles.

They would then rehearse some annoying or humiliating incident provoked by the offensive person and let loose a torrent of abuse leading unavoidably to a fight in which they would beat, scratch or murder their enemy.

The sound of their own voice or the remarks of passers by would generally wake them up at the climax; their hearts then would beat wildly, they would be out of breath, if not bathed in perspiration, but they would experience withal a certain amount of satisfaction from the victory they had won and they would feel full of what a patient of mine termed “almost murderous energy.”

This form of “abreaction,” when it does not assume the form of a constant indulgence taking the place of positive action, is rather desirable. The psychoanalytic treatment consists, in part at least, in the production of day dreams based on memories which free in the patient a certain amount of repressed energy. Thus a great deal of unrelated and unconscious material is made conscious and related. Day dreams, without any definite direction and unchecked, are likely, however, to be very dangerous and to exert a paralysing influence on the dreamer.

The concentration and meditation recommended by some Hindoo philosophers can accomplish valuable results if the subject has a clear, analytical mind and knows how to correlate the scraps of thoughts which are thus allowed to rise to consciousness.

For childish people, which are easily caught in the meshes of their fancies and let their imagination run away with them, that indulgence is deadly and it has led millions of Orientals into a nirvana-like idleness and weakness, destructive of energy and life, a negative escape from reality.

This is one of the reasons why, in many forms of neurosis, a rest cure is the most dangerous form of treatment. The neurotic’s attention is generally directed away from reality. His energy is too often deflected toward fictitious goals located outside of the real world. The neurotic has to be brought back into contact with life and human beings; he has to be trained to accept them as they are and to enjoy them for what they are, instead of imagining what they might be. The idleness and seclusion of the rest cure may negative all efforts in that direction.

The rest cure from which day dreams cannot be excluded, is simply an abnormal flight from reality sanctioned and abetted by a physician ignorant of psychology.

The day dreams which produce happiness, which promote creation, scientific or artistic, and which lead the individual into the stream of life, are sound and healthy dreams. Those which only lead to more dreaming and away from life, are neurotic phenomena, devoid of any redeeming grace.

CHAPTER XV: NEUROSIS AND DREAMS

The sight of the execution made those ideas more concrete and more obsessive. The recurrence of a death dream simply showed that the obsession was gradually overpowering his personality and seeking realization. The dream work, endeavouring to solve the problem of how to end his life, offered an easy solution: he did not have to commit suicide; he was being put to death. Finally the death wishes overthrew his personality and he killed himself.

An epileptic was tortured every night by a dream in which a group of boys playing Wild West (he personifying the Indian) were pursuing him, throwing sticks and stones at him and finally cornering him. At the very minute where they were laying hands on him, he would experience a “dying” feeling and wake up in great discomfort. One night he turned round to face the gang which dwindled down to one small urchin whom he spanked. That night he slept soundly and the next day his fears of having a new fit disappeared. Neither that dream nor his fits have returned. It was not the dream that gave him fits, nor was it the last dream which cured him. The obsessive dreams were wish-fulfilment dreams, showing him how to dodge life’s duties through his sickness which was a convenient, though painful, unconscious excuse and how to solve his life problems by getting out of reality.

The last dream revealed a change in his mental attitude. He was not to seek any longer a neurotic escape from reality but face reality and fight his own battles.

A patient suffering from delusions had the following dream:

“A woman appeared to me and told me that it was all a dream and that all my troubles would soon end.”

Associations to that dream showed that the woman who appeared to my patient was a midwife who had helped her in a confinement some thirty years before (rebirth symbolism). At that time she almost died from puerperal fever and was also “saved” by a dream in which her grandparents appeared to her and told her that she would recover.

Her dreams, in which she placed in the mouth of other people the expression of her own wish for health, corresponded well in their mechanism with her delusions in which she heard people berating her for her imaginary sins.

At the time of the dreams, her delusions had lost their terrifying character and were only a mild annoyance to her. She had acquired enough insight to doubt their reality and to refer them to her unconscious thoughts.

The woman who imagines that in every voice she hears she can distinguish the voice of the man she unconsciously loves builds up a “story” like the dreamer who, perceiving coldness in her feet at night, saw herself falling into a lake.

The technique is exactly the same in both cases.

Actual sensations are transformed into delusions closely associated with the dreamer’s or the neurotic’s complexes.

