DREAM WORLD

November 4, 1999
		Susan Dentzer reports on the latest analysis of dreams and Freudian theory. Then, Assistant Professor of Psychiatry at Harvard Medical School Robert Stickgold and President of the American Psychoanalytic Association Robert Pyles debate the dream world. The Health Unit is a partnership with the Henry J. Kaiser Family Foundation.

June 7, 1999: The White House conference on mental health Forum: Health Insurance and Mental Illness January 1999: Freud's Legacy Sept. 8, 1998: Treating Schizophrenia July 27, 1998: A schizophrenic man opens fire at the Capitol. Dec 23, 1997: Many homeless people suffer from mental illness May 9, 1996: Health insurance for mental health Complete NewsHour coverage of health   American Psychoanalytic Association Harvard Medical School The Freud Exhibit, including a schedule and exhibit preview FreudNet, a library resource about Freud	ACTOR IN SCENE FROM "SPELLBOUND": I kept thinking while I was dreaming that all this meant something. SUSAN DENTZER: Of all the things that float through our heads, dreams are among the most mysterious. ACTOR IN SCENE FROM "SPELLBOUND": I can't make out just what sort of a place it was. SUSAN DENTZER: The ancients thought the images in dreams were a tip-off from the gods about impending events. But it was Sigmund Freud who recognized that rather than being a form of telepathy, dreams came from within our heads. One hundred years ago today, Freud published his treatise on the subject, "The Interpretation of Dreams." He called dreams the "royal road to the unconscious" -- albeit a fairly dark and dangerous road at that. In Freud's view, dreams were full of hidden meaning and repressed desires. Freud employed that theory in his own treatment of patients, called psychoanalysis. He told one disbelieving client that a dream he had had, of wolves sitting in a tree, stemmed from a traumatic childhood experience of watching his parents make love. Freud's work spawned a movement but later advances cast doubt o his theories. Today, neuroscientists have sophisticated tools like magnetic resonance imaging that let them observe the brain at work and some of the physiological processes that produce dreams. That evidence suggests a real biological basis for many of the dream phenomena Freud described, even if his analysis of what dreams mean still seems wide of the mark. Many scientists believe that dreams occur mainly during regular sleep episodes known as REM sleep, for Rapid Eye Movement. Parts of the brain that control emotion are then highly active, while other parts that control functions like logic aren't. That could help explain some of the very hallmarks of dreams that Freud identified, such as strange imagery and a collapsed sense of time. What still isn't clear is what -- if anything -- dreams mean, or what -- if any -- purpose they serve. And a century after Freud waded into the topic, it could still take years to find out.
	A theory about dreams
	TERENCE SMITH: Our dream panel includes Robert Stickgold, a cognitive neuroscientist and assistant Professor of Psychiatry at Harvard Medical School, and Robert Pyles, a psychoanalyst and president of the American Psychoanalytic Association. Gentlemen, welcome to you both. I'm curious what you both think. It's been a hundred years since Freud published this seminal work, and he still is a source of great controversy. I wonder, beginning with you, Dr. Pyles, how you see Freud and his work today. ROBERT PYLES, American Psychoanalytic Association: Well, Freud's work was at the time revolutionary in moving the treatment of mental illness from - into a humanitarian phase from the previous organic and descriptive phase. And so it was extremely important. Freud was the first to say that the associations, dreams, thoughts, symptoms of patients have meaning and can be understood, and that the understanding of those symptoms and thoughts can be used in the treatment and alleviation of suffering. And I think that aspect of his work is still just as true today as it was then.
	Freud and his work
	TERENCE SMITH: All right. Dr. Stickgold, how do you see him and his work? ROBERT STICKGOLD, Harvard University Medical School: Well, I think he was a brilliant man who came up with some insights into the human mind that still are very valuable today, but when it comes to his attempts and those after him to explain scientifically how the mind works and how dreaming, for example, comes about, its purposes, its mechanism, I really think it's time to give Papa Freud a rest, that the theories that he had are not from a scientific perspective of much use to us anymore today. TERENCE SMITH: Is he being over-interpreted? ROBERT STICKGOLD: Well, I think a lot of people want to hold onto it. I think a lot of people feel that if we move towards a biological explanation of such phenomena as dreaming that we're going to lose the mystery and the wonder and the beauty of the human mind, and frankly, I don't think anything could be further from the truth. I think that as we move to a scientific understanding, that that beauty and that wonder just gets - gets more intense and more beautiful. And so I think the over-interpretation is sort of holding on to something that's okay to let go of now.
