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Freudian Slip: Do Dreams Still Have a Role in Psychiatry


Freud set forth his theories about the importance of dreams in his landmark work The Interpretation of Dreams, published in 1900. By his own admission, Freud never could figure out what women wanted, but when it came to understanding the importance of dreams, the old boy may really have been on to something, says Reiser in an interview with WebMD.

"I think there's so much emotion about Freud one way and another, but his statement [about dreams being the royal road to the unconscious], taken in the context of 1900, wasn't so bad," he says. "I would say that even then, I don't think he meant that dreams were the only road, but that dream images can lead us to convincing memories."

Reiser contends that although Freud lacked the scientific data available today, he understood intuitively that talking about the significance of dream images through psychotherapy could lead the patient back to early traumatic memories. Freud thought that if the patient could be induced to recall repressed, painful memories -- and those memories could be aired and examined in the light of day -- they would be rendered harmless and the patient would be cured. "We no longer think that all," Reiser says.

But dreams can be used, he contends, to help a patient understand that the conflicting emotions he is currently experiencing are complicated by older, unrecognized emotions that are still meaningful, but just beyond his conscious grasp, a bit like a word at the tip of the tongue that just won't come to mind.

"In a way, [a dream] can show the patient that was then, and this is now," Reiser says. "You don't have to so terrified of offending your boss, just because you were so terrified of your father way back then."

Reiser emphasizes that dream interpretation won't cure a psychiatric disorder the way that penicillin will cure a bacterial infection. But dreams may be signposts along the road that can point the way to improvement. And here the "old school" of psychoanalysis finds itself in parallel with the "new school" of brain biology research.

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