‘The house is on fire.  Mum and I are standing out in the street looking at the flames.  Mum is very upset.  But I am holding in each hand a leash of strings that go up into the house.  ‘Don’t worry mum,’ I say, ‘I’ve got everything on strings.’ 

Andrew’s dream expresses his predicament so appropriately.  He is the middle child of a one parent family.  They live in a small maisonette on a council estate in Buxton.  His mother struggles to earn enough to pay the rent and to keep food on the table.  His father left years ago; contact is sporadic.  His sister got herself pregnant at 15 and is struggling to complete her education and bring up her baby.  His brother is constantly   in trouble for truancy, aggressive behaviour and petty theft.  Andrew helps his mother and keeps his head down; he has to stay in control otherwise he is lost.  Now 50 years later and recently retired and feeling disconnected from his fractured family, his lover and his colleagues at work, Andrew remembers his dream.

So what are dreams.  Are they, as Professor Jim Horne, head of the sleep research centre at Loughborough University asserts, like a screen saver on a computer?  Or do have a deeper symbolic significance – a coded communication?  In antiquity, people believed that dreams were messages sent by the Gods.  Aristotle in his book, Parva Naturalia, dismissed this, explaining how dreams were based on residual images, left in the mind from events that had happened in a person’s life.  They were like forms reflected in water.  If the motion of the water is disturbed by eddies, it can be difficult to discern the image. 

In his ‘Interpretation of Dreams’, Freud insisted that the symbols in dreams were the ‘the meaningful stuff of the working day, connecting with themes that represented a person’s deepest wishes or dreads.  But he also saw the vision distorted, but not as reflections on troubled water but more like the abstractions of cubism.    Dreams are constructed from all kinds of different perspectives;  they have no rules.  Dreamers dream with their hearts not with their heads. Logic of time and space are ignored, some images are represented in great detail – others are sketched over,  there are sharp discontinuities in the dream narrative and the dreamer is represented in all of the characters. 

Despite the apparent lack of reason and logic, dreamers accepts the facts without dispute; they surrender to them, watching helplessly as things transform, converge, change and swap meanings.   There is an inability to reflect during dreaming.  But within the confused logic of the dream narrative, there is always a thematic thread – an intuition. Freud talked about the latent and manifest content of the dream.  The latent content is the theme – a wish or dread, too painful to think about, is often woven together with meaningful events of the previous day to produce the manifest dream – using processes such as condensation – the clustering of several meanings into an image and displacement, the shifting of emotionally painful experiences into a more benign image.  He saw dream as a compromise with an internal censor, a text that bore witness both to unconscious wishes and their repression. 

Dreams can be enormously complex.  It would be impossible for most of us to produce such abstract yet meaningful scenarios from within our conscious imagination.  Our brains work is metaphor and meaning.   Everything we think about, everything we do, carries meaning and is conveyed in metaphor.  And we see meaning in everything that happens.  So just as meaning and metaphor influence our conscious thought, so they influence the manifest content of our dreams, and because the rules of logic is suspended, the emotional meaning is often more clear.  This is why Freud regarded dreams as ‘the royal road to the unconscious’.  

Dream symbols are not universal.  Standard dream interpretations, dream dictionaries and dream analyses by mail exploit the gullible and vulnerable.  The sea is not always about sex ; …. and sometimes a cigar is –well – just a cigar!   Similarly there is little to support Jung’s notion that dreams are a manifestation of an archaic collective unconscious.  Dreams are personal. Dream interpretation must be based on the associations and concerns of the individual.  

Dreams are evanescent – unless they are written down or actively remembered and rehearsed immediately after waking, they disappear.  They do not enter our memory unless we convert them into a conscious memory or the scenes are so powerful, strange or frightening they are fixed by the strength of the emotion.  So what we dream and what we report as dream may be quite different. We remember our dreams more when we are disturbed by crisis.  This may not mean that we dream more; it just may mean that our sleep is disturbed, lightened by danger, that we are more conscious of dreaming – our dreams are more likely to wake us.    

Recordings of the electrical activity of the brain revealed that sleep is not consistent, there are three or four phases of sleep.  People fall deeply asleep and over the next ninety minutes, sleep becomes lighter.  This cycle may occur three or even four times during the night, but the proportion of light sleep is greater towards morning.  Dreaming was thought to occur only during the lightest phase of sleep, called rem (rapid eye movement) sleep because it is accompanied by rapid side to side movements of the eyes but paralysis of the limb muscles.  That is incorrect.  The fact is that we dream during all phases of sleep but because rem sleep only just on the dark side of consciousness, we are more likely to recall our dreams.   

