Dreams and the therapeutic process. Dreams provide an invaluable resource for people who suffer from depression. In my new book, Dreamwork in Holistic Psychotherapy of Depression (Karnac Books, 2017), I focus on dream interpretation in holistic psychotherapy of depression, linking Jung with insights derived from existential psychology. Dreams initiate a process within us that can alleviate depression and various symptomatic behaviors that mask empty, depressed feelings. I wrote this book to inspire and give hope to anyone who struggles with depression and for clinicians interested in an effective holistic approach to treatment. My goal is to demonstrate how dreamwork can benefit those experiencing this almost universal human affliction.
Dreams and the Therapeutic Process in Depression
Depression manifests in irritable or hopeless mood, loss of interest in most or all activities and daily life, fatigue, diminished appetite and loss of interest in sex, withdrawal from social interactions, feelings of guilt, self-blame, or worthlessness, impaired concentration and decision making, loss of motivation, and, in some cases, suicidal thoughts, plans, or suicide attempts. These symptoms comprise a disorder that can negatively impact our health, our safety, our productivity, our relationships, and above all our happiness.
Depression afflicts tens of millions of people worldwide, plus an estimated one in ten people in the United States and the United Kingdom. In 2011, the United States Centers for Disease Control and Prevention (CDCP) reported that antidepressant use in the United States has increased nearly 400% in the last two decades. Antidepressants are the most frequently used class of medications by Americans eighteen to forty-four years old. By 2008, 23% of women ages forty to fifty-nine years old were taking antidepressants.
In total, according to the CDCP, 11% of Americans take antidepressant medications. “More than 60% of Americans taking antidepressant medication have taken it for two years or longer, with 14% having taken the medication for ten years or more. Less than one-third of Americans taking one antidepressant medication and less than one-half of those taking multiple antidepressants have seen a mental health professional in the past year” (USCDCP, 2011).
In other words, a large number of depressed individuals take medication without getting psychological treatment. This book affirms the value of psychotherapy in alleviating depression. It introduces what I’ve found to be a promising approach using dreams and the therapeutic process.
According to a report in the Guardian newspaper (November 20, 2013), one in ten citizens of Iceland also take antidepressants daily. A 2011 study in China reported that 36 million people in that country suffer from depression, with approximately 10% of those seeking treatment. In a British Broadcasting Company report titled “Is England a nation on anti-depressants?” Mark Easton (2013) wrote:
Analysis of prescribing statistics reveals a number of English towns and cities where approximately one adult in six is now prescribed anti-depressants in an average month. . . . [M]ore than 50 million prescriptions for anti-depressants were issued last year, the highest ever number and 7.5% up on the year before. . . . Official guidance from the National Institute for Health and Care Excellence (NICE) urges doctors in England to treat patients suffering mild to moderate depression with psychological therapies. Medication is recommended for more severe depressive illness in conjunction with therapy. . . . However, access to psychological therapies is patchy.
All of this is to say that depression is a social problem of the first order, affecting nearly everyone, whether it is our friends, family members, coworkers, neighbors, our clients, or ourselves. This book describes a gentle methodology, with few risks or side effects, that uses dreams as a mirror in which to see ourselves and our situation in the light of timeless mythic meanings, ennobling our suffering and relieving some of its relentless ache.
Apart from these brief introductory details, I’m not going to present hard numbers, statistics, or graphs with facts about depression, which are available elsewhere. I’m interested here in stories that feed the soul. I ask you, the reader, to allow yourself to be touched by other people’s experiences. These distilled therapeutic conversations will hopefully inspire future dialogues between therapists and clients, between couples and family members and friends, and as inner dialogue in transforming individuals engaged in self-exploration through dreamwork. I present these narrative portraits as a contribution to the empirical study of dreams, psychotherapeutic process, and the evolution of personality. These stories illustrate that dreamwork generates moments of clarity that allow us to gain traction on our problems and begin to turn our lives around.
