Contemporary Psychoanalysis, 25(1), 108–126.
“I had a dream. You always write down dreams. This one is disgusting! I was in a restaurant and I ordered a certain dish made up of certain types of meats, delicacies, kidney, prosciutto, sautéed in urine. I thought it was disgusting, but they said try it, and I did, and I liked it. I thought it was gruesome. I heard that dreams are wish fulfillments; is that true?”
Mrs. D. is an attractive, married, woman in her early thirties. She has been in psychoanalytic treatment for three years sorting out a chaotic and horrendous life history. Raised by a strict, puritanical, rigid Catholic mother who could tolerate no disagreements or any attempts at autonomy or disobedience and by a distant, working class, sometimes alcoholic father who was prone to physically abuse her brothers and to sexually abuse her. While the specifics of the sexual abuse remain unclear, there now seems little doubt that she was repeatedly abused between the ages of five and eight.
A younger sister, having dropped out of college, returned home following a dramatic suicide attempt. Mother now spends much of her time taking care of this daughter. From a young age, Mrs. D. attempted to defy her mother, to challenge her views on religion, and to struggle for some measure of autonomy. Her experience has been consistent: mother loves, nurtures, and protects at times of weakness, neediness, and compliancy. She becomes cold and distant with the least sign of strength and independence.
In her early 20s Mrs. D. married an Asian professional. Her family was outraged. But her marriage has deteriorated as her husband would like to have a child, and Mrs. D. has not, or has not felt ready. Three “accidental” pregnancies have been terminated by abortion. It was her concerns about the repeated abortions and her sense that not wanting children might be indicative of underlying problems, and finally her sister's suicide attempt, which precipitated her decision to enter treatment.
The dream (introduced above) occurred in the third year of treatment, on a week in which she had made an appointment to begin marital counseling with her husband. I had made the referral to a male therapist after much discussion with the patient about her marital concerns.
Mrs. D. is a psychologically unsophisticated patient who has recently begun to read psychologically oriented self-help books. When she introduced the reported dream by noting my interest in dreams, I took this to be the first association to the dream. Was she attempting to cater to me, to serve me a dish, and would it be a delicacy or something less appetizing? When she bracketed the dream with a reference to wish fulfillment, I thought, how sensitive of her to tune into my area of interest. How could she have known I was looking for just such a dream “specimen”?
My first response to the dream was simply to wait in silence. The manifest theme of the dream, the dream story which I had been told, had a clearly organized structure. This was a story of being told to do something, to swallow something, and of being disgusted but enjoying it. This simple theme resonated with my knowledge about this patient and in particular with my experience in the transference-countertransference. What was it she was serving me? More to the point, what was it she felt that I was trying to shove down her throat? Mrs. D.'s dream and its analysis will be further reviewed after an examination of some theoretical issues.
Dreams have a special significance for all psychoanalysts and to some they are still regarded as the most important source of material provided by patients. For many years, psychoanalysis was identified with dream analysis, and dreams were exploited by analysts as “the royal road” to the unconscious. For Freud (1900), dream analysis revealed hidden and disguised childhood sexual wishes. Through the method of free association, the analyst could unearth the buried but preserved infantile past and bring to consciousness the derivatives of the drives.
Freud recognized and described the dramatic quality and composition of dreams. He elaborated that they have plots, characters, settings, beginnings, middles, and endings. Freud believed that the narrative coherence of dreams argued against their being considered the product of random neurological processes. In clinical work with dreams, however, Freud argued that analysts “should disregard the apparent coherence between a dream's constituents as an unessential illusion” (Freud, 1900, p. 449). For classical psychoanalytic theory, dreaming is both meaningful and motivated, but the meaning and motivation are to be found not in the manifest content, but in the dreamer's associations.
Freudian technique has always been cautious and reserved about the clinical use of manifest content. Attention to manifest content was thought to lead the analyst astray and to divert attention from the unconscious depths. However, from the beginning of the history of psychoanalysis there have always been some dissenting opinions regarding manifest content. Some early analytic writers suggested that the manifest content itself be viewed as an important communication.
As early as 1916, Jung focused attention on thematic aspects of dream structure. He suggested looking at dreams as forms of drama (1916, p. 266) and thought that most dreams had a discernible structure to which the analyst could attend as an aid to interpretation. The dream structure included the exposition (consisting of the identified characters, the setting, and the initial problem), the development of the plot, the climax of the action or the culmination, and the solution or final result. It was because of Jung's interest in narrative themes and dream structure that he recognized the potential for studying dreams in series.