People subject to hallucinations project outside of their body symbolic figures representing wishes they have endeavoured to repress and which they refuse to recognize as a part of their personality.

They hear voices which say certain things they are trying not to think of, for they consider such thoughts as obscene, criminal or otherwise unjustifiable.

Dreamers likewise represent their disabilities as something entirely separate from their bodies and their personality.

The stammering patient dreaming that he was delivering a very eloquent speech but was interrupted by howling hoodlums, repressed out of consciousness the idea of his speech disturbance and gratified his ego by saying: “But for those hoodlums I could speak very well.”

Trumbull Ladd suffering from inflammation of the eyelids dreamt that he was trying to decipher a book in microscopic type: An attempt at shifting upon the book the responsibility for his difficulties in reading. The dream said: “There is nothing wrong with your eyes, but the type is too small.”

A young woman struggling with an unjustifiable attachment for a married man told me the following dream:

“I was surrounded by little devils carrying pitchforks. I was afraid of them at first, but I finally grabbed them all in a bunch and dropped them into the fireplace. A pit opened under them and closed again and I felt free.”

Her psychology was the same psychology which in the Middle Ages caused religious people to invent the devil. Her desires which she refused to recognize as hers were little devils endeavouring to tempt her. We deal more easily with a stranger than with ourselves and “the devil tempted me” sounds more forgivable than “I did what I had always wanted to do.”

What makes it difficult for neurotics at times to tell the difference between their dreams and reality is that the emotions felt in dreams are accompanied by the same inner secretions as when felt in the waking life. A fear dream releases adrenin and a vivid sexual dream is followed by a pollution. The bodily sensations following certain dreams are evidential facts which some neurotics do not know how to controvert.

The hallucinations of delirium tremens patients which are generally accompanied by anxiety, illustrate the fact that we can be terrified and tortured by a dream which is a symbolized fulfilment of our conscious or unconscious wishes.

It is admitted by all but the very ignorant that immoderate drinking is not induced by a taste for drink but by a desire to escape reality, in the majority of cases, to drown the consciousness of financial or sexual difficulties.

The most common hallucinations of drunkards are those of snakes and lice. Snakes are almost without exception symbolical of the male sex. To the majority of neurotics, lice are symbolical of money and American slang recognizes that association in the expression lousy with money.

The “DT” patient has his wishes fulfilled. He is covered with vermin and snakes crawl about his bed. He has all the symbolical wealth and the symbolical potency or homosexual love he could wish for. But curiously enough he does not understand those symbols and is terrified by the manifest content of his morbid dream.

The story of Nebuchadnezzar in the book of Daniel is a fine illustration of the relation between dreams and insanity.

The king began to lose his sleep which was disturbed by nightmares. In the morning, however, the memory of those nightmares seemed to be entirely gone. Daniel contrived to reconstruct a forgotten anxiety dream in which the king saw a gigantic figure with head of gold, breast and arms of silver, belly and thighs of brass, legs of iron and feet of iron and clay and which toppled down when struck by a stone.

Here we have a morbid attitude to reality, the king visualizing his position (which unconsciously appeared to him precarious), through that unstable figure, and also expressing a neurotic wish to be delivered from his anxiety through the final catastrophe.

Later the king had another dream visualizing his fears and death wishes through a different image: A mighty tree grew till its head reached the heavens. Then an angel cried: “Hew down the tree, leave the stump and roots in the earth, in the tender grass of the field; let it be wet with the dew and let his portion be with the beasts.”

Fear of defeat and a neurotic desire to escape reality via a regression to the animal level are clearly indicated in this dream and in Daniel’s interpretation of it.

Very soon after, auditory hallucinations began to appear. “A voice fell from heaven,” speaking out the unconscious wishes which the king craved to gratify.

In a siege of dementia praecox, Nebuchadnezzar ate grass like oxen and his body was wet with the dew from heaven; his hair grew like eagle’s feathers and his nails like birds’ claws.

After a period during which he, like all cases of changed personality, led an easier, simpler, more primitive life, without any responsibilities, Nebuchadnezzar recovered and related thus his return to reality:

“My reason returned unto me; for the glory of my kingdom, mine honour and brightness returned unto me; and my counsellors and lords sought unto me; I was established in my kingdom and excellent majesty was added unto me.”