Dream Work in Psychology
In this book I describe my approach to psychotherapy, which reflects who I am as a quirky individual—a meditator, a musician, a capable athlete, and a student of dreams since the age of fourteen.
As a therapist, my work is formed at a place where several rivers meet. I follow Jung’s example in seeking wholeness and individuation through alignment with the internal order of the Self, which gradually reveals its blueprint for individual development.
I am interested in the therapeutic benefits of yoga and meditation and introduce these methods to many of my clients. I consider them natural antidepressants. I’m also influenced by existential-humanistic psychology, especially the works of Carl Rogers, James Bugental, Rollo May, Irvin Yalom, Sidney Jourard, Viktor Frankl, and Amedeo Giorgi. A number of my examples illustrate how I combine Jung’s reverence toward the unconscious and its symbols with the change-producing principles articulated by the great existential therapists.
I consider my work holistic in that I believe many factors contribute to our mental health; nutrition, spirituality, supportive relationships, healthy emotional expression, and discovering and enacting our life’s work can all play a role. I utilize dreams and the therapeutic process as one component of holistic psychotherapy and lifestyle. It further includes the judicious use of music, meditation, hatha yoga postures and breathing, plus aerobic exercise, healthy diet, visualization and efforts to reduce over stimulating influences such as caffeine, drugs, computers, and stress.
Dream Work in Psychology: Transforming Disciplines
Pursued alongside these transforming disciplines and lifestyle changes, dreams and the therapeutic process can be a tremendous catalyzing force. Once a client tells me a dream, therapy accelerates. Borrowing a term from the philosopher Edward de Bono, I look at dreams as provocative operations inviting creative thinking about our problems and possibilities. Dreamwork provokes unexpected feelings and insights, enabling us to think and see things differently. But it takes effort and requires an investment in the process. I understand that for many people it’s easier to just take a pill, and that is certainly an available option. This book is for people who want to do the work, including those who currently take antidepressant medications. I support resorting to whatever helps us bear the weight of existence, including prescribed drugs, intensive psychotherapy, deep meditation, peaceful time in nature, cardio workouts, dancing, swimming, and mindful cooking and gardening. There are so many ways we can become more harmonious and balanced. I also believe in the importance of finding meaning in our occupations, so that we love doing our jobs. But the method we’ll be discussing here—in-depth work with our dreams—is capable of producing especially beneficial and revitalizing effects.
Dreamwork, the practice of exploring the meaning of dream narratives and symbols, is a way to reimagine ourselves through the artistic eye of the unconscious, painter of dreams. I don’t want to oversimplify dreams, but many of them do have common themes, such as images of bodies of water, settings in the childhood home or in the hospital; encountering animals, antagonists, and rivals; or the appearance of a helpful figure. Yet with all their common, recurring elements, dreams exhibit remarkable creativity and originality, spontaneously generating unique personal symbols that mark and sanctify key life passages.
I’m not a physician and in this book I don’t approach depression as a biochemical disorder or brain imbalance. I leave that to medical experts who are knowledgeable in that area. While I recognize that many people need medications as a stabilizing influence, I don’t consider depression a single, uniform phenomenon that can be solved entirely through pharmaceutical treatment. I view depression as an outgrowth of developmental and existential challenges that can be sensitively understood and addressed therapeutically. We all have our own story, our own causes and sources of sorrow. Attending to the startling images of dreams prompts us to sort out past traumas and all the things happening in our relationships, families, and careers, generating renewed energy and commitment to specific indicated tasks.
As I describe the transformative power of dreamwork, I hope to share with you a book about depression that’s actually enjoyable to read. What I find makes it enjoyable is the people and their stories, their will to overcome adversities, their sense of humor and rediscovery of life’s joy and purpose. This book is a study of the human growth that’s possible when we listen and respond to the provocative messages of dreams, which never cease to perplex, animate, and fascinate. Those seeking relief from depression will discover that this is a way to access answers and solutions from within.
Excerpt from Dreamwork in Holistic Psychotherapy of Depression, Karnac Books, in press, Fall 2016.