Discussion

I want to thank Dr. Gershman for his interesting presentation, which shows a refreshing eclectic approach to his clinical use of dreams, responding to the dreamer rather than to a theory of personality.

In working with the dream it is helpful, as Dr. Gershman points out, to relate the patient's behavior in the office and in his living to the dream, so that the dream can be used to show the recurrent pattern of his problem more clearly in these contexts. As the patient catches on in the course of treatment to the continuity of the dream with the most problematic aspects of the way he is living his life, he takes on the responsibility for sharing it with the analyst. The analyst then functions as a kind of guide to hold the patient to what is most authentic in his experience of himself in this respect.

However, the analyst is not an anonymous outside observer in this process. In his interaction with the patient the analyst participates in what is typical and most characteristic of the patient's relationships to others—the transference. The patient not only repeats, but he experiences the analyst as a person. There is much communicated by the analyst in spite of his efforts to maintain a therapeutic incognito. This enters to a greater or lesser degree into the content of the patient's dreams.

Hence the analyst can also discover more about himself as his work proceeds; but more importantly for the patient, he can make therapeutic use of the countertransference. Dreams are often subtly organized to protect the patient in a way that duplicates the neurotic pattern of the waking state with the important people of his life, including the analyst.

Hence the analyst, by the use of his own spontaneity, can contribute an infusion of new ideas, fresh appraisals, and a challenging reconsideration of issues. Of course, this can be abused to sponsor acting-out with the patient, or indulging in the analyst's own private difficulties. But with a spirit of dedicated enquiry to the patient