NDJ:1 Barbara Schiff

Smarter While Asleep
a working paper

It seems that some people are smarter when they are asleep than when they are awake. I am thinking of the patient who during sessions communicates superficially but then reports dreams with deeper themes and meanings than their conscious communications convey. In this paper I will give some examples of patients like this who are more maturely organized and thus smarter and deeper when they are dreaming than when they are awake. The framework for mature organization is based on Stanley I. Greenspan’s developmental diagnos­tic system. Therapists using Greenspan’s system determine patients’ adaptive and maladaptive capacities based on his insightful model of the development of the mind which emphasizes the ability to make symbols as one does in dreams and art forms.

The first patient that comes to mind is a young woman who at the present time has been in therapy for ten years, twice a week. At the start of therapy she was a disorganized bulimic incapable of even the simplest representations. During her treatment hours her speech was stilted and there were many very long silences. She has changed since that difficult beginning and recently told me that the first breakthrough toward organizing her chaotic mind came because of a dream. On a night that she had argued with her husband she dreamt of an angry pink camel that frightened her. The interpretation of the dream was that this was a picture of her and of her mother, both angry women symbolized by the color pink with the usual two breasts represented by the camel’s humps. She said she had a gut feeling of complete satisfaction with that interpretation rather like the “aha” of which many people speak. She had never before experienced her mind as so settled and organized. At the time of the interpretation she did not show her pleasure with her ability to make a repre­sentation of herself and her mother but she held onto this memory at the many times when her brain did not seem to work at all. The dream gave her confi­dence in her ability to understand, organize and symbolize thoughts, and the memory of this ability supported her through the many times she was panicked and her mind would not think.

Another vignette on this theme comes from my own therapy. Toward the end of the middle phase I had a dream of a sick person who needs to go to the hos­pital. Consciously, I could not fathom the dream’s meaning. My therapist inter­preted to me that this dream was an indication of my growing health because I recognized that I was sick. At the time I could not have verbalized or thought those words “I am sick.” But while I was sleeping I was smarter. The dream and its interpretation had the same effect on me that the camel dream had on my patient. I felt in my gut that the interpretation was correct and was pleased with my insight and truthfulness, characteristics I did not display when awake.

In some cases it is a patient’s defenses that make her seem boring. Fear can paralyze thought, feeling and communication. In these two vignettes both patients were so pleased with the workings of their minds that their fears of exposing themselves were defeated by the pleasure of their creativity. Sometimes if you tell a screaming toddler “you are angry” a broad smile comes over her as she says, “I am angry.” The content of her knowledge has taken a back seat to the process of understanding and naming. Knowing something about herself is so enjoyable that what she understands loses its threat.

As a therapist it is sometimes difficult to help a patient be objective about herself without a breakdown in the patient feeling supported. In dream analysis sometimes the breakdown can be circumvented because the thoughts and feel­ings come from the patient’s own mind originally. Thus, two things take place. First, and most important the patient experiences a cohesiveness as a result of her own creativity. Next, whatever the content of the dream interpretation, the patient feels a connection as a result of the therapist’s interpretation that some­one else knows and can recognize her. In a sense the patient may feel criticized but what she gets back in return is so valuable that the criticism loses its sting.

Dream analysis is a vital joint venture for a very frightened chaotic patient. It may be the only time or the only time in a long time that she could be calm and unthreatened enough to be on the same “wave length” as another person.