Not infrequently neuroses and psychoses are ushered in by a dream and their termination is announced by a dream.

This should not be understood to mean that the dream either “causes” the neurosis or “cures” it. That mistake has often been made by psychologists of the old school. Taine, among others, cites the case of a policeman who once attended a capital execution.

This spectacle made such an impression on him that he often dreamt of his own execution and finally committed suicide.

It would be absurd to believe that the sight of the execution “put the idea of suicide into his head.” He undoubtedly had been consciously or unconsciously revolving death thoughts in his mind.

The sight of the execution made those ideas more concrete and more obsessive. The recurrence of a death dream simply showed that the obsession was gradually overpowering his personality and seeking realization. The dream work, endeavouring to solve the problem of how to end his life, offered an easy solution: he did not have to commit suicide; he was being put to death. Finally the death wishes overthrew his personality and he killed himself.

An epileptic was tortured every night by a dream in which a group of boys playing Wild West (he personifying the Indian) were pursuing him, throwing sticks and stones at him and finally cornering him. At the very minute where they were laying hands on him, he would experience a “dying” feeling and wake up in great discomfort. One night he turned round to face the gang which dwindled down to one small urchin whom he spanked. That night he slept soundly and the next day his fears of having a new fit disappeared. Neither that dream nor his fits have returned. It was not the dream that gave him fits, nor was it the last dream which cured him. The obsessive dreams were wish-fulfilment dreams, showing him how to dodge life’s duties through his sickness which was a convenient, though painful, unconscious excuse and how to solve his life problems by getting out of reality.

The last dream revealed a change in his mental attitude. He was not to seek any longer a neurotic escape from reality but face reality and fight his own battles.A patient suffering from delusions had the following dream:

“A woman appeared to me and told me that it was all a dream and that all my troubles would soon end.”

Associations to that dream showed that the woman who appeared to my patient was a midwife who had helped her in a confinement some thirty years before (rebirth symbolism). At that time she almost died from puerperal fever and was also “saved” by a dream in which her grandparents appeared to her and told her that she would recover.

Her dreams, in which she placed in the mouth of other people the expression of her own wish for health, corresponded well in their mechanism with her delusions in which she heard people berating her for her imaginary sins.

At the time of the dreams, her delusions had lost their terrifying character and were only a mild annoyance to her. She had acquired enough insight to doubt their reality and to refer them to her unconscious thoughts.

The woman who imagines that in every voice she hears she can distinguish the voice of the man she unconsciously loves builds up a “story” like the dreamer who, perceiving coldness in her feet at night, saw herself falling into a lake.The technique is exactly the same in both cases.

Actual sensations are transformed into delusions closely associated with the dreamer’s or the neurotic’s complexes.

People subject to hallucinations project outside of their body symbolic figures representing wishes they have endeavoured to repress and which they refuse to recognize as a part of their personality.

They hear voices which say certain things they are trying not to think of, for they consider such thoughts as obscene, criminal or otherwise unjustifiable.

Dreamers likewise represent their disabilities as something entirely separate from their bodies and their personality.

The stammering patient dreaming that he was delivering a very eloquent speech but was interrupted by howling hoodlums, repressed out of consciousness the idea of his speech disturbance and gratified his ego by saying: “But for those hoodlums I could speak very well.”

Trumbull Ladd suffering from inflammation of the eyelids dreamt that he was trying to decipher a book in microscopic type: An attempt at shifting upon the book the responsibility for his difficulties in reading. The dream said: “There is nothing wrong with your eyes, but the type is too small.”A young woman struggling with an unjustifiable attachment for a married man told me the following dream:

“I was surrounded by little devils carrying pitchforks. I was afraid of them at first, but I finally grabbed them all in a bunch and dropped them into the fireplace. A pit opened under them and closed again and I felt free.”

Her psychology was the same psychology which in the Middle Ages caused religious people to invent the devil. Her desires which she refused to recognize as hers were little devils endeavouring to tempt her. We deal more easily with a stranger than with ourselves and “the devil tempted me” sounds more forgivable than “I did what I had always wanted to do.”