In the meantime he had become reconciled with reality and had given up his paranoid attempts at being the mightiest factor in the world.

By accepting as a possibility the existence of a mightier power, he protected himself against the ignominy of a possible defeat. Against an omnipotent God, even he could not prevail.

Freud writes: “The overestimation of one’s mental capacity, which appears absurd to sober judgment, is found alike in insanity and in dreams, and the rapid course of ideas in the dream corresponds to the flight of ideas in the psychosis. Both are devoid of any measure of time.

“The dissociation of personality in the dream, which, for instance, distributes one’s own knowledge between two persons, one of whom, the strange one, corrects in the dream one’s own ego, fully corresponds to the well-known splitting of the personality in hallucinatory paranoia; the dreamer, too, hears his own thoughts expressed by strange voices.

“Even the constant delusions find their analogy in the stereotyped recurring pathological dreams.

“After recovering from a delirium, patients not infrequently declare that the disease appeared to them like an uncomfortable dream; indeed, they inform us that occasionally, even during the course of their sickness, they have felt that they were only dreaming, just as it frequently happens in the sleeping dreams.”

CHAPTER XVI: SLEEPLESSNESS

In other words, they create imaginary “emergencies” which require the usual preparation for fight or flight, that is, keen observation of our environment, arterial tension, etc., all conditions which make sleep impossible.

Yet we cannot say that coffee, tea or cocoa, without some other contributing cause would always bring about sleep disturbances.

Bleuler writes: “I had been in the habit of drinking every night several cups of very strong tea which never prevented me from sleeping. Since I have had the influenza, things have been very different. I must be careful not to partake of such stimulants before going to bed. But even then, their effect depends on my mental condition. They affect me more at certain times than they do at others. If I am the least bit excited their effect is increased. When I am perfectly relaxed, I may not feel any bad effects.”

A bedroom into whose windows flashes of light or waves of sound may pour, is the not ideal place in which to seek escape from reality. Yet thousands of people sleep soundly in Pullman berths or even in day coaches, unmindful of the noise, light and bustle.

We must keep in mind an observation made by Bleuler at the Zürich clinic:

“When many people sleep in the same room, as in an insane asylum, some complain that they cannot sleep because their neighbour is snoring. Whoever tries to prevent the snoring or to move the snorer to another bed will have an endless task. The trouble is with the patient who is disturbed by snoring. It is not the noise itself but the attention he pays to it which disturbs him. One can see in wards for agitated patients most of the patients sleeping peacefully while some one disturbs the ward with the most savage howling.

“The trouble lies, not in a special sensitiveness of the nervous system, but in the attitude we take toward a certain noise.”

Lack of exercise during the day will often cause us to toss and turn many times in our bed after retiring. There seems to be in every living being a craving for activity without any positive aim, activity which accomplishes nothing besides using up unused energy or relieving certain inhibitions.

Children and all young animals seem to be unable to remain motionless for any length of time. In children and puppies, for example, the gleeful shouts and barking which accompany that display of muscular activity show unmistakably that it vouchsafes them a great amount of gratification.

The satisfaction of the free activity urge which is one of the aspects of the ego-power urge is probably submitted to a strong repression in men and animals at a rather early age by the safety urge; frightened children and animals stop playing and become at times paralysed by fear.

On the other hand there are many sluggish individuals who lead an most inactive life and yet sleep long hours without any interruption.

Indigestion causes insomnia and so does hunger but it is also a fact that many indiscreet eaters are made drowsy by their very indiscretion and sleep soundly after a meal which would distress many other people. Also we find in the sayings of many races statements to the effect that sleep assuages hunger; the average prisoner sleeps in spite of the insufficient meal served at night in the majority of jails.

Constipation seems at times to bear the guilt for restless nights and so do cathartics which, with some subjects, produce intestinal tension several times during the night but whose effect is not noticeable in other subjects until they wake up in the morning at the regular time.

Toothache will keep some people awake while others will go to sleep in order to forget their toothache.

Examples of that sort could be cited ad infinitum.

In case of sleeplessness, the first thing to do is to remove all the possible physical causes which can be reached directly or with the help of a physician.

Thyroid irritation for instance may at times make one more sensitive to even faint noises and a thorough medical examination should be undergone.

The dentature should be examined with the help of X-ray photography in order that pus pockets, impaction, and other defects, not observable with the naked eye, may be revealed and remedied.

