Professional Documents
Culture Documents
193200, 1998
Published by Elsevier Science Inc.
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ARTICLE
Abstract The Dream Interview Method of dream interpretation can be applied to dreams depicting
alcohol and drug use to elucidate the meaning of such dreams in relation to stages of recovery. This
paper summarizes the method and demonstrates its application utilizing seven dreams collected from clients in psychotherapy and participants in dream workshops. The incorporation of such interpreted dreams
into substance abuse treatment as well as their relationship to other life issues is discussed. Published by
Elsevier Science Inc.
Keywords addiction; recovery; dreams; psychotherapy; groups; using dreams.
INTRODUCTION
FROM FREUDS COCAINE dreams (Byck, 1974) to Alcoholics Anonymous (Denzin, 1988), the literature on substance abuse and its treatment contains numerous references to dreams associated with the recovery process,
one study reporting increased dreaming in 33% of subjects withdrawing from cocaine (Brower, Maddahian,
Blow, & Beresford 1988). Such dreams have become increasingly recognized as valuable clinical treatment resources (Brown, 1985; Flowers & Zweben, 1996; Wurmser,
1984). More recently, it has been noted that dream work is
highly compatible with brief therapy (Flowers, 1993), and
that this particular focussed technique of dream interpretation can be an asset under the current economic limitations
on psychodynamic psychotherapy (Flowers, 1995).
Individual interpretations of one well-documented and
notorious subgroup of these dreams, which depict the actual use of alcohol and drugs and are commonly called
using dreams, have only rarely been discussed in the lit-
METHOD
These specific interpretations of seven using dreams
were collected from work with clients prior to and during
recovery. Most of the clients were seen in an addiction
recovery group, one in individual psychotherapy, and
one in a dream interview workshop training. All the
dreams were interpreted using the dream interview
method, which has been found useful in the treatment of
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to the public. Participants come with a wide range of issues, which are not discussed independent of a dream interview.
I was doing heroin or some drug and giving it to someone
younger. A man came in who wanted us to stop doing it. I was
with about 3 other people. We were in some kind of program.
The man came over and told me about 3 things that I should
look at. I wanted to write them down. One was the movie Wine
and Roses. It definitely had roses in it. I thought in the dream
that it was about drunk people. The man gave me a friendly
hug. It felt really good. We kept hugging and he took me down
to the floor. I was surprised that he was being sexual in a room
full of people; he was a suit and tie kind of guy. He then turned
into Mao Tse Tung. I wasnt so attracted any more.
The dream interview led the client to acknowledge an addiction to marijuana, which was the most addictive
drug (heroin), and which was taking over her life, so
that she did not care about anything but the drug. She
was indeed gradually trying to control it with a program
of her own devising, that is decreasing the frequency of
the binges. Finally, she recognized herself in the conservative man in the dream: she was being supportive of her
own efforts, not making herself wrong, and was urging
herself to look at the issue of the good (roses) in her
life being drowned out by the addiction (wine, drunk
people). In addition, she was becoming more intimate with
the more out-there emotional and sexual sides of herself in a way that felt good but inappropriate. This in turn
had triggered a transition within that part of herself from
conservative to an insidious, dangerous, repressive,
cold and distant Mao-style dictatorship, which she also
recognized as a part of herself that she invokes to try to
control her own behavior.
Early RecoveryRelapsing
Case 2. This very disturbing dream occurred on an inpatient unit during early recovery. It was actually reported in the addiction recovery group 10 years later,
when the guest therapist (first author) came to work with
the group on dreams. The dreamer had an illness but was
medically stable, abstinent from illicit drugs, and committed to remaining healthy. The group had focused on
his tobacco smoking as an additional health hazard. This
old dream was reported as he was preparing himself to
address his tobacco smoking, and was talking openly
about his resistance to giving up cigarettes.
At the time of the dream, the patient had been forced
into treatment. I was playing the role of being in treatment and didnt want to have those dreams.
I was with my drug friends. Everybody was getting off. I
was shooting up. The needle was in my arm, I could feel it. I
felt happy, I was going back to what was safe, familiar, comfortable. I awoke before I had any good feeling. I felt disappointed.
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Late Recovery
Case 6. The client presented this dream in recovery
group saying, I had a using dream, just a little one.
I was trying to use a needle to avoid getting back on methadone. I was hiding it.
I was so relieved when I woke up. It scared me! I was so
scared!