Dreaming associated with rem sleep is often accompanied by anxiety, but seems to help reduce our fears by creating symbolic associations that confer meaning out of conflict.  These dreams are driven by emotion.  Just as emotional preoccupations can interrupt our waking thoughts and actions, so they create an allegory of our sleep.  Brain scans have shown that during rem sleep, regions of the prefrontal cortex, involved in arousal, emotion, memory and motivation and situated in the mezzanine of the skull the brain are activated together with a region at the occipito-parietal-temporal junction which generates abstract thinking from concrete perception and creates metaphor. What remains inert is the part of the brain which provokes and initiates actions.  The neuroscientist, Mark Sohms, summed this up by saying that in dreamwork,  compared to the generation of ideas while awake, the scene shifts from the motor end of the apparatus to the perceptual end.  The dreamer does not actually engage in motivated activity during sleep but rather imagines himself doing so and because the capacity for reflection is inactivated, the dreamer accepts the imagined scene for a real perception. 

Nightmares, sleep terrors, sleep walking and bed wetting are different.  They occur during the deepest phase of sleep – phase IV or slow wave sleep and are more like a brief psychotic attacks than dreams.  Arousal during that phase is associated with mental confusion, disorientation and uncontrolled anxiety. 

So do dreams have a purpose?  Carl Jung clearly thought so.  He considered that dreams contribute to the self regulation of the psyche, giving expression to instincts which derive from the most primitive levels of nature.  Freud went one stage further.  He thought that dreams enable us to create meaning out of psychological reality so that our everyday life becomes bearable.  They were a kind of wish fulfilment, he suggested.

So was Shakespeare correct when he had Macbeth declare that dreams knit up the ravelled sleeve of care.  Do they protect us from the terror by creating stories that are tolerable?  Igor Stravinsky thought so; he considered them part of his psychological digestive system, though Nathaniel Kleitman, the discoverer of rem sleep, declared they were more like vomiting, a way of getting rid of an irritant.  Jim Horne thinks much the same. He suggests they are just the cinema of the mind, – B quality movies generated in the cortex from messages that arise in the brain stem – fictitious and purely for entertainment.

Although it is generally accepted wisdom that it is best to sleep on a problem, can   dreams really foretell the future and lead to discovery?  Many creative people would support this idea. Leonardo da Vinci attributed many of his inventions to dreams. Elias Howe, the inventor of the sewing machine,  is said to have dreamt the inspiration of a needle with a hole near its tip. James Watt invented the process for making lead shot after dreaming about being in heavy rain.  He experimented by pouring molten lead from a church tower into a moat.  Freidrich Kekule the inventor of organic chemistry, derived the structure of the benzene ring after dreaming of a snake swallowing its tail.  The patterns of the periodic table of elements came to Dmitri Mendeleev in a dream.  Paul McCartney woke up with the tune of ‘Yesterday’ going round and round in his mind, but the lyric he thought of was ‘Ham and Eggs’.

Aristotle dismissed prophetic dreams as coincidence, but he acknowledged that dreams may cause people to see things clearly and even change behaviour.  His supposition is supported by the recent research, demonstrating how rem sleep activates the emotional limbic system and plays a decisive role in remembering ideas and events that have emotional significance and even how sleep can restructure mental representations, leading to new ideas and solutions.      

Nightmares seem to be different.  Not only do they occur during the deepest stages of sleep, but they do not seem to come up with creative solutions.  Quite the reverse; soldiers with shell shock, sufferers of post traumatic stress disorder, remain trapped in the same repetitive nocturnal terror. Their trauma causes them to repeat the same scenario night after night with all the shock and horror of when it first happened. But nightmares are not dreams; they are more the failure of dream.  Too much anxiety has rendered the symbolisation of dream ineffective, so the real images and thoughts remain unprocessed.  Very severe depression can be treated by deliberate sleep deprivation, which may avoid the recurrent nightmares but can cause induce a lack of empathy and ability to see the bigger picture – that kind of functional narcissism that avoids the pain of reality.  Maybe severe depression and recurrent nightmares are caused by too much reality in which fantasies do not work and the psyche collapses in the night.

I encourage my patients to tell me their dreams.  They may appear bizarre and complex but they are always meaningful.  They provide important insight into the way a mind is working to deal with the fears generated by conflicts of desire and reality, they reveal the nature of those conflicts and offer imaginative solutions; balm to hurt minds.  And of course, dreams can be changed and the dreadful reality of nightmares can be made accessible to dream.  As the storyteller, Ben Okri, wrote in ‘The Famished Road’,  ‘A dream can be the highest point of a life.’