The diet should be regulated so as to exclude indigestible foods while assuring, especially at night, sufficient nourishment.

All stimulants should be avoided.

A walk before retiring is very beneficial in all cases, not because it “tires” the subject, but because it absorbs the chemical products thrown into the blood for emergencies which did not arise in the course of the day. A long walk or any arduous exercise, on the other hand, might do more harm than good if they brought about the phenomenon of the second wind.

Any form of physical or mental exercise involving rivalry or competition is to be avoided at night. The excitement caused by the “fear of losing” would again fill the blood with “fight or flight” products. Heated discussions, the witnessing of exciting films or plays, drives with a daredevil chauffeur, etc., are not conducive to peaceful sleep.

When all those means fail, many devices have been offered to insomnia sufferers, such as prayer or counting sheep, reading, listening to some monotonous stimulus like the buzzing of a faradic inductor, or of an electric fan.

A distinction must be made between stereotyped prayer (such as the Lord’s Prayer) and personal prayer rehearsing one’s worries and asking for help. The latter kind is not unlikely to revive all the day’s problems and to set the would-be-sleeper solving them over again at the very time when he should forget them.

The repetition of some passage which was memorized in childhood and which, from long familiarity has become perfectly impersonal, may go a long way toward creating the monotony, and hence the feeling of safety, without which there cannot be any sleep.

After following all the rules I have laid down a number of people will still be unable to sleep. When the physico-psychic causes have been removed without improving the condition of the subject, the psychico-physical factors should then receive attention.

As I said before, normal people can sleep under almost any conditions because their vagotonic activities function regularly, while neurotics cannot sleep well even under ideal conditions because their sympathicotonic activities are constantly raising a signal danger and imagining emergencies amidst the safest surroundings, mental and physical.

The insomnia sufferer is suffering from some fear. That fear has to be determined and uprooted by psychoanalysis.

Some people cannot sleep because they have gone through a period of sleeplessness and expect it to endure for ever. The men of the Emmanuel movement often had the following experience: a subject would explain that he could not sleep under any circumstances. The Emmanuel healer would ask him to sit in a chair in which, he said, many people had fallen asleep, and after a few minutes of soothing conversation or concentration, the insomniac would doze off peacefully. In certain cases, such a cure may be permanent; in other cases, when the results are obtained through transference and suggestion, the help of the psychological adviser or hypnotist may be too frequently required.

Other subjects are prevented from sleeping by “worry.” Telling a careworn insomniac not to worry is as silly and useless as telling a lovelorn person to stop being in love.

Discussing a patient’s worries with him, however, often accomplishes much good, for it compels him to sift all his evidence, which may be convincing to him but to no one else. The worried person who is beginning to experience doubts as to the magnitude of his trouble, is like the patient suffering from delusions who has lost faith in his delusions.

The parasitic fears and cravings which attach themselves to some small worry and, at times, magnify it out of proportion, may in such a way be disintegrated and dissociated from the actual, justified fear.

Giving the patient “good reasons” why he should not worry, is again a sort of suggestion of the most futile and least durable type.

Obsessive fear which is at the bottom of every worry is due to certain complexes, at times apparently unrelated to the actual disturbance, and which cannot be unearthed and uprooted except by a thoroughgoing psychological analysis.

This is especially true of certain cases of insomnia which the patient reports as follows. “I fall asleep with difficulty and with a certain apprehension. I sleep an hour or two during which I have awful dreams which I cannot remember. After which I hardly dare to close my eyes again.”

This is what I would call the fear of the unknown nightmare, and the anxiety dreams responsible for it must be patiently reconstituted from the scraps which invariably linger in the subject’s memory, even when he imagines that he cannot remember any dreams. The procedure will be explained in the next chapter.

While the psychoanalytic treatment is being applied, however, the patient must be made aware of a fact which will comfort him to a certain extent.

Patients often fear that if their sleeplessness is not relieved “at once” they will “loose their minds.” Thereupon they beg to be given some narcotic.

We must remember that the results of sleeplessness depend mostly upon the attitude which we assume toward that condition. It may seem paradoxical to state that its bad results are mainly due to our fear of them but it is true nevertheless.

