Why Are Dreams Important in Psychotherapy?

by Carol Campbell, MFT

If you have ever experienced psychotherapy, you may have noticed that your therapist paid particular attention whenever you mentioned having had a dream. Therapists and shamen and healers of all stripes in virtually any culture have their reasons for finding wisdom in the everyday – or should I say every-night – experience of dreaming. I have found it helpful for my psychotherapy patients to know a bit about why dreams are such a rich treasure to think about together in our sessions.

Sigmund Freud, the great originator of psychoanalysis, spoke of dreams as providing a unique means of accessing the language and symbols of the unconscious mind. In fact, he is reported to have called dreams the "royal road to the unconscious mind." To Freud, dreams had only one purpose: to keep the dreamer asleep in order to restore vitality. A dream is a safe way for otherwise dangerous or disturbing feelings, thoughts, wishes, and fears to be managed as the dreamer sleeps. Otherwise it might feel dangerous to go to sleep, and the person would suffer from sleep deprivation. When all is well, the dreamer enjoys a restful sleep while the dream processes whatever difficult issues may be on the dreamer's mind.

A troubling emotional concern that can be dealt with by an effective dream while the dreamer sleeps is then much less likely to be a burden when the sleeper is awake. The trick is to have the dream stay within limits of what is tolerable, or else it becomes a nightmare and the sleeper awakens.

Those who came after Freud expanded upon the usefulness of dreams as fruitful sources of information about what a person honestly thinks or feels about his or her problems, relationships, and circumstances. The human mind has an incredibly creative way of gathering little snippets from one's day (the "day residue"), mixing it with symbols and people from one's past, and coming up with some sort of storyline that expresses secret-coded feelings and thoughts. This remarkable process, designed to integrate our daily experiences into our overall lives, all happens as we sleep!

By looking at the symbols and elements of a dream, a therapist and patient together can gather clues to better understand the wishes and fears that have been perhaps felt too scary or dangerous to let come to consciousness in any other form. If you can understand some of the possible meanings of your dream, you can move unconscious information to your conscious mind, and thereby have access to more internal resources as you think.

When a person is in psychodynamic therapy (which is focused on the relationship of the patient and the therapist), it is prudent to assume strong likelihood that any of the patient's dreams may have something to say about the relationship of the patient to the therapist. For example, let's say Lisa has a dream in which a kind woman approaches her and offers to guide her up a steep mountain, but part way up the mountain, the woman disappears, leaving Lisa frightened, alone, and angry. This could have a meaning, among many others, that Lisa feels betrayed by the therapist, because the therapist is available for the time of the sessions, but then Lisa is left alone between sessions, on weekends, over holidays, etc. How Lisa handles these feelings will be in great part dependent on the quality of her attachment to her early caregivers.

The process of coming and going to and from therapy sessions is an extremely important aspect of psychoanalytic work. It replicates the cycle of a baby having its mother present and then absent, present and then absent. The developmental step of acquiring basic trust only evolves when the baby has had a good enough experience of being tuned into, neither too intrusive nor too neglectful.

Most psychodynamic therapies involve a great deal of focus on how the patient handles the separations from the therapist, and the patient's dreams are a very helpful tool in deepening the patient's awareness of ambivalent feelings about that process. Symbols in dreams provide a rich expression of what may be felt but unknown to consciousness.

A more recent evolution in thinking about dreaming is that in fact we are always dreaming, not just when we sleep. There is always communication going on between the unconscious and the conscious minds. So it becomes useful to pay attention to fantasies, day dreams, slips of the tongue, etc. as further clues to what is going on in the unconscious mind.

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Carol L. Campbell, MFT, is a licensed marriage and family therapist providing psychotherapy and psychoanalysis for individual adults and couples in Palo Alto, California. She has degrees from Brown University and Santa Clara University and has been licensed since 1991. Carol is a graduate of the Palo Alto Psychoanalytic Psychotherapy Training Program sponsored at Stanford by the San Francisco Center for Psychoanalysis and was a candidate at the Psychoanalytic Institute of Northern California in San Francisco from 2010-2011. She is also a clinical member of the California Association of Marriage and Family Therapists and the Northern California Society for Psychoanalytic Psychology.