Meetings of the Psychoanalytic Association of New York

January 5, 1981. A SIGNIFICANT DREAM WITHIN A DREAM. Austin Silber, M.D.

Inspired by a patient's report of a dream within a dream, Dr. Silber explored the specific meanings of this phenomenon for his patient, as well as its more general theoretical implications. In her dream, which occurred in the latter part of her analysis, the patient wanted to tell a dream to a therapy group composed of the same people who belonged to a church group she was part of in her waking life. The dream within the dream was: "D.'s wife, M., tickled me." The patient's current conflict between her waning religious devotion and her continued participation in the church discussion group, led by a clergyman named D., was part of the day residue for the dream. However, Dr. Silber focused attention on the patient's associations to the dream within the dream. M. reminded the patient of a friend she had when she was thirteen years old who tickled her while lying on top of her and pressing against her. The analyst, sensing the patient's resistance to affect associated with this memory, reconstructed that she had probably responded sexually to her friend's actions. The patient responded by recalling two memories of her mother: one, when she was about thirteen years old, of her mother walking in on her while she was bathing, telling her to carefully wash her vagina now that she was menstruating and showing her how to do this by rubbing a washcloth in her open hand; the other, when she was about three years old, of her mother again using her own body (now her genitals) to show her daughter how to correctly wipe herself after urinating. In discussing the first memory, the patient said she remembered feeling embarrassed; after she reported the second memory, she experienced anxiety (a claustrophobic feeling) and then sexual arousal in the session. The analyst felt that his reconstruction of