Response

Dear Sir,

I would like to thank Dr Blechner for contributing new references to my research on ‘Dreams that turn over a page’. I agree that Arieti's schizophrenic patient's dream is a good example of the kind of dream in which the primitive anxiety-inducing content frightens the dreamer, although the psychoanalyst might consider it as a sign of progress in psychic integration. Arieti's observation seems to confirm my hypothesis about the role played by primitive anxieties and defence mechanisms in dream formation. I have described ‘dreams that turn over a page’ mainly in neurotic patients, but the fact that similar dreams have been described by Arieti in a schizophrenic patient confirms not only that this kind of dream appears in psychotic patients, but also in patients who have a more or less developed psychotic part of their personality, like borderline patients as well as neurotic patients themselves—although to a lesser extent.

In his interesting article (‘Changes in the dreams of borderline patients’; Contemp. Psychoanal., 19:485-98), Blechner has contributed to the description of changes in the dreams of borderline patients by showing how they shift from dreams with predominantly concrete content to more complex dreams which result from a better capacity to symbolise. With reference to the modifications he has described, I think that the ‘dreams that turn over a page’ may at first be considered as primitive dreams, but as they accompany integrative processes, they can be considered paradoxically as a sign of progress. In my opinion, they not only reflect an improvement in the patient's capacity for symbolisation but also in his/her capacity to reunify the dispersed parts of the self, a shift which is characteristic of the working through of the depressive position.

When I wrote this article I assumed that dreams of this kind had already been observed. But as they did not seem to have been conceptualised as such before, I could hardly find any references to similar