Repairing broken links between the unconscious, sleep and instinct: and the conscious, waking and instinct

Dement (1986), doyen of sleep research in the United States and now chairman of the Association of Professional Sleep Societies, recently wrote: ‘Sleep Disorders Medicine is being practised, in one form or another, all over the United States, in thousands of places … Our professional standards must be clearly defined and adjusted for the future.’

For years problems studied were discussed as ‘sleep problems’ but gradually they came to be discussed as ‘sleep—wake problems’, as the descriptions of being partly awake while asleep, and partly asleep while awake, have become more complex.

If we search for and find lost links between sleep and the unconscious, and waking and the conscious, we may come to talk more about the relationships between the instincts of sleep and waking, their fusions, their conflicts, the varieties of normal sleep at different ages and in different situations, and the varieties of normal waking at different ages and in different situations, as well as what we wake up to, and what we are able to do only when awake. In talking to patients and colleagues we may become less apt to forget the importance of the sequence waking-sleeping-dreaming-waking-sleeping, and will watch for evidence of conflict of instincts as part of this sequence which is continually repeated, until — we hope — we reach a second childhood when, ideally, sleeping and dying become more nearly the same thing, just as we used