Evolution of dream narratives during clinical follow-up: An observational longitudinal qualitative analysis of ten homoeopathic cases
Nikunj Jani, Chirag Shah
International Journal of Research in Psychiatry July 1, 2026 DOI: 10.22271/27891623.2026.v6.i2a.109 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational longitudinal qualitative case-series analysis Peer reviewed |
|---|---|
| Sample size | 10 |
| Population | Ten clinical cases previously analyzed in a published thematic study of dream narratives |
| Key findings | In six of ten cases, follow-up records showed an explicit change in dreams, including reduced frequency or recurrence, reduced disturbance despite persistence, disappearance, and one marked qualitative transformation in which threatening waves became smaller and the sea calmer until they merely touched the patient's feet. The authors argue that longitudinal observation of dreams may add a useful qualitative dimension to clinical follow-up. |
Abstract
Background: A thematic analysis of ten clinical cases identified five recurring domains in dream narratives: threat, anxiety and loss of control; suppressed and repressed emotional experience; aggression, conflict and the threatened self; attachment, sexuality and unmet relational needs; and vulnerability, isolation and inadequacy. The present analysis examines the follow-up component of the same cases, with particular attention to how dream narratives changed over time.
Objective: To explore changes in dream narratives during clinical follow-up and examine these changes alongside the documented clinical course.
Methods: An observational longitudinal qualitative case-series analysis was undertaken using the same ten cases analysed in the previously published thematic study. The published five-theme framework was retained as the baseline framework. The original case records were reviewed for baseline dream narratives and documented follow-up. Changes were classified as reduction in frequency or recurrence, reduction in intensity or emotional impact, qualitative transformation, disappearance of dreams, or no specific change documented. Clinical changes were recorded separately, and no dream change was inferred from clinical improvement alone. Reporting was guided by the Standards for Reporting Qualitative Research (SRQR).
Results: In six of the ten cases, the follow-up record showed an explicit change in dreams. These included reduction in frequency or recurrence, reduced disturbance despite persistence of the dream, disappearance of dreams, and one marked qualitative transformation. In the latter case, threatening waves progressively became smaller and the sea calmer, eventually becoming waves that merely touched the patient's feet. Four cases had documented clinical follow-up but no specific change in dream content, frequency or intensity was recorded.
Conclusion: Dream narratives showed several forms of change during clinical follow-up, ranging from reduction in frequency to substantial qualitative transformation. Longitudinal observation of dreams may add a useful qualitative dimension to clinical follow-up, particularly when changes in emotional tone and narrative form are considered alongside the broader clinical picture.