Brief Psychotherapy using Dream Interpretation

I believe it to be true that dreams are the true interpreters of our inclinations; but there is art required to sort and understand them.

The value of dream interpretation during brief psychotherapy has concerned a number of psychotherapists. Wolberg1 has noted that the value of the use of dreams in therapy is dependent upon the therapist's comprehension of dynamics. Greenson2 has pointed up the significance of Gutheil's3 observation that the dream has declined in clinical importance. He thinks that Freud's4 view of the dream as “the royal road to a knowledge of the unconscious activities of the mind” no longer applies. Gutheil blamed the neglect of dream material on a misconception of so-called “free association,” a skillful analyst's most important tool. It should be noted, however, that with reference to dream interpretation, free association is not an issue. Associations to dreams are determined and defined by the dream content.

This brings us to consideration of the following issue. In brief psychotherapy, how deeply should we penetrate or probe the unconscious, unaided by a patient's associations as possibly revealed in dreams? I think that reintroducing dream analysis into brief psychotherapy can hasten the revelation of problems and conflicts and contribute significantly to shortening the average psychotherapeutic treatment. I have found this technique to be invaluable for analytically oriented brief psychotherapy. It has been my experience that change through insight was blocked, often effectively, by resistance to self-experience. This change was quite common in students who were struggling with independence-dependence conflicts. College, and particularly graduate school, often provides a setting where feelings and values derived from the family of origin can be displaced into the school situation.

My patients were all young, married medical students, acting out or fantasizing