Dreams and Psychosis

In opening the panel John Frosch explained that it had been necessary to limit the panels to half a day, as a result some of the presentations would have to be shortened. In order to provide an overview of the subject Frosch presented his paper, "A Survey of Psychoanalytic Contributions to the Relationship between Dreams and Psychosis." He pointed out that Freud, as many others had done before him, drew frequent analogies between dreams and psychosis in his writings. He recalled the passage from The Interpretation of Dreams (1900) in which Freud described three possible relations between dreams and mental disorders. These were: (i) etiological and clinical connections, as when a dream represents a psychotic state or introduces it or is left over from it; (ii) modifications to which dream life is subject in cases of mental disease; and (iii) intrinsic connections between the structure of dreams and psychosis.

Initially in 1900 Freud stressed the similarity between dreams and psychosis, emphasizing that the principal difference was between the harmless nightly relaxation of censorship that occurs in the former and the pathological reduction of censorship, or overwhelming intensification of unconscious excitation, in the latter. Frosch observed that it is difficult to keep one's bearings in Freud's discussions of the subject. He adhered more strictly, for example, to the analogy between dreams and psychosis in some of his writings than in others. Freud also tried to summarize at various times the differences between dreams and mental disorders, suggesting that in dreams a withdrawal of cathexis might affect all systems equally, whereas in schizophrenia, for example, only cathexis of the system Ucs. would be withdrawn. Frosch described further how Freud had attempted unsuccessfully to distinguish dreams and various types of mental disorders on the basis of the topographical theory. What emerged from this attempt was the clear difficulty of seeking to differenti