The clinical and predictive value of the initial dream of treatment.

The initial dream reported in psychotherapy provides clinically useful information. Analyzing 63 patients' first treatment dreams, independent evaluators found that these dreams almost always contain negative emotions. The psychodynamic themes in these dreams reliably predict core issues that emerge later in therapy. Transference—feelings toward the therapist—is evident in many initial dreams and is often negative. The most common dream themes fall into relational or injury categories. These themes, along with positive or negative transference, relate to how well patients progress in therapy. The findings confirm that the first dream reported in treatment offers significant predictive and clinical information.

Study at a glance

Abstract

The authors collected the initial dreams of treatment from 63 patients and independently evaluated the manifest dream report (MDR). Variables included: Affect and Valence of Affect; Associations; Psychodynamic Theme; Psychodynamic Theme as Predictor of Core Psychodynamic Issues; Transference; Gender; Psychodynamic Theme Categories; Clinical Progress in relation to Psychodynamic Theme Categories and Transference. The initial MDR invariably contains Affect that is frequently Negative. The Psychodynamic Themes of MDRs are dependable predictors of Core Psychodynamic Issues that emerge during treatment. Transference is evident in a significant number of MDRs and is often Negative. Gender of the majority of MDRs is predictable. The most frequent Psychodynamic Themes of initial MDRs fall into Relational and Injury Categories. Relational and Injury Themes, as well as Positive and Negative Transference, are associated with clinical progress. This study confirms that the initial MDR of treatment provides a significant amount of clinical and predictive information.