Sleep and Dreams in the Analytic Hour: The Analysis of An Obsessional Patient

Many interesting forms of resistant behavior appear during the analytic hour. An inability to hear or to understand the analyst and a tendency even to sleep during the session are occasionally encountered, and several cases have been reported in the analytic literature.

Ferenczi5 observed that patients in a state of resistance sometimes complain of sleepiness, which he regarded as an expression of dissatisfaction with wearisome treatment. He had a patient who went to sleep several times and had a dream which revealed his wish to be overpowered sexually by the analyst.

Stone14 described a passive patient who often exhibited “exasperating pseudo-stupid reactions,” sometimes accompanied by drowsiness. These occurred when the analyst began to speak. Stone attributed this to the patient's conflicting wishes to depend on him and to be self-sufficient. The sleep also represented hostility to the analyst and escape from what the patient perceived as the analyst's aggressive attacks, as well as a means of protecting the analyst from the patient's hostility.

Gabe7 described an obsessional man whose sleep during the therapy hour was understood as a means of inhibiting as well as expressing aggression, a death wish to atone for his angry feelings, and a wish for reunion with his mother.

Dosuzkov3 reported a thirty-five-year-old man whose sleep on the analyst's couch was understood to be both a resistance and a wish to relive and master his childhood fears concerning enuresis.

Scott13 described an obsessional patient who sometimes slept while lying silently on the couch, hoping the therapist would speak. The psychoanalytic situation was reminiscent of the early feeding situation,