We assume that we shall be exhausted by a sleepless night. We go to bed in fear and trembling, wondering whether we will or will not sleep. That anxiety is sufficient to liberate secretions which produce an unpleasant muscular tension and a desire for activity. This keeps us awake until the chemical contained in those secretions have been eliminated. In the meantime, we develop a fit of anger which releases some more of the identical chemicals. After which we are doomed to many hours of unrest and agitation.

During those restless hours we toss about angrily and exhaust ourselves physically. About dawn, when sleepiness generally overtakes even the most restless, we finally doze off and are awakened by our alarm clock or some other familiar disturbance and once more relapse into anger at the waste of our sleeping hours and the disability which we feel is sure to result from it.

We naturally feel worn out. If, on the other hand, we would resign ourselves to our sleeplessness, realize that rest, even in the waking state, will relieve our organism of all its “fatigue” and that, by complete relaxation in the waking state, we can liberate almost as many of our unconscious cravings as in the unconsciousness of sleep; if we were as careful not to waste uselessly our inner secretions as we are not to touch live wires, we would lie down as motionlessly as possible, and would consign to the scrap heap all the absurd notions as to the dire results of a sleepless night; we would then awaken in the morning as refreshed by the two or three hours of sleep that would finally be vouchsafed us as by the usual eight or ten.

The amount of sleep one needs varies with every individual and increases or decreases according to unconscious requirements. Hence, statements to the effect that one needs eight or ten hours’ sleep are absurd and dangerous.

Many people are worried over the fact that their sleep is irregular, that is, that they sleep six hours one night and ten the next night and possibly only four hours the third night.

This is probably as it should be. Our requirements vary with varying conditions. After eating salt fish one may need several glasses of water to slake one’s thirst, while one may not need to drink a drop of any liquid after partaking of juicy fruit.

One should also dismiss as an idle superstition the dictum according to which sleep before midnight is more beneficial than sleep after midnight. Hundreds of newspapermen, watchmen, policemen, printers, railroadmen, etc., work nights and sleep in the day time and do not contribute more heavily than other professions to the ranks of the mentally deranged.

Older people, whose urges are at low ebb and do not require the satisfaction vouchsafed by dream life should become reconciled to the fact that they need few hours sleep; they should refrain from taking narcotics and go to bed later than they do, so as not to “lay awake all night,” which generally means that after dozing an hour or two in an armchair and retiring at ten they wake up normally about one or two in the morning.

Sleep is important in health but even more so in mental disturbances. The solution for the complicated problems of the neurotic’s life depends upon the wealth of facts contained in the unconscious rising freely to the surface in dreams and relieving the uncertainty. The tragedy is that except in cases of sleeping sickness, the neurotic who needs more sleep than the healthy subject, generally gets much less.

The neurotic should sleep preferably at night and avoid day sleep. This for two reasons. He should keep in touch with reality when reality is active and obvious, as during the day. With the falling of the shadows, reality acquires a tinge of indefiniteness which lends itself to many misinterpretations and to fancies of the morbid type.

Sleeplessness in the ghostly hours of the night is a poison for the neurotic, for everything at such times is exaggerated, distorted and the slightest worry is transformed into a terrible danger. Many children could be spared fits of “night terrors” if they were not forced to go to bed very early, after which they are likely to wake up in the middle of the night, disoriented and fearful.

It has been said that insomnia was the cause of insanity and experiments such as those made at the University of Iowa show that men kept awake for a prolonged period of time begin to have delusions and hallucinations similar to those of dementia praecox. But it must be remembered that the men who submitted to those experiments were not allowed to “rest.”

The contrary proposition, that is, that insomnia is induced by insanity is more plausible psychologically.

And indeed every psychiatrist has made the observation that some insane people sleep very little, so little in fact that such protracted periods of sleeplessness would kill the average normal person. That observation has been confirmed by Bleuler, who as the head of the Zurich psychiatric clinic and one of the most tireless psychological experimenters in the world, is in a position to speak with authority.

Neurotics sleep very little, and the more severe their case is, the less they sleep. Return of normal sleep generally coincides with a cure and has been by many credited with bringing about the cure. Hence the many “rest cures” suggested for the mentally disturbed patient.

The truth of the matter is that the absolutely insane person who lives all his absurd dreams in his waking life no longer needs the unconsciousness which the normal individual requires in order to escape from reality. The insane man who knows he is a combination of a Don Juan, a millionaire and a powerful ruler, need not dream of becoming all those characters. He has attained his goal and it is only the continued conflicts with reality which may reach his consciousness in his lucid moments which necessitate the unconsciousness of a few minutes or hours of sleep in which reality no longer intrudes into his absurd world.

