Relating Addict: Dreams and the Therapeutic Relationship

Understanding Dreams in Trauma: Beyond Repression

This blog post explores the role of dreams in individuals with trauma, particularly those with borderline or psychotic presentations, and here, we delve more deeply than the Freudian concept of repressed unconscious, examining the idea of an "unrepressed unconscious" shaped by early experiences (Scalabrini et al. 2021):

The Compulsion to Repeat

Trauma survivors often experience dreams that seem to repeat the traumatic event. This repetition isn't a conscious choice but rather a way for the mind-body system to initially process what it couldn't handle. These dreams lack the symbolic language of neurosis and instead focus on raw emotions and sensory details.

The "Unrepressed Unconscious"

Freud's theory emphasized repressed memories, those actively pushed down. However, for traumatized individuals, especially those with pre-verbal experiences, the trauma may be "unrepressed" - lodged in the amygdala (our emotional center) and influencing us unconsciously.

The Role of Memory Systems

Our memory systems play a crucial role. Repressed memories involve active forgetting and are linked to conscious thought. Unrepressed memories, often from pre-verbal stages, reside in the implicit memory system, with the amygdala playing a central role.

Dreams as a Bridge

Traumatic dreams can bridge the implicit (bodily) and explicit (narrative) memory systems. Triggers in daily life or therapy can reactivate these memories, leading to dreams that express them in sensory and emotional ways.

The Importance of Nightmares

Nightmares, often accompanied by intense emotions, are crucial to processing trauma. They represent an initial attempt to verbalize what was previously nonverbal. Through dreams, patients can integrate these experiences into their conscious awareness. A safe and supportive therapeutic relationship is essential. By focusing on bodily sensations and verbalizing emotions, therapy helps patients utilize dreams as a symbolic tool to work through past experiences.

Beyond the Neurotic Spectrum

Severely borderline and narcissistic patients may have difficulty with dreams or remembering them. This difficulty is linked to problems with symbolizing emotions. The body receives emotions but doesn't connect them to feelings, leading to a "short circuit" where emotions remain trapped in the body. (Scalabrini, et al, 2021)

Conclusion

Dreams in trauma offer a window into the "unrepressed unconscious." By understanding the link between implicit memory, emotions, and dreams, therapists can help patients utilize dreams for healing and integration.

References

Scalabrini, A., Mucci, C., & Esposito, R. (2021). Dreaming the unrepressed unconscious and beyond: repression vs dissociation in the oneiric functioning of severe patients. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(2). https://doi.org/10.4081/ripppo.2021.545