At the end of the 1960’s, when I was working at the 1st Moscow Medical Institute, I ran a number of experiments on the disruption of sleep patterns in cases of neurosis. I would systematically wake my patients during REM sleep and ask them what they had been experiencing before I woke them. Healthy subjects when woken from REM sleep would usually (in 80 – 90% of cases) report vivid and detailed dreams, packed with images and a high level of activity on the part of the characters involved. Furthermore, the more emotionally sensitive the subject, the more open he was to experiences and vulnerable in conflict situations, the longer the accounts of the dreams, the richer the imagery. Since neurotic patients are emotionally more fragile than even the most sensitive healthy individuals, I expected them to have very high levels of dreaming activity.
But I discovered the exact opposite: in almost half the cases they couldn’t tell me anything at all about their dreams, saying either that they hadn’t had any or that they couldn’t remember them. In those instances where it was possible to get an account of a dream, they were as a rule short, fragmentary, with few images and little action.
I couldn’t believe it. I doubted the reliability of my results. Then I began seeing articles in the journals about research at various laboratories around the world which described a similar paucity of dreams in depressives, sleep-walkers (lunatism) and sufferers from certain psychosomatic illnesses. It was then I asked myself whether there might not be an important general principle underlying this phenomenon that was common to all these quite different conditions.
Meanwhile, both in our laboratory and in other centres facts were accumulating which demonstrated the importance of REM sleep and dreams for psychological adaptation. In the light of this idea, I began to see a drop in the number of dreams in a patient as a sign of the inadequacy of this defensive system. Then a bold hypothesis came to me: what if the illnesses develop precisely because this mechanism – REM sleep and dreams – is not functioning for some reason?
Incidentally, this hypothesis had its antecedents: certain classics of psychiatry had suggested that the roots of mental illness should be looked for in disturbed sleep, while Freud asserted that closing the ‘safety valve’ of dreams would lead to an ‘explosion in the boiler’ – the onset of mental disorders. When the concept of search activity, in which dreams have a key role – compensation, overcoming of renunciation of search and restoration of search behaviour during the subsequent period of wakefulness – received its final formulation, the hypothesis that inadequate REM sleep and dreams accompany illness found its natural place: if the function of REM sleep is disrupted and renunciation of search cannot be overcome, then neurotic and psychosomatic disorders develop.
But why is the function of REM sleep disrupted? Why do dreams disappear? My first answer was simple. Dreams cannot withstand the burden placed on them, the requirements placed on them by difficult, stressful situations, and the reaction is capitulation. Instead of being substituted in dreams by an active position, by search, this reaction of capitulation begins to seep into the content of dreams, continues there (this is what happens during depression), going down ever deeper and strengthening. But why do dreams fulfill their adaptive function in some people, and they stay healthy, while this mechanism breaks down quite quickly in others? What are the processes taking place in the dreams themselves?
Today we are gradually finding an answer. More and more studies are showing that dreams depend on the strength of thinking in images and are closely connected with the ability to create polysemantic context. The specifics of thinking in images, that is the key to understanding dreams and their functional deficiency in the unwell.
Some years ago there was a certain vogue in the literature on neurosis and psychosomatic illness for the concept of alexithymia as the most common variant of different forms of pathology. What is alexithymia? The condition is characterised by an inability to express one’s own experiences, emotions and feelings, a person’s inability to be in contact with his own inner world. A person is detached, as it were, from everything inside himself which cannot be analysed in a strictly logical, ordered way. All the nuances of his own spiritual stirrings remain closed to him. This led to a supposition that alexithymia was the result of a breakdown in the connections between the right and left hemispheres. However, a breakdown like that should produce a situation similar to what follows the severing of the corpus callosus and the splitting of the two hemispheres. Since this is not the case, there are more reasons to suggest that the root cause of alexithymia lies in a functional deficiency of the right hemisphere, of thinking in images. This approach provides an explanation for both the typical combination of alexithymia with a paucity of dreams and a falling off in the number of dreams reported.
In my opinion, a deficiency of thinking in images, during both wakefulness and sleep, is one of the foundation stones, along with lowered search activity, of the most varied forms of pathology. It is apparent in an insufficiently formed and differentiated image of one’s own self, that most fundamental phenomenon for human behaviour. Like any right-hemisphere image, the self-image possesses all the characteristics of polysemy and infinitude, for it is engaged in complex, contradictory and numberless inter-relationships with other people and the world as a whole.
