Discussion of a Dream Pair Reported by a Patient with Early Essential Hypertension

In Emotional Factors in Hypertension, Alexander1 stated: 'The comparative study of a series of cases suffering from essential hypertension indicates that chronic, inhibited, aggressive hostile impulses, which always appear in connection with anxiety, have a specific influence upon the fluctuations of the blood pressure. Furthermore, it suggests that patients suffering from hypertension have a characteristic psychodynamic structure. This consists in a very pronounced conflict between passive, competitive, aggressive hostile impulses which lead to fear and increase a flight from competition toward the passive dependent attitude… Characteristic for the hypertensive patient is, however, his inability to relieve freely either one of the opposing tendencies: neither can he freely accept the passive dependent attitude nor freely express his hostile impulses. A kind of emotional paralysis can be observed which results from the two opposing emotional attitudes blocking each other… One of the best founded discoveries of psychoanalysis is that impulses which are inhibited in their expression sustain a chronic tension which is apt to have a permanent—or we may call it a tonic—effect upon certain physiological functions. This is the etiological theory of the psychogenic organ neuroses. An acute elevation of the blood pressure is part of the normal reaction to acute rage and fear.'

The patient whose dreams are discussed in this paper was a man of forty-five, married, the father of three children. He held a very important position as the head of a food processing company. He