Dreams in the Therapy Room

Water rolled over my knees as my bare feet hit the stone path. The stream was clear, and the sky was perfect. A dolphin came up to me, singing. It swept by like a friendly dog. I petted the creature and saw more around me. I came to a window and looked out. The dolphin voices turned into some kind of ominous, familiar sound and I woke up.

Dreams have always held personal meaning to me. I've often found within them vivid metaphors and expressions of things I had not been aware of. Even when painful or nightmarish, I have treasured my dreams.

I am not alone; people have found value in dreams perhaps since the beginning of time. Psychoanalytic greats such as Carl Jung and Sigmund Freud felt dreams to be highly significant, interpreting these as signs of unconscious fears, wishes, and psychological troubles. Carl Jung in particular voiced that dreams could also be influenced through a collective unconscious, seeing that as people throughout the world encountered and created meaning, we would draw some similar symbolism in an almost metaphysical way, even if we had never met.

Today, dream interpretation in psychotherapy is much more rare. Even in the psychodynamic traditions, the meaning (if any) that an individual assigns to their dream is more significant than anything the therapist might read into it.

Yet, intense dreams are common during times of processing. Dreams of grief, particularly after the loss of someone we felt highly attached to, are almost routine (Black et al., 2019). In addition, while post-traumatic stress disorder (PTSD) nightmares can be disruptive and terror-striking, these often relate to aspects of the trauma that have not been fully processed. Within eye movement desensitization and reprocessing therapy (EMDR), a therapy that couples bilateral stimulation traditionally in the form of rapid eye movements with therapeutic processing, a scene from a PTSD nightmare will sometimes be used as a target. Of interest, some have suggested that mimicking some of the activities of REM sleep (the phase of sleep most associated with dreaming) is part of its mechanism of change (Stickgold, 2008).

Within most therapy, however, dreams are not often explored. Dreams lack a concrete, measurable quality that is often sought out through cognitive behavioral therapy (CBT). In addition, with little empirical research behind it, some consider dream exploration in therapy less scientific. It is intimidating and therapists understandably exhibit caution, particularly in regards to not projecting their own meaning into someone else's experience.

Yet, not all pieces of life people find meaning in are easily accessed through research. While I do not interpret dreams, clients often volunteer dreams they have had as important to something they are working through in therapy. Many therapists (myself included) do believe that dreams can be part of making sense of the world. In time, maybe, dream exploration will become more commonplace in the therapy room.

To find a therapist, please visit the Psychology Today Therapy Directory.