While controversy has continued, there seems to be a growing consensus among analysts on the value of manifest content (Panel, 1984). Erikson's (1954) examination of the Irma dream alerted analysts to the clinical usefulness of manifest content. Pulver (1987) recently described how analysts condemn the interpretation of the manifest dream while they belie that position in their clinical behavior. He points out how psychoanalytic training texts emphasize the dangers of working from manifest content, but that many analysts are convinced of its great value. Pulver outlines many ways in which the manifest dream contributes to our understanding of the dreamer.
Kohut's description of self-state dreams has once again brought the controversy regarding the clinical use of manifest content to the center of analytic debate. Kohut (1977) described the existence of two types of dreams, structural-conflict dreams and self-state dreams. Structural-conflict dreams are described in the terms of classical theory. According to Kohut, they are dreams which express verbalizable latent content. They are the dreams of “guilty man,” and they are interpreted along the traditional lines of drive and defense. The analyst follows associations, which lead to latent dream thoughts derived from conflict between id, ego, and superego. Self-state dreams are those in which the meaning of the dream can be understood with only a knowledge of the dreamer, but with little associative activity, on the basis of manifest content alone. These dreams are attempts to bind the nonverbal tensions of traumatic states with the aid of verbalizable dream imagery. They are adaptive attempts to master the anxiety generated by a disturbing change in the state of the self.1
Kohut's approach has once again brought up the controversial question of how much to pay attention to the manifest theme of the dream and how much to rely on a detailed pursue of the patient's associations to dream elements. Kohut advised that with self-state dreams “free associations do not lead to unconscious hidden layers of the mind; at best they provide us with further imagery which remains on the same level as the manifest content of the dream” (Kohut, 1977, p. 109). Kohut (1977) argues that urging a patient to free associate to a dream, that is to break it up into its parts and to associate to each component, can be a disorganizing experience to some patients. This type of analysis can feel to fragile patients as if they themselves are being taken apart. Self-psychologists believe that it is not necessary to pursue the patient's associations, day residue, or the various dream details. The dream is understood directly, from manifest content, as a portrayal of the dreamer's dread of threats to the integrity of the self. More traditional analysts have expressed concern that an approach which relies on manifest content is superficial, and that it may lead to interpreting the dream material in accordance with preconceived ideas about the patient or in line with prior theoretical convictions. Attending to the patient's associations more rigorously serves to keep the analyst in touch with the meaning of the dream to the patient, and it allows the patient to play a more active role in the psychoanalytic process.
Slap and Trunnell (1987) criticized the self-psychology literature for not providing associations to dreams. They felt that this reflects the self-psychologist's conviction that these data do not contribute to the understanding of dreams. Because these data are not reported, any attempt to validate the concept of self-state dreams is made difficult.
Why has there been so much controversy about the clinical value of manifest content? To understand the debate, we need to examine the place of the dream in Freud's theoretical model. Psychoanalytic dream theory and the technique of dream interpretation developed in such intricate connection with psychoanalytic theory and technique as a whole that dream interpretation became the Shibboleth of classical psychoanalysis. Freud's discovery of the psychoanalytic method and his own self-analysis centered on the investigation of his own dreams. In The Interpretation of Dreams (1900), Freud presented his theory of dreams embedded in a general theory of mind, a theory of the structure of neurosis, and a theory of psychoanalytic methodology. What characterizes the Freudian point of view is that the manifest dream is seen as a facade whose purpose is to conceal and disguise and not to reveal the inner psychological life of the dreamer.
Freud explained the phenomena of dreaming in terms of the topographic theory. The dream work took place in the system Ucs, and was governed by the laws of the primary process. Freud considered the distinction between primary and secondary process thought to be among his most important contributions. He considered these two modes of thought to be antagonistic. Primary process thought was associated with the unconscious and was characterized by symbolization, displacement, and condensation. It tended to be visual rather than verbal and to disregard the laws of syntax, time, and place. In contrast, secondary process thought was characterized by logic and rationality and tended to be verbal and associated with the ego.
It has largely been assumed that Freud considered dreams to be brought about through the primary process exclusively. Any aspect of dreams that reflected more organized thought reflected secondary process thinking tacked onto the dream as part of secondary revision. At times Freud did write as if secondary revision did its work after the dream “has already, in a certain sense, been completed” (Freud, 1900, p. 313). But later, in the same work, Freud's position vacillated, and he wrote:
We must assume rather that from the very first the demands of this second factor constitute one of the conditions which the dream must satisfy and that this condition, like those laid down by condensation, the censorship imposed by resistance, and representability, operates simultaneously in a conductive, and selective sense upon the mass of material present in the dream-thoughts.