Since insomniacs can rest without sleep and insomnia does not lead to insanity, there is no reason why narcotics should be administered. There is a very good reason on the other hand why they should never be administered except in case some harrowing pain has to be relieved and shock avoided.

For one thing, their effect is problematic and depends also to a great extent from the subject’s mental condition.

Kraepelin noticed that large doses of alcohol failed to produce the usual muscular lameness in subjects who were agitated. Bleuler makes the interesting suggestion that our central nervous system only “accepts” narcotics when they are “wanted” and keeps drugs, carried about in the blood stream, from being assimilated by the organism when the organism is not “willing” to submit to their influence.

But the most cogent reason why narcotics should never be resorted to in “nervous” sleeplessness is that they do not relax the organism but paralyse it by killing it partly. If they only dulled consciousness and freed the unconscious, they would accomplish some good but we do not know of any agent besides sleep, which accomplishes that successfully.

Narcotics partly kill both consciousness and unconscious. While their effect lasts, the very phenomenon which makes the neurotic a neurotic is exaggerated. In the neurotic’s waking state, unconscious complexes manage to free themselves, somewhat indirectly. In the stupor of drugged sleep, the repression is complete. Hence the horrible feeling which is often experienced when awakening from drug-induced sleep. Normal sleep is brother to life, but drug induced sleep is indeed akin to death.

Neither can hypnotic suggestion be recommended as a cure for sleeplessness, except of course, in emergencies.

About the end of the nineteenth century, a Swedish physician, Wetterstrand, inaugurated a method of treatment which was founded on a just estimate of the value of sleep, although Wetterstrand himself could not at the time have understood the psychology of it.

He had in Upsala a “house of sleep” furnished with innumerable divans and couches on which his patients were allowed to rest for hours in hypnotic sleep.

Of course this procedure had two glaring defects: hypnotism is a neurotic phenomenon which should not be applied to the treatment of a neurosis and, secondly, sleep in the daytime is generally enjoyed at the expense of the night’s sleep.

At the same time, the sleep which patients enjoyed in Wetterstrand’s “Grotto of Sleep,” as it was called at the time, must have been of a somewhat curative kind; for the house was as silent as a grave. Thick carpets deadened all sounds and all the lights were dimmed. No stimuli were allowed to produce in the sleepers any fear reactions.

What Wetterstrand really supplied to his patients was an ideal bedroom and an opportunity for an absolutely uninterrupted sleep of several hours. We do not know, however, how many of them were robbed of the effect of such an ideal environment by the anxiety dreams which the quietest bedroom cannot exclude.

The conclusion to be drawn from what has been said in the preceding chapters is that the real mission of sleep is to free the unconscious, to relieve the tension due to repressions and to give absolutely free play to the organic activities which build up the individual.

Hence the goal is sleep of sufficient duration, sleep undisturbed by physical stimuli, sleep FULL OF DREAMS but FREE FROM NIGHTMARES.

No more potent curative agent could be found than that kind of sleep, whether the ills to be remedied are of a “mental” or of a “physical” nature. Not until all the fear-creating complexes have been disintegrated by psychoanalysis, however, can the insomniac hope to enjoy that perfect form of “rest.”

CHAPTER XVII: DREAM INTERPRETATION

The technique of dream interpretation is unfortunately, like every detail of the psychoanalytic technique, very slow and at times discouraging. The layman trained by quack literature to expect quick results, is apt to appear scornful when a conscientious analyst, asked to interpret offhand an apparently simple dream, refuses to perform that task and confesses that he does not know the meaning of it.

When little Anna Freud dreamt that she was feasting on all sorts of dainties, no elaborate technique was needed to ferret out the enigma of such a vision. When Ferenczi’s patient, however, saw herself strangling a white dog, the wish-fulfilment formula, applied indiscriminately, would have given poor results.

To the patient, the white dog symbolized a snarling woman with a very pale face.

Dream interpretation must never be attempted without the dreamer’s assistance.

Snakes are almost always sexual symbols, but if on the day preceding the dream the subject was frightened by a snake or killed one or played with one, we should require a good deal of other evidence before we could safely assert that a snake dream on that night indicated fear, desire or repression of sexual cravings.

