Dreaming and Psychoanalysis: Commentary on a Sample Dream

From my modern classical psychoanalytic perspective, I approach dreams as part of the conversation my patients and I engage in to see what their symptoms mean, what the dreams do for them, and what the dreams interfere with in the patients' functioning. I think of dreams as representing conflicts among elements of affect, fears, moral judgments, and defenses. These concepts are for me the skeleton of the dream. Dreams for me are not more important than slips, jokes, songs, reports of movies, books, life events, or complaints. All of these are ways in to the fantasy life of the patient. Each person has her own preferred way of expressing her own fantasies, but any of these ways can be intertwined with others, and in my mind this interweaving is the connection net that we used to call associations. In this way of thinking, there cannot be a dream without associations. A session in which a dream is reported provides associations, the history the patient narrates provides associations, the feeling in the consulting room during a session provides associations, and the analyst's own introspection can provide clues to possible associations. the associations to the dream are always there; understanding them and what their connection adds to our understanding of the dream is the work of the analyst and the patient alike. the analyst has a history of experience in understanding such associations and making such connections and gradually empowers the patient to do so for herself. An aspect of treatment that I especially enjoy is a patient's or the analyst's use of metaphor in understanding what is being said while not being overtly stated.

For instance, a colleague who had recently immigrated to the United States and understood English as she had been taught it in school reported to her supervisor that her new patient was psychotic. the patient had said that he had butterflies in his stomach. the metaphor escaped my colleague, as did the patient's sense of humor. This unfortuna