A Note on a Waking “Blank Stage” Analogous to Isakower's Phenomena, the Dream Screen, and Blank Dreams

In 1948 and 1953, Lewin (7, 8) formulated and reformulated the concept of a dream screen. The gist of the original formulation was that dreams are projected on a surface, a surface which represents the breast. His reformulation incorporated other concepts such as the Isakower phenomena, a hypnogagic phenomena which includes tactile, enveloping sensations; and the blank dream, a dream without content.

A phenomenon was noted in one of my patients which includes many aspects of the dream screen, the Isakower phenomena, and the blank dream, but occurred in a purely waking state somewhat similar to Kepec's waking screen (6). This patient's initial diagnosis was reactive depression. This was her second admission to the hospital. Briefly, her case history is as follows:

The patient is a 28-year-old, white, married female from a small town in a farming community. She had one previous episode when she was brought to the hospital in a depressed and suicidal state, was given shock treatment, recovered from the acute episode and was paroled. She was committed this time because of severe depression and inability to care for herself and her children. She was found stuporous in her room which was indescribably-dirty. She had not washed in two months and was quite emaciated.

Developmental history revealed that her father died when she was very young and the entire job of child-rearing fell to the mother. It appeared that she was a lonely, sensitive child with a rather strict mother who constantly told her what to do and what not to do, but never explained why. Sex was a strictly forbidden household topic. She was known to be a “sweet, gentle girl”. At the age of 16 she entered into a heterosexual relationship with the village “ne'er do well” and became pregnant. They were forced to marry and, shortly after, she delivered her first child. Her husband did not believe in contraception, thus she became pregnant three times in rapid succession, bearing three more children. Her