Dreaming and Psychopathology: Dream Recall and Dream Content of Psychiatric Inpatients

Two motives have stimulated investigating the relationship between dreaming and mental disorders. First, the dream state itself was conceptualized by several theorists (e.g., 1) as a mental disorder and, in reverse, hallucinations of schizophrenic patients have been thought of as breakthroughs of dreams into the waking state (e.g., 2). Second, many clinicians since Freud have attempted to use dreams in the diagnosis and treatment of their patients (e.g., 3). The basic assumption for the present study is the so-called continuity hypothesis (e.g., 4,5) which states that waking-life experience is reflected in dreams. For patients with mental disorders, it should thus be possible to detect waking symptomatology by studying the dream reports of these patients. The literature reviews of Kramer and Roth (6), Mellen, Duffey and Craig (7) and Schredl (8) showed that the majority of empirical studies supports the continuity hypothesis. On the one hand, it was found that hallucinations of schizophrenic patients are not dreams experienced during the waking state (e.g., 9) and that the concept of dreaming as a mental disorder is not very helpful (cf. 10). On the other hand, dreams of schizophrenic patients are typical for this disorder, i.e., the dreams are more bizarre and are characterized by aggression and negative emotions (6). For depressive patients, Beck and Hurvich (11) and Beck and Ward (12) have found an increased amount of "masochistic" themes in their dreams. Subsequent studies (overview: 13) confirmed that dreams of depressive patients are more negatively toned and include unpleasant expeDreaming and Psychopathology: Dream Recall and Dream Content of Psychiatric Inpatients