The Nightmares

Madeline, fifty-two, a psychotherapist, comes in after having a “terrible night.” “I just had one nightmare after another,” she reports with utter helplessness. “Tell me about it,” I say, knowing that she was going to, but also wanting her to know that I was curious about the content. “I dreamt I got my period and then I was bleeding non-stop. I think it was like I was having a miscarriage, which I have had in the past. It was like I was reliving that horrible experience, even though that was thirty years ago.” Madeline says, offering up an interpretation of her nightmare. “Do you have any idea why it came to your mind last night?” I ask, wondering if something had triggered her. “Yes, my son is leaving for his semester abroad and I think that is triggering feelings of loss inside of me.” Madeline says, clarifying the connection between her dream and her present state of mind. “Dreams are powerful tools that remind us what we are dealing with internally.” I say, stating what she already knows, but still feeling compelled to say it. “Yes, but I did not like waking up so upset,” Madeline says, as if reminding me not to intellectualize her distress. “Of course not. I am sorry about that.” I say, reminding her that I feel for her. “And what were your other nightmares?” I ask, reminding her that I was thinking about her opening remark. “I also dreamt that I had sexual intercourse with one of my former patients and I was horrified at my behavior.” Madeline says, with some shame, but also knowing that this was a dream, and hence she has no conscious control over the content. “Again, I wonder if you have an idea about what that was about.” I say, knowing that she is aware that I want her to take her dream one step further. “Yes, I think that my eating is out of control and I am mad at myself for gaining weight, so  this dream was in line with that.” Madeline says stringing her anger at herself for her eating together with her anger at herself in the dream. “Your self-hatred came out at night.” I say, repeating her idea, to let her know that I am thinking about what she is saying. “Your internal world is pretty black right now,” I say, ending our session with a summary comment. “You got that right,” she says, leaving a little bit less distressed, compared to the beginning of our session.

The Recurring Dream

     Maryann, fifty-five, married with three grown children, says with horrible distress in her voice, “I had this dream last night. I think I have had this dream ten or twenty times in my life and each time I wake up in a sweat and I don’t know what to do about it. ” I wonder about the content of the dream, but I hesitate to ask that directly. Maryann continues “In my dream I get pregnant. I know I am pregnant but I drink a lot of alcohol and then I wake up the next morning, in the dream, and I feel horribly, horribly guilty and confused. I can’t figure out why I drank knowing I was pregnant. I can’t stand to live with the guilt of carrying this baby to term and wondering what, if anything, I did to this innocent child’s brain. I tried so hard to get pregnant in the dream, that I am just amazed with myself that I could sabotage the experience by my drinking.” Maryann seems to be chastising herself as she describes the dream. It feels to me that the dream is a platform for her to express her self-hatred, but I don’t say that yet. “What do you think is going on?” I ask, wondering if we are going to come to the same conclusions. “”I don’t know,” she says. “I think that with my children grown, I feel empty inside, and yet at the same time, I don’t want to fill the space with another child.” I feel surprised by her interpretation of her dream. Like in my earlier post, https://shirahvollmermd.wordpress.com/2010/04/09/a-dream/, Maryann’s dream allows her to express her internal world in a way that would be more difficult if she could not frame it within the context of a dream. “In other words, your recurring dream expresses your ambivalence towards engaging with a new baby. Maybe a baby is not an actual baby, but a new project, a new focus for your life.” I say, expanding on Maryann’s understanding of her dream. “Well, it does not feel like ambivalence. It feels like I am a horribly stupid and foolish person to knowingly destroy a baby that I wanted so much.” Maryann says with utter contempt for herself. “It sounds like you are feeling guilty about something, and this guilt is very deep, hence your recurring dream,” I say, stating the obvious, but wanting to open up an exploration of her guilt. “I think I could have been a better parent. I think I could have been more patient with my kids. I feel really bad about that.” Maryann states, as tears roll down her face. “Tell me more,” I say, wanting to understand her better, and hoping that with self-understanding will come forgiveness. “I was working full-time. I had a very stressful job and when I came home I often yelled at my kids because I was frustrated with work,” she says with a feeling of terrible regret. “We have to stop,” I say, but I think we should keep talking about this. Your repeating dream mandates that.” I say, confirming that a recurring dream, even more than one powerful dream, is a good clue to a meaningful theme in Maryann’s internal world.