	What dreams are made of
	TERENCE SMITH: Dr. Pyles, what is dreaming? What are dreams? ROBERT PYLES: I wonder if I could just comment on the last point? TERENCE SMITH: Certainly. ROBERT PYLES: I think that the - one of the reasons for holding on to some of Freud's thinking about dreams is that it is extremely useful clinically, and it is my hope, as new technological advances allow us to understand the workings of the mind, that there will be a true integration of the psychological aspects of the mind and the physiological aspects of the mind. TERENCE SMITH: Dr. Stickgold, do you see it as useful clinically? ROBERT STICKGOLD: It probably is, but I think a lot of different approaches to looking at dreams are useful clinically, and I wouldn't begrudge the Freudian one. I think sometimes if you lean too heavily on the concept that all dreams are wish fulfillment, you get stuck in a pattern that I would consider counter-productive. But it still has value as long as you leave room for that integration that Dr. Pyles is talking about with the physiology and the biology. TERENCE SMITH: Well, Dr. Stickgold, from what we know today, what is going on when we dream? ROBERT STICKGOLD: Well, I think what's going on when we dream is that the brain is trying to carry out the most difficult task it has in life, which is to make sense of the world. And, in a way, this fits with what Freud has said too, but from my perspective, what's actually happening is the brain is looking at different memory systems and different ways that we have memory stored and literally going like a Netscape or a Web searcher, looking for connections that make sense and trying to find out which kinds of memories that make sense to biologically and physically connect to each other to help us deal better with the world. So we're forming new associations, forming new connections in the brain, and that what we're doing when we're dreaming is watching the brain as it goes through that process. TERENCE SMITH: Is that a description, Dr. Pyles, that you would agree with? ROBERT PYLES: I think it's probably exactly right, and I'm not - and I think it's one that most psychoanalysts would agree with. I mean, I think many psychoanalysts view dreams as problem-solving mechanisms, attempts to cope with the world, just as was said, and the understanding of the dream and the use of it in clinical work really enables the therapist to help the patient -- assist the patient in his attempts to cope. TERENCE SMITH: I know, Dr. Stickgold, that some people say they don't dream. I wonder do they, in fact, not dream, or do they not remember the dreams? ROBERT STICKGOLD: The people who we all know who say they don't dream, in fact, do. If we take those people and bring them into the sleep laboratory and wake them up out of their REM sleep periods, they can recall dreams with the same 80 or 90 percent probability that everybody else does. The people who tend to report that are people who sleep very soundly through the night and who wake up with an alarm clock. And both of those phenomena make it that much less likely that you'll actually recall your dreams. ROBERT PYLES: Interestingly, in therapy, we often get people who say they don't dream, but as soon as they start actually paying attention, they do remember their dreams. TERENCE SMITH: And you think it is still useful, Dr. Pyles, to use these dreams and to interpret these dreams in therapy? ROBERT PYLES: I think it's extremely useful because I think of it as being very much like the eye doctor who examines your retina; it's the only kind of examination that can - that you can peer inside the body without some kind of surgical intervention. And I think with dreams you get a very clear understanding of how the patient's unconscious works. And so, from that point of view, it's not curative in itself, but it certainly helps the therapist and the patient understand how they are trying to cope with the world. TERENCE SMITH: Dr. Stickgold, what - tell us what's going on today in dream research an where you think it might take us in the next hundred years.
	Freud and the next hundred years
	ROBERT STICKGOLD: Well, there's two general directions that people go. And one is to try to understand more about the actual characteristics of dreams, the fact that they're bizarre, that they're hyper emotional, that they tend to leap from one story to another, to try to understand the actual natural history of what dreams are like. And that we're then trying to use to play back onto the physiology, to understand the mechanisms underlying it. The other way that research is going is looking at actual processes of how the brain when it's sleeping modifies memories and the role of the brain in both consolidating memories and integrating memories, and the function of this for the - you know, for people, for animals in general -- and then seeing how what we see in dreams themselves can reflect on to this biology. So I think what we're starting to do is learn more about the function of it. It's true that you can use that information, you can use any information from a person's memory. And I'm not convinced that dreams are that much better than other approaches to the unconscious, whatever the unconscious might be, but that we're starting to really understand dreaming as part of a process of a biological system and a brain that's just wondrously complex and which produces the mind and the consciousness that we all so much love. TERENCE SMITH: All right. Yes, go ahead, Dr. Pyles. ROBERT PYLES: I very much agree with that, and I think Freud would too. ROBERT STICKGOLD: But Freud said that the purpose of dreams was to keep us from waking up, and that the dream process involves disguising feelings and beliefs, and libidinous drives from within us. And I don't know if you've sort of moved beyond that, but the current biology gives no evidence or support for that kind of model of dreaming. TERENCE SMITH: Dr. Pyles, a final word. ROBERT PYLES: I think it has to be remembered that Freud was a neurobiologist, and he had great faith that one day the neurobiological sciences and psychology would come together in a true psycho-bio-socio understanding of the mind, and we are in great hopes that this is happening. TERENCE SMITH: All right, gentlemen, thank you both very much. ROBERT STICKGOLD: My pleasure. ROBERT PYLES: Thank you.