The Clinical Use of the Analyst's Dreams of the Patient1

THIS PAPER WILL PRESENT THE THERAPEUTIC USE of the psychoanalysts' dreams of patients, with particular emphasis on the interpersonal context of the dreams. This is a topic within psychoanalysis that has a very long history but on which very little has been written. This fact is somewhat perplexing since the "specimen dream" of psychoanalysis is Freud's own dream of Irma which occurred in 1895 and is presented and analyzed in the Interpretation of Dreams(1900). This dream was only one of a number of Freud's own dreams presented in this seminal work, but from our standpoint the importance of it is that it clearly shows Freud attempting to further his understanding of a patient and aspects of his relationship to that patient through his dream. Briefly, Freud dreamed of attending a reception at which Irma was present. Freud took her aside to reproach her for not accepting his "solution" to her difficulties. She complained further of a somatic difficulty, and Freud became concerned he had missed an organic problem. He examined her finding white patches in her mouth as well as scabs that were formed like bones of the nose. Other friends of Freud then examined her including Otto. It was determined that it was an infection. Freud remembered that Otto had given her an injection of some preparation and Freud believed that the syringe had not been clean. The analysis that followed emphasized many aspects of Freud's relationship with this particular patient as well as the competition and annoyance he felt for Otto who had criticized his treatment of Irma. To Freud, the wish of the dream was to shift the blame for Irma's pain to Otto away from himself. It is unclear how the analysis of the dream was used