CHAPTER ONE (CONTINUED...)
H. The Relation between Dreams and Mental Diseases
When we speak of the relation of dreams to mental
derangement, we may mean three different things: (1) etiological and
clinical relations, as when a dream represents or initiates a psychotic
condition, or occurs subsequently to such a condition; (2) changes which
the dream-life undergoes in cases of mental disease; (3) inner relations
between dreams and psychoses, analogies which point to an intimate
relationship. These manifold relations between the two series of phenomena
were in the early days of medical science- and are once more at the
present time- a favorite theme of medical writers, as we may learn from
the literature on the subject collated by Spitta, Radestock, Maury, and
Tissie. Recently Sante de Sanctis has directed his attention to this
relationship. * For the purposes of our discussion it will suffice merely
to glance at this important subject.
* Among the more recent authors who have occupied
themselves with these relations are: Fere, Ideler, Lasegue, Pichon, Regis
Vespa, Giessler, Kazodowsky, Pachantoni, and others.
As to the clinical and aetiological relations between
dreams and the psychoses, I will report the following observations as
examples: Hohnbaum asserts (see Krauss) that the first attack of insanity
is frequently connected with a terrifying anxiety-dream, and that the
predominating idea is related to this dream. Sante de Sanctis adduces
similar observations in respect of paranoiacs, and declares the dream to
be, in some of them, "la vraie cause determinante de la folie." * The
psychosis may come to life quite suddenly, simultaneously with the dream
that contains its effective and delusive explanation, or it may develop
slowly through subsequent dreams that have still to struggle against
doubt. In one of de Sanctis's cases an intensively moving dream was
accompanied by slight hysterical attacks, which, in their turn, were
followed by an anxious melancholic state. Fere (cited by Tissie) refers to
a dream which was followed by hysterical paralysis. Here the dream is
presented as the aetiology of mental derangement, although we should be
making a statement equally consistent with the facts were we to say that
the first manifestation of the mental derangement occurred in the
dream-life, that the disorder first broke through in the dream. In other
instances, the morbid symptoms are included in the dream-life, or the
psychosis remains confined to the dream-life. Thus Thomayer calls our
attention to anxiety-dreams which must be conceived as the equivalent of
epileptic attacks. Allison has described cases of nocturnal insanity (see
Radestock), in which the subjects are apparently perfectly well in the
day-time, while hallucinations, fits of frenzy, and the like regularly
make their appearance at night. De Sanctis and Tissie record similar
observations (the equivalent of a paranoic dream in an alcoholic, voices
accusing a wife of infidelity). Tissie records many observations of recent
date in which behaviour of a pathological character (based on delusory
hypotheses, obsessive impulses) had their origin in dreams. Guislain
describes a case in which sleep was replaced by an intermittent insanity.
* The real determining cause of the madness.
We cannot doubt that one day the physician will concern
himself not only with the psychology, but also with the psycho-pathology
of dreams.
In cases of convalescence from insanity, it is often
especially obvious that while the functions may be healthy by day the
dream-life may still partake of the psychosis. Gregory is said to have
been the first to call attention to such cases (see Krauss). Macario
(cited by Tissie) gives an account of a maniac who, a week after his
complete recovery, once more experienced in dreams the flux of ideas and
the unbridled impulses of his disease.
Concerning the changes which the dream-life undergoes
in chronic psychotics, little research has been undertaken as yet. On the
other hand, early attention was given to the inner relationship between
dreams and mental disturbances, a relationship which is demonstrated by
the complete agreement of the manifestations occurring in each. According
to Maury, Cabanis, in his Rapports du Physique et du Moral, was the first
to call attention to this relationship; he was followed by Lelut, J.
Moreau, and more particularly the philosopher Maine de Biran. The
comparison between the two is of course older still. Radestock begins the
chapter in which he deals with the subject by citing a number of opinions
which insist on the analogy between insanity and dreaming. Kant says
somewhere: "The lunatic is a dreamer in the waking state." According to
Krauss, "Insanity is a dream in which the senses are awake." Schopenhauer
terms the dream a brief insanity, and insanity a long dream. Hagen
describes delirium as a dream-life which is inducted not by sleep but by
disease. Wundt, in his Physiologische Psychologie, declares: "As a matter
of fact we ourselves may in dreams experience almost all the
manifestations which we observe in the asylums for the insane."