What makes it difficult for neurotics at times to tell the difference between their dreams and reality is that the emotions felt in dreams are accompanied by the same inner secretions as when felt in the waking life. A fear dream releases adrenin and a vivid sexual dream is followed by a pollution. The bodily sensations following certain dreams are evidential facts which some neurotics do not know how to controvert.

The hallucinations of delirium tremens patients which are generally accompanied by anxiety, illustrate the fact that we can be terrified and tortured by a dream which is a symbolized fulfilment of our conscious or unconscious wishes.

It is admitted by all but the very ignorant that immoderate drinking is not induced by a taste for drink but by a desire to escape reality, in the majority of cases, to drown the consciousness of financial or sexual difficulties.

The most common hallucinations of drunkards are those of snakes and lice. Snakes are almost without exception symbolical of the male sex. To the majority of neurotics, lice are symbolical of money and American slang recognizes that association in the expression lousy with money.

The “DT” patient has his wishes fulfilled. He is covered with vermin and snakes crawl about his bed. He has all the symbolical wealth and the symbolical potency or homosexual love he could wish for. But curiously enough he does not understand those symbols and is terrified by the manifest content of his morbid dream.

The story of Nebuchadnezzar in the book of Daniel is a fine illustration of the relation between dreams and insanity.

The king began to lose his sleep which was disturbed by nightmares. In the morning, however, the memory of those nightmares seemed to be entirely gone. Daniel contrived to reconstruct a forgotten anxiety dream in which the king saw a gigantic figure with head of gold, breast and arms of silver, belly and thighs of brass, legs of iron and feet of iron and clay and which toppled down when struck by a stone.

Here we have a morbid attitude to reality, the king visualizing his position (which unconsciously appeared to him precarious), through that unstable figure, and also expressing a neurotic wish to be delivered from his anxiety through the final catastrophe.

Later the king had another dream visualizing his fears and death wishes through a different image: A mighty tree grew till its head reached the heavens. Then an angel cried: “Hew down the tree, leave the stump and roots in the earth, in the tender grass of the field; let it be wet with the dew and let his portion be with the beasts.”

Fear of defeat and a neurotic desire to escape reality via a regression to the animal level are clearly indicated in this dream and in Daniel’s interpretation of it.

Very soon after, auditory hallucinations began to appear. “A voice fell from heaven,” speaking out the unconscious wishes which the king craved to gratify.In a siege of dementia praecox, Nebuchadnezzar ate grass like oxen and his body was wet with the dew from heaven; his hair grew like eagle’s feathers and his nails like birds’ claws.

After a period during which he, like all cases of changed personality, led an easier, simpler, more primitive life, without any responsibilities, Nebuchadnezzar recovered and related thus his return to reality:

“My reason returned unto me; for the glory of my kingdom, mine honour and brightness returned unto me; and my counsellors and lords sought unto me; I was established in my kingdom and excellent majesty was added unto me.”

In the meantime he had become reconciled with reality and had given up his paranoid attempts at being the mightiest factor in the world.

By accepting as a possibility the existence of a mightier power, he protected himself against the ignominy of a possible defeat. Against an omnipotent God, even he could not prevail.

Freud writes: “The overestimation of one’s mental capacity, which appears absurd to sober judgment, is found alike in insanity and in dreams, and the rapid course of ideas in the dream corresponds to the flight of ideas in the psychosis. Both are devoid of any measure of time.“The dissociation of personality in the dream, which, for instance, distributes one’s own knowledge between two persons, one of whom, the strange one, corrects in the dream one’s own ego, fully corresponds to the well-known splitting of the personality in hallucinatory paranoia; the dreamer, too, hears his own thoughts expressed by strange voices.

“Even the constant delusions find their analogy in the stereotyped recurring pathological dreams.

“After recovering from a delirium, patients not infrequently declare that the disease appeared to them like an uncomfortable dream; indeed, they inform us that occasionally, even during the course of their sickness, they have felt that they were only dreaming, just as it frequently happens in the sleeping dreams.”