A tooth pulling dream related by a subject who expects to go through the ordeal of dental extraction should not be hastily admitted to be a symbolical dream.

Even apparently obvious dreams may assume an entirely different complexion when we inquire into the associations which every detail of them conjures up from the subject’s unconscious.

A year ago or so a Chicago woman sued her husband for divorce because he had been, while talking in his sleep, saying endearing things to his stenographer. That woman was both right and wrong.

The fact that her husband dreamt of his stenographer was evidence that the girl was “on his mind,” consciously or unconsciously. But we could not, without examining the husband’s unconscious reactions decide to what extent the stenographer herself, as a distinct personality, obsessed him.

Every man is more or less of a fetichist, irresistibly attracted by certain details of the feminine body, for ever seeking those characteristics and appreciating them above all others wherever found. When only one such characteristic and no other attracts a man, the man is known as a perverse fetichist.

When the various fetiches which attract a man are found in one woman, let us say red hair, dark eyes and a slender build, we have the foundation for a passionate and durable love.

When only one of those characteristics is found in a woman, that characteristic is bound to attract the man’s attention regardless of the interest or lack of interest the woman may present for him. A red haired woman, while otherwise totally unattractive, might, to a red hair fetichist, symbolize the beauty he seeks and intrude into his dream pictures, although she personally could not attract him sexually in his waking state.

Every one has had the experience of embracing in dreams some person who in the waking state would not inspire the dreamer with any desire. If we analyse carefully the appearance of the “ghostly love” we will in every case notice that he or she is endowed with a certain characteristic which is one of the constituting elements of our “love image.”

The Chicago woman should have taken her troubles to an analyst, not to a judge.

I have dwelt at length on that example to show a few of the pitfalls which threaten the careless interpreter of dreams.

The second rule I would formulate is this: Do not try to interpret one dream. Wait until you have collected a large number of dreams, let us say, twenty or thirty of them.

Then classify them according to their character as follows:

Pleasant and unpleasant dreams. Healthy and morbid. Masochistic and sadistic. Childish or adult. Regressive, static or progressive. Positive or negative. Varied or recurrent. Personal or typical. Hypnogogic and hypnapagogic visions, etc.

Care must be taken then to note all the words and thoughts which appear most frequently in many dreams and which are likely to refer to important complexes.

Whenever possible two versions of each dream should be studied.

The subject should write down his dreams as soon as he wakes up, either in the morning or right after an anxiety dream which may have disturbed him in the course of the night.

The version of almost any important dream which the subject tells the analyst will be found quite at variance with the version written immediately after awakening.

Here is a dream reported orally to me by a patient.

“I saw you through a restaurant window, having lunch with your wife.”

Here is the same dream as I found it in the patient notes:

“You were to deliver a lecture in a park. There was a number of good looking girls there. One especially attracted my attention. As there was quite a little mud in the park she wore rubber boots. You were late in appearing and I went to look for you. I saw you sitting at a table in a restaurant with your wife, waving to some acquaintance on the side walk.”

The discrepancy between the two versions is quite amusing.

After that preparatory work of classification and comparison, the actual work of interpretation can begin.

Hebbel once wrote: “If a man could make up his mind TO WRITE DOWN ALL HIS DREAMS, WITHOUT ANY EXCEPTIONS OR RESERVATIONS, TRUTHFULLY AND WITHOUT OMITTING ANY DETAILS, TOGETHER WITH A RUNNING COMMENTARY CONTAINING ALL THE EXPLANATIONS OF HIS DREAMS WHICH HE COULD DERIVE FROM HIS LIFE MEMORIES AND FROM HIS READING, he would make to mankind a present of inestimable value. But as long as mankind is what it is, no one is likely to do that.”

The technique of dream interpretation could not have been described more accurately nor more aptly.

The person whose dreams are to be analysed should relax completely, stretched out on a couch in a quiet room, listening for a while to some monotonous noise such as the buzzing of a fan or of an inductor, his mind concentrated on the story of the dream.

Then he should tell in a rambling way, without trying to edit the things that rise to his consciousness, all the associations of ideas connected with every word of the dream. While we can interpret our own dreams and jot down our own ideas, the assistance of some sympathetic, discreet person makes the process much simpler. Jotting down notes detracts one’s attention from the images rising to consciousness.

