Illness Following Dreams1

The occurrence of acute reactions in the wake of certain dreams is a phenomenon for which no satisfactory explanation has been offered, although it is a common experience in psychoanalytic therapy. These reactions vary in their intensity, their nature and their duration. They include transitory or prolonged illnesses which appear immediately on awakening from a dream or they may not occur until several hours after a night's sleep. If the patient remembers his dream he frequently tells us that his symptom is caused by it or connected with it. Otherwise he often senses that his distress is somehow related to his sleep. If his complaint does not appear until several hours after sleep and he does not remember having dreamed he has no explanation for the occurrence of his symptom. These are the patients who may consult physicians and undergo various examinations to no avail because the symptoms of which they complain are psychological in origin and are usually transitory in nature.

These acute reactions which occur in connection with dreams are either psychological or somatic and vary from mild and fleeting phenomena to prolonged and incapacitating illnesses. Those which I have observed and which I will discuss include instances of migraine, skin lesions, an acute anxiety state and an agitated depression requiring hospitalization.

In his review of the literature of the dream Freud (1) referred to the investigations of the German, French and Italian psychiatrists who had reported their observations about the relations between dreams and psychoses. He then stated that 'Fere refers to a dream which caused an hysterical paralysis. Here the dream is offered us as the ætiology of mental disturbance, though we equally consider the prevailing conditions when we declare that the mental disturbance shows its first manifestation in dream life, that it has its first outbreak in the dream.' Following Freud's discovery that the same mechanisms are at work in the formation of n