Using conversation analysis of audio recorded psychoanalytic sessions, the paper investigates dream interpretation as conversational practice. We focus on the ways in which the “real world” meanings of objects or events in the dream are collaborative created. Three routes for the meaning creation were found. (1) In plain assertions, either the analyst or the patient asserts the meaning of a dream element, for example, stating that the cow in the dream means women. (2) In meaning creation through redescription, the analyst describes anew events belonging to the real world or the dream, that have been referred to in the earlier talk. The re-description makes possible the subsequent assertion of explicit linkages between the dream and the real world. (3) In merging of referential worlds, the analyst extends the patient's real-world description by images that are recognizably from the dream; the world of the dream and the real world are thus momentarily merged. On the basis of our observations, we suggest that the dream interpretation in psychoanalytic practice does not primarily involve revealing repressed and unconscious ideas, but rather, it involves reminding the patient of something that the patient already knows but is reluctant to think or talk about.