DISCUSSION
In our experience, using dreams represented about 30%
of the dreams presented in the recovery group, but a
much smaller proportion of the dreams from other settings. This higher proportion of using dreams reported in
the recovery group compared to workshops probably reflected both the composition of the group, which included a higher proportion of people in recovery, and its
purpose. The purpose of the group was to provide support for recovery and an arena to explore issues that
emerged once abstinence was secured. Though many of
the group participants were stable in their abstinence, using dreams are normally worrisome and so might be
more likely to be presented to a dream consultant, regardless of when they occurred. By contrast, participants
in the workshops are probably more guarded about revealing using dreams. Patients in individual therapy during recovery regularly reveal using dreams in our experience, similar to the recovery group, but they are a small
proportion of their total dreaming, probably because individual therapy encompasses a much wider psychological focus.
Looney (1972) also found wide variability (05% to
75100%) in the percent of dreams that are using dreams
reported by persons in addiction treatment, with the majority under 74%. We hypothesize that our findings probably reflect the proportion of clients in the recovery
group in earlier recovery. Early recovery seems to be accompanied by more using dreams, and they certainly
evoke the greatest attention and anxiety from the dreamer,
with the possible exception of other nightmares. It is
common and highly distressing for patients to awaken
confused about whether they have actually used or not.
They may also interpret using dreams as a failure of motivation or effort on their part. Reassurance and explanation that withdrawal phenomena may also influence the
production of these dreams is useful. Knowledge of them
as a resource through dream interviewing seemed to have
an empowering effect.
As recovery progresses, it is noticeable that the frequency of using dreams gradually diminishes, one client
stating that he had had no using dreams since his eighth
year of recovery. However, it is not unusual for occasional using dreams to occur at key moments in people
with long-term stable recovery. They often reflect the
presence of a major stressor, difficult emotional experience, or life transition (Case 6). In such cases, using appears to represent a return to earlier mode of coping
(Case 7), and the using signals the danger of events and
experiences in the current life situation. Once the
dreamer focuses on these events and acknowledges their
importance, the using dreams tend not to recur. Dream interviewing appears to actively facilitate this process, pinpointing the dynamic of the conflict as well as the general issues.
Although using dreams are described by a number of
authors (Denzin, 1988; Looney, 1972; Morrison, 1990),
there are few articles describing the interpretation of using dreams from either large numbers of patients, or one
persons dreams in sequence throughout addiction recovery. A few specific interpretations of individual using
dreams are described in the psychoanalytic (Smaldino,
1991; Wurmser, 1984) and addiction (Brown, 1985;
Kaufman, 1994) literature. However, addiction is noticeably absent from Nattersons (1993) comprehensive text
on dreams in clinical practice.
In psychoanalytic interpretations (Denzin, 1988), using dreams have been taken literally at their manifest content, and been supposed to indicate repressed wishes or
desires to use, and to represent continuations of waking
preoccupations with this issue. Brown (1985) extends
this idea to characterize similar drinking dreams of early
recovery as having an unconscious alert function, as in
Case 4. This using dream affirms sobriety or functions as
a guidepost to progress in recovery. Much of the time,
neither of these dream types requires sophisticated interpretation skills, since the general meaning is often transparent. Nonetheless, we were interested to note that when
dream interviewing was conducted, although the clients
interpretation did not fundamentally change, further useful information was added as details were defined and interpreted to reveal specific dynamics. Understanding these
dynamics helped tailor appropriate management strategies. This supports the validity of our previous clinical
impressions that these early recovery using dreams help
affirm sobriety in a variety of ways, and extend the help
into specific treatment indications.
An alert function is also served in a very different way
by dreams such as Case 2. These might be called relapsepending dreams, distinguished by the disappointment
upon awakening, and they may indicate a potential predictive tool for clients and therapists, in a very similar
fashion to that suggested by Fiss (1991) research. Also
of interest here, the dreamers in Cases 2 and 3 did not actually experience the high in the dream, similar to
Looneys (1972) experience. One explanation might be
that her sample and Case 2 consisted of clients in the recovery process, and, therefore, less likely to reexperience
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health systems, an ability to pick up the thread of treatment quickly and accurately midstream becomes more
and more imperative for therapists and primary physicians alike. Moreover, the fact that pairs of clients can
become proficient in dream interviewing without a therapist allows them to monitor their own needs in recovery,
and so correctly inform a new therapist or seek appropriate supports in a timely fashion. In addition, the increasing use of medication as a less expensive treatment is not
always appropriate in addiction recovery that makes the
development of rapid and inexpensive psychodynamic
treatments even more urgent. Additional reports of dream
interviewing in recovery will be necessary to further
evaluate the efficacy of this method.
REFERENCES
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Brown, S. (1985). Treating the alcoholic. New York: John Wiley & Sons.
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APPENDIX A
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Step 2. Recapitulation
Interviewers Steps for Recapitulation:
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APPENDIX D
Step 5: Summary