The specific points of agreement in consequence of
which such a comparison commends itself to our judgment are enumerated by
Spitta, who groups them (very much as Maury has done) as follows: "(1)
Suspension, or at least retardation of self-consciousness, and
consequently ignorance of the condition as such, the impossibility of
astonishment, and a lack of moral consciousness. (2) Modified perception
of the sensory organs; that is, perception is as a rule diminished in
dreams, and greatly enhanced in insanity. (3) Mutual combination of ideas
exclusively in accordance with the laws of association and reproduction,
hence automatic series-formations: hence again a lack of proportion in the
relations between ideas (exaggerations, phantasms); and the results of all
this: (4) Changes in- for example, inversions of- the personality, and
sometimes of the idiosyncrasies of the character (perversities)."
Radestock adds a few additional data concerning the
analogous nature of the material of dreams and of mental derangement: "The
greatest number of hallucinations and illusions are found in the sphere of
the senses of sight and hearing and general sensation. As in dreams, the
fewest elements are supplied by the senses of smell and taste. The
fever-patient, like the dreamer, is assailed by reminiscences from the
remote past; what the waking and healthy man seems to have forgotten is
recollected in sleep and in disease." The analogy between dreams and the
psychoses receives its full value only when, like a family resemblance, it
is extended to the subtler points of mimicry, and even the individual
peculiarities of facial expression.
"To him who is tortured by physical and mental
sufferings the dream accords what has been denied him by reality, to wit,
physical well-being, and happiness; so, too, the insane see radiant images
of happiness, eminence, and wealth. The supposed possession of estates and
the imaginary fulfilment of wishes, the denial or destruction of which
have actually been a psychic cause of the insanity, often form the main
content of the delirium. The woman who has lost a dearly beloved child
experiences in her delirium the joys of maternity; the man who has
suffered reverses of fortune deems himself immensely wealthy; and the
jilted girl sees herself tenderly beloved."
(This passage from Radestock is an abstract of a
brilliant exposition of Griesinger's (p. 111), which reveals, with the
greatest clarity, wish-fulfillment as a characteristic of the imagination
common to dreams and to the psychoses. My own investigations have taught
me that here is to be found the key to a psychological theory of dreams
and of the psychoses.)
"Absurd combinations of ideas and weakness of judgment
are the main characteristics of the dream and of insanity." The
over-estimation of one's own mental capacity, which appears absurd to
sober judgment, is found alike in both, and the rapid flux of imaginings
in the dream corresponds to the flux of ideas in the psychoses. Both are
devoid of any measure of time. The splitting of the personality in dreams,
which, for instance, distributes one's own knowledge between two persons,
one of whom, the strange person, corrects one's own ego in the dream,
entirely corresponds with the well-known splitting of the personality in
hallucinatory paranoia; the dreamer, too, hears his own thoughts expressed
by strange voices. Even the constant delusive ideas find their analogy in
the stereotyped and recurring pathological dream (reve obsedant). After
recovering from delirium, patients not infrequently declare that the whole
period of their illness appeared to them like an uncomfortable dream;
indeed, they inform us that sometimes during their illness they have
suspected that they were only dreaming, just as often happens in the
sleep-dream.
In view of all this, it is not surprising that
Radestock should summarize his own opinion, and that of many others, in
the following words: "Insanity, an abnormal morbid phenomenon, is to be
regarded as an enhancement of the periodically recurring normal
dream-state" (p. 228).
Krauss attempted to base the relationship between the
dream and insanity upon their etiology (or rather upon the sources of
excitation), thus, perhaps, making the relationship even more intimate
than was possible on the basis of the analogous nature of the phenomena
manifested. According to him, the fundamental element common to both is,
as we have already learned, the organically conditioned sensation, the
sensation of physical stimuli, the general sensation arising out of
contributions from all the organs (cf. Peisse, cited by Maury, p. 52).
