The Use of Dreams in Psychiatric Work with Children

Therapists who are interested in the dynamics of human behavior are acquainted with the significance of dreams, through the publications of the psychoanalytic school. There are many psychiatrists who are not analysts but who know something of the psychoanalytic literature, and use dream material in their work with adults. They have developed skills in understanding dream symbolism and in recognizing latent conflicts in the dreams, working chiefly with the manifest content of the dream.

The literature on the direct psychiatric treatment of children contains few references to the use of dream material unless the child is undergoing psychoanalytic treatment, in which case dream material is used—as in adult analytic work—to get at unconscious material that produces conflict. In our work at the child guidance clinic in St. Paul, as in most other child guidance clinics, there is little opportunity to do very intensive case work. In rare instances it has been possible to offer a child psychoanalytic treatment, seeing him three or four times a week over a period of several months to a year or more. In the main those children who need intensive treatment are seldom seen more than once a week. Many of the children are seen for only one or two interviews in order to establish a diagnosis and recommend indirect treatment. One of our aims has been to increase our treatment program and to this end all of the members of the staff are doing therapeutic work with children. The role of the social worker in direct treatment work with children has recently been discussed by the writer.2

Whether the child comes in for diagnostic interviews or for treatment, an attempt is made in the psychiatric interview to get dream material. This has been going on for the past thirteen years in the