Letters From Modern Psychiatry

Alen J Salerian MD     www.modern psychiatry.gr

                                 Why Do We Dream ?

  In early 20^th-century Dr Freud and psychoanalytic psychiatry began teaching   the crucial importance of dreams to treat psychiatric ailments..     Since then ,  exploring dreams , has become  a classic therapeutic method   consistent with the  psychoanalytic theory that   dreams   may offer  critical  clues  to  discover  suppressed unconscious conflicts  . Today  many  clinicians still believe subliminal influences may explain  various  mental maladies  as diverse as depression, anxiety, worry , psychosis or  interpersonal conflicts.

  Let’s give  Dr Freud some credit  for introducing  eigenvalues- the crucial importance of invisible or not so easily observable influences- in psychiatry.

    Of interest and partly thanks to  the  technological  advances  we have also   gained new insights into  dream biology.

  Today ,we know for instance  how and when  we dream.

  We dream when our brain function  transitions from  deep sleep (non-rapid eye movement stage ) to  light sleep (rapid eye movement phase,).. This phase of sleep is a stage between wakefulness and sleep. Of significance during this phase,  prefrontal cortex function is less than  perfect. Or we can say that , our thinking is less than logical and we have less than perfect mastery of  emotions and  primitive drives. This of course means  messages from  rabbit and monkey brain  are poorly  filtered or tamed.

    In deep sleep, the brain really sleeps . There is no thinking, feeling or dreaming . Although In deep sleep brain is mostly inactive it  still responds to pain .For instance we can be awakened by painful stimuli.

  Countless brain disorders  that  disrupt normal sleep  or  deep sleep  may lead to abnormally long or  frequent light  sleep stages associated with intense  dreaming.

   In essence dreams and dream contents are by products of a less than functional prefrontal cortex   transitioning from deep sleep to wakefulness when prefrontal cortex  can neither effectively  contain  messages from rabbit ( limbic) brain nor think logically. Dream contents reflect unfiltered, unedited  messages from  our limbic brain. They are raw, unprocessed sensory input stored in limbic brain that have not been Incorporated into logical thinking and consciousness.

      Diverse dream properties offer clues to  brain function for  any alteration in sleep architecture and dreaming are associated with brain dysfunction. Conditions as diverse as  sleep apnea, depression, anxiety, stress , drugs and withdrawal from drugs( alcohol,  benzodiazepines, morphine like substances,  anti depressants etc) contribute to  abnormal sleep  interrupted by colourful , vivid, entertaining or violent  dreams.

     In summary, the advances in our understanding of brain function offer a significantly different  paradigm about  dreams  than what Freud  proposed  about a century ago.: dreams matter; don’t take their content  seriously.