Chapter 11: On Prediction and the Manifest Content of the Initial Dream Reported in Psychoanalysis

Controversy persists among psychoanalysis over the issue of the importance of the initial dream reported in psychoanalysis. One group considers it part of our analytic mythology; others claim, however, that at times it may be revealing of central psycho-dynamic issues. But documentation for the latter belief is scant and insufficient, since it tends to be mainly confined to clinical aspects of a single case. Freud (1911) referred to initial or early dreams, not specifically the initial dream, when he stated, “These initial dreams may be described as unsophisticated: they betray a great deal to the listener, like the dreams of so-called healthy people” (p. 95).

In this chapter we intend to review and comment on studies undertaken to validate the hypothesis that the presence of certain specific overt elements in the initial manifest dream report in psychoanalysis may be useful in predicting a limited therapeutic outcome, a limited capacity for analyzability, and could point as well to the presence of severe character pathology and certain types of ego organization. This is not intended to mean that no therapeutic gains could be expected, but that, to use a well-known concept,