The undeniable agreement between dreams and mental
derangement, extending even to characteristic details, constitutes one of
the strongest confirmations of the medical theory of dream-life, according
to which the dream is represented as a useless and disturbing process, and
as the expression of a diminished psychic activity. One cannot expect, for
the present, to derive the final explanation of the dream from the psychic
derangements, since, as is well known, our understanding of the origin of
the latter is still highly unsatisfactory. It is very probable, however,
that a modified conception of the dream must also influence our views
regarding the inner mechanism of mental disorders, and hence we may say
that we are working towards the explanation of the psychoses when we
endeavour to elucidate the mystery of dreams.
ADDENDUM 1909
I shall have to justify myself for not extending my
summary of the literature of dream-problems to cover the period between
the first appearance of this book and the publication of the second
edition. This justification may not seem very satisfactory to the reader;
none the less, to me it was decisive. The motives which induced me to
summarize the treatment of dreams in the literature of the subject have
been exhausted by the foregoing introduction; to have continued this would
have cost me a great deal of effort and would not have been particularly
useful or instructive. For the interval in question- a period of nine
years- has yielded nothing new or valuable as regards the conception of
dreams, either in actual material or in novel points of view. In most of
the literature which has appeared since the publication of my own work the
latter has not been mentioned or discussed; it has, of course, received
the least attention from the so-called "research-workers on dreams," who
have thus afforded a brilliant example of the aversion to learning
anything new so characteristic of the scientist. "Les savants ne sont pas
curieux," * said the scoffer Anatole France. If there were such a thing in
science as the right of revenge, I in my turn should be justified in
ignoring the literature which has appeared since the publication of this
book. The few reviews which have appeared in the scientific journals are
so full of misconceptions and lack of comprehension that my only possible
answer to my critics would be a request that they should read this book
over again- or perhaps merely that they should read it!
* The learned are not inquisitive.
In the works of those physicians who make use of the
psycho-analytic method of treatment a great many dreams have been recorded
and interpreted in accordance with my directions. In so far as these works
go beyond the confirmation of my own assertions, I have noted their
results in the context of my exposition. A supplementary bibliography at
the end of this volume comprises the most important of these new
publications. The comprehensive work on the dream by Sante de Sanctis, of
which a German translation appeared soon after its publication, was
produced simultaneously with my own, so that I could not review his
results, nor could he comment upon mine. I am sorry to have to express the
opinion that this laborious work is exceedingly poor in ideas, so poor
that one could never divine from it the possibility of the problems which
I have treated in these pages.
I can think of only two publications which touch on my
own treatment of the dream-problems. A young philosopher, H. Swoboda, who
has ventured to extend W. Fliess's discovery of biological periodicity (in
series of twenty-three and twenty-eight days) to the psychic field, has
produced an imaginative essay, * in which, among other things, he has used
this key to solve the riddle of dreams. Such a solution, however, would be
an inadequate estimate of the significance of dreams. The material content
of dreams would be explained by the coincidence of all those memories
which, on the night of the dream, complete one of these biological periods
for the first or the nth time. A personal communication of the author's
led me to assume that he himself no longer took this theory very
seriously. But it seems that I was mistaken in this conclusion: I shall
record in another place some observations made with reference to Swoboda's
thesis, which did not, however, yield convincing results. It gave me far
greater pleasure to find by chance, in an unexpected quarter, a conception
of the dream which is in complete agreement with the essence of my own.
The relevant dates preclude the possibility that this conception was
influenced by reading my book: I must therefore hail this as the only
demonstrable concurrence with the essentials of my theory of dreams to be
found in the literature of the subject. The book which contains the
passage that I have in mind was published (in its second edition) in 1910,
by Lynkeus, under the title Phantasien eines Realisten.
* H. Swoboda, Die Perioden des Menschlichen Organismus,
1904.
ADDENDUM 1914
The above apologia was written in 1909. Since then, the
state of affairs has certainly undergone a change; my contribution to the
"interpretation of dreams" is no longer ignored in the literature of the
subject. But the new situation makes it even more impossible to continue
the foregoing summary. The Interpretation of Dreams has evoked a whole
series of new contentions and problems, which have been expounded by the
authors in the most varied fashions. But I cannot discuss these works
until I have developed the theories to which their authors have referred.
Whatever has appeared to me as valuable in this recent literature I have
accordingly reviewed in the course of the following exposition. |
