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February 28, 1961. TRAUMA AND DREAM. Martin H. Stein, M.D.
Dr. Stein described certain subtle modifications of consciousness (dreamlike states) observed during the reanalysis of a woman whom he had successfully analyzed for two years some ten years before. The first analysis had revolved around severe obsessional fears that she would strangle her two little boys. Within a short time, her fears disappeared and considerable insight was achieved. For instance, she was able to understand that a prolonged and painful series of middle ear infections was related to her fantasy life. Throughout this analysis her sexual life was apparently unimpaired. The second illness, characterized by depression, was precipitated by her husband's coronary occlusion and his 'weakness' in facing the fact of his illness. This analysis, in marked contrast to the first, was characterized by lack of psychological understanding, a paranoid tendency to distort the analyst's remarks, and forgetting much that had been said to her even earlier in the hour. She frequently used clichés as a resistance and as a means of expressing her need for revenge. These phenomena finally were understood when the patient reported a fantasy: just before the session she imagined that she had fallen asleep in her car and had slept through the hour. It became clear that she was treating the analytic hour as if it were a dream, and had distorted