The assistant, however, should confine himself to mentioning the next word or the next part of the dream as soon as the subject seems to have exhausted the associations brought forth by one part of it.

The most surprising results are often obtained in that simple way. Facts which the subject had entirely forgotten, connections he had never been aware of, will suddenly jump into consciousness; the dream will gradually assume a meaning and its interpretation may at times reach an unexpected length. A dream of one line may suggest associations covering five or six pages.

It may happen that in spite of the subject’s efforts to remember his dreams and of devices such as being awakened in the course of the night, etc., the only memories preserved of the night’s visions will be scraps such as “going somewhere,” “talking to somebody,” “something unpleasant,” etc.

In such cases, the subject should be allowed to sink into what Boris Sidis calls “hypnoidal sleep” by being made to listen to some continuous noise in a partly darkened room, all the while thinking of the “dream scrap.”

“While in this hypnoidal state,” Sidis writes, “the patient hovers between the conscious and the subconscious, somewhat in the same way as in the drowsy condition, one hovers between wakefulness and sleep. The patient keeps on fluctuating from moment to moment, now falling more deeply into a subconscious condition in which outlived experiences are easily aroused, and again rising to the level of the waking state. Experiences long submerged and forgotten rise to the full height of consciousness. They come in bits, in chips, in fragments, which may gradually coalesce and form a connected series of interrelated systems of experiences apparently long dead and buried. The resurrected experiences then stand out clear and distinct in the patient’s mind. The recognition is fresh, vivid, and instinct with life, as if the experiences had occurred the day before.”

Through this procedure, patients are often enabled to recollect forgotten dreams and nightmares.

Certain patients do not forget their dreams but refuse to report them. In such cases the simplest procedure consists in asking the patient to make up a dream while in the analyst’s office, that is to put himself in the hypnoidal state described above and to tell the images and thoughts that come to his mind. Or if the analyst suspects the existence of a certain complex, he may ask the patient to build up a dream on a topic so selected that it will touch that complex.

A question which audiences have asked me hundreds of times is: “Cannot the patient make up something that will deceive you entirely and throw you on the wrong trail?”

My answer to such a question is emphatically negative.

A study of the literary and artistic productions of all races has shown that in every “story” and in every work of art, the writer or artist was solely bringing to consciousness his own preoccupations, in a form which may have deceived him but which does not deceive the psychologist slightly familiar with the author’s biography.

Brill tells somewhere how his attention was first drawn to the value of artificial dreams and of so called “fake dreams.”

In 1908, he was treating an out of town physician, suffering from severe anxiety hysteria. The patient was very sceptical, did not co-operate with Brill, never talked freely and pretended he never had dreams. One morning, however, he came for his appointment bringing at last one dream. “He had given birth to a child and felt severe labour pains. X., a gynecologist who assisted him, was unusually rough and stuck the forceps into him more like a butcher than a physician.”

It was a homosexual fancy. Asked who X. was, the patient said he was a friend with whom he had had some unpleasantness.

Then he interrupted the conversation, saying: “There is no use fooling you any longer. What I told you was not a dream. I just made it up to show you how ridiculous your dream theories are.”

Further examination, however, proved that the patient was homosexual and that his anxiety states were due to the cessation of his perverse relations with X. The lie he had made up was simply a distorted wish closely connected with the cause of his neurosis.

As Brill states very justly, “everything which necessitates lying must be of importance to the individual concerned.”

Personally, I have found that, with certain patients, the artificial dream method is productive of better results than the free association method. With the docile patient who has much insight and a positive desire to rid himself of his troubles, the association method reveals quickly the darkest corners of the unconscious. The patient who, on the other hand, constantly answers: “I cannot think of anything,” and is always on his guard, the association method wastes much valuable time and is very discouraging to patient and analyst.

It is not always advisable for the analyst to reveal to his subjects the import of their dreams. It is especially when the meaning of their dreams is frankly sexual that discretion and tact are necessary. In cases of a severe repression of sexual cravings extending over many years, when, for instance, one has to deal with a woman, no longer young and whose attitude to life has been rather puritanical, a good deal of educational work has to be undertaken before the subject can be enlightened.

She must be gradually led to consider sex as a “natural” phenomenon before she can be made to accept the sexual components revealed by her dreams as a part of her personality.