Chapter 5. From the Initial Interview to Therapy

Introduction

Readers of this book will frequently encounter the interpretation of dreams as being the via regia to the unconscious and, at least as dreamers, they will also have taken this royal path. A dream cannot be equated with the unconscious but it is, in Freud's words, the via regia to it, getting lost somewhere in the depths of the unconscious. Dream interpretation enables analysts to get close to unconscious fantasies. The interpretations lead to the latent, i. e., the unconscious meaning of the dream. To be precise, then, the interpretation and not the dream itself is the via regia to the unconscious.

The series of dreams described in this chapter were embedded in a course of treatment that formed a significant phase in the life history of a patient and in the course of his illness. In order to be able to follow dream interpretations critically, it is essential to be aware of the patient's biographical background, his illness, and the implications of his illness for his self-esteem. Information and discussion of these points serve several purposes. For example, a patient's dreams are influenced by his neurotic and somatic illness. It therefore seems logical to take this case as a starting point for discussing general problems of psychoanalysis and psychosomatic medicine that go far beyond dream interpretation.

In 1924 Rank published a monograph entitled Eine Neurosenanalyse in Trau-men, in which he described a therapy that took the form of a pure dream analysis. In interpreting a large number of dreams during a 150 session therapy, which was successful, he did not distinguish between abstract interpretations and individual therapeutic ones. We mention this typical publication from the 1920s because the contrast between it and the present day demonstrates the progress that has been made in analytic technique. We believe it is essential to make the reader aware of the individual steps in an analyst's interpretative work in his dialogue