(p. 499)
But in the very next sentence Freud again depreciates the organized aspect of the dream by saying that of the conditions involved in the formation of dreams, secondary revision is “the least cogent.”
Why did Freud wish to minimize the importance of secondary revision and of the organized quality of dreams, and why have analysts since Freud continued to disparage the organized narrative quality of dreams? Because Freud used dreams as his talking-point in describing the functioning of mind, the method of free association and the topographic theory, he emphasized a certain view of the dream. Freud was determined to use dreams to prove the topographic model of the mind, the primary process functioning of the unconscious, the importance of infantile sexuality, as well as the usefulness of the free-association method. Even after the development of structural theory, Freud continued to view dreams in much the same way.
Free association is the technical term for the method used to uncover the hidden meaning of the dream. In dream interpretation, the dream must first be broken up into its component parts, that is, it must be “analyzed.” The method is very specific in breaking down the dream into its parts and not treating it as a whole. “Our first step in the employment of this procedure teaches us that what we must take as the object of our attention is not the dream as a whole but the separate portions of its content” (Freud, 1900, p. 103). The assumption is that the free associations to the various details will ultimately converge on a common theme.
The dreamer's associations begin by diverging widely from the manifest elements, so that a great number of subjects and ranges of ideas are touched on, after which, a second series of associations quickly converge from these on to the dream-thoughts that are being looked for.
(Freud, 1923, p. 110)
In describing Freud's position that the dream needs to be analyzed into its components to be interpreted, I am referring to an aspect of method and not to technique. By method I mean a mode of pursuit, a way of approaching the dream, in contrast to technique which refers to practical details. Freud was capable of great flexibility regarding the technique of analyzing a dream as can be seen in his description of “several technical procedures” (Freud, 1923, p. 109). However, from a methodological viewpoint, he argued the need to take the dream one piece at a time and to disregard its apparent coherence. Freud described his method as employing interpretation “en detail and not en masse … it regards dreams from the very first as being of a composite character, as being conglomerates of psychical formations” (Freud, 1900, p. 104).
It can be seen that to focus on manifest content was not only to be seen as superficial and missing the psychic depths, but more importantly it represented a challenge to the psychoanalytic “method” of investigation. Freud insisted that the dream be broken up into its parts and not treated as a whole. He was adamant about this because he needed to be certain that the insights into the unconscious would not be lost or trivialized. Freud anticipated, quite correctly, that if the dream were not broken up into its constituents, if it were taken as a whole, as a story, that the distinction between primary and secondary process would break down.
Seeing the manifest content of the dream as resulting from secondary elaboration which occurs after the dream is completed has enormous clinical consequences. The manifest dream story is then seen not as the “real” dream, but as an added on afterthought. It is seen as nothing but a false impression, a concocted story to disguise and mislead. This view of manifest content is in accord with the dichotomies that Freud was constructing at this early point in the history of psychoanalysis. Thus, manifest hides latent, conscious conceals unconscious, surface buries the depths, defense distorts wish, and present reenacts the past. It can quickly be seen why anyone focusing on the manifest dream story would be suspected of heresy. Clearly, to focus on manifest content was to be neglecting the unconscious, drives, the psychic depths, the nature of primary process thought, the past, and in particular infantile sexuality. A focus on manifest content would clearly mark anyone as a revisionist. This was especially true since Jung did focus on manifest content and also did dissent in regard to sexuality and other basic psychoanalytic tenets.
In my view, this aspect of the history of the development of psychoanalytic theory has had a stultifying effect on progress in dream theory and in the clinical technique of dream interpretation. Specifically, it has led to a false polarization between work with dream associations and attention to the manifest dream theme. Classical analysts have tended to neglect the coherently organized dream narrative. This is a result of the broader trend to neglect and minimize all of the more organized, structured, developmentally mature aspects of dreams. Any organized aspect of a dream is dismissed as due to the results of secondary elaboration or secondary revision, but not really a part of the dream. It is as if it could be assumed that the “real” dream is a result of primary process and that all of the seemingly organized aspects of dreams are added on after the fact.
I have been describing Freudian dream theory as it emerged in the context of the topographic theory...
