The first dream as a psychodiagnostic tool: II. Parameters.

In the first part of this communication, we examined the way sleep is both disturbed and protected. Briefly stated, something that happened during the day revived a repressed childhood conflict, and this gave rise to a wish-impulse which would waken the dreamer if it were allowed into consciousness. To preserve sleep the wish is disguised (and gratified in a hallucinatory manner), in part, by one or more dream mechanisms, which make the dream acceptable to the censor but unintelligible on awakening. Nonetheless it can be understood, in part, by asking the patient to report what comes to mind when he or she thinks of the dream (free-associates). This together with factors to be discussed here can help the primary physician interpret the dream and decide whether or not the patient is a suitable candidate for brief supportive therapy. The decision-making process is aided by an inquiry into the nature of the psychologic conflict inherent in an asthmatic attack. For as Sharpe4 observed, the patient's psychologic attitudes are set down early in life and restaged again and again throughout life and in dreams.