To understand how the self-image is formed and why it makes a person unique, we need go no further than an interesting and rather mysterious film My American Uncle by Alain Resnais. The film is half fictional, half documentary. At a first, and superficial, glance the director wanted to use cinema to comment on the ideas of the French physiologist and pharmacologist Professor Henri Laborit. The professor features in the opening scenes and then later, at intervals, throughout the film describing experiments he performed on rats. Placed in a difficult, stressful conflict situation, a stronger and emotionally tougher rat will come to dominate, bullying and tormenting a weaker partner, forcing it into a subordinate position. Soon the subordinate rat develops duodenal ulcers and dies. Then actors then play out a scene in which a morally weak clerk, who is in competition with a strong, aggressive colleague, feels helpless, depressed, anxious, humiliated and ends up with an acute stomach ulcer.
To underline that the behaviour of humans and rats are essentially identical, at the climax of the conflict the actors playing the rivals suddenly put on rat masks, to underline that there is no difference between people and animals, and that this, apparently, is what the good Professor Laborit wants to tell us. The whole film is constructed this way. Certain biological principles demonstrated by the behaviour of rats are applied directly to humans and illustrated by the actors. But watch the film carefully and after a while you become suspicious: by making such a simplistic, literal illustration might not the director be poking fun at the professor, engaging him in polemic by exaggerating his position and taking it to an absurd extreme? The actual title seems to confirm this suspicion. Because what’s the film got to do with an American uncle? There’s only one reference, a fleeting one at that, in the entire thing. It comes when one of the characters remembers hearing a family legend when he was a child about an uncle who had emigrated to America long before and what had happened to him. This legend had a big impact on the development of the boy’s character. Yet this one brief mention is sufficient to give the whole film its title – My American Uncle. And if I understood Resnais’ intention correctly, this was a very subtle touch. Because the seemingly incidental fact of a family legend, not real events, having a serious influence on the boy’s character represents a wholesale rejection of all Laborit’s thesis that there are direct parallels between humans and animals. Animals do not have that entire symbolic world, the world of culture, which is capable of exerting a more significant influence on a person’s development than the most serious real events. Having understood this, you begin to notice analogous hints sprinkled about the film: you notice how another character’s reactions to literary heroines determined his development, and so on.
This does not mean that man is free from the power of biological first principles. Search activity preserves physical health in both humans and rats, and capitulation leads to somatic illnesses in both, too. But whether or not a person experiences capitulation is determined not only by the real situation and not just by past experience of life. A very significant role is played by the experiences of spiritual life which are influenced by ‘non-material’ factors such as books, films, family legends – all a person’s cultural baggage. The self-image, the regulator of our behaviour, is linked by a multitude of connections with precisely this ideal world of culture. It is this world that to a large extent shapes the self-image as it reflects and absorbs all the established social norms, so tightly bound to the consciousness. Nevertheless, the self-image itself remains a fully-fledged, full-blooded, polysemantic image, an image that cannot be encompassed within even the most meticulous analysis, because its connections with the past, present and supposed future of a person, as also with the whole image of the world, are infinite. The self-image is, as I noted before, the plenipotentiary of the consciousness in the realm of thinking in images, and in this guise is responsible for the mechanisms of defence: never fully realised (because it is polysemantic), the self-image is the first to encounter new information (the right hemisphere perceives it faster than the left) and decides what can and what cannot be let through to the consciousness. From this, though, it follows that a deficiency in thinking in images will disrupt the formation of the self-image. This will, in turn, lead to disruption in the mechanisms of psychological defence, to disruption in psychological adaptation, to disintegration of behaviour. And so dreams, in which thinking in images plays a decisive role, lose their capacity to protect.
What causes inadequacy in thinking in images? After all, we are born with high potential for such thinking. In early childhood the right hemisphere enjoys the advantage, and it is only gradually and with great effort that logical thinking becomes dominant (only much later, frequently not until adulthood, is this compensated by the development of right-hemisphere polysemantic thinking). There is a perfectly good explanation for this. An infant must first of all perceive the world as a whole, in the round, without contradiction, and he must, first and foremost, learn to react to the vague, polysemantic signals that come from it. The emotional reactions of people are also perceived holistically, because such reactions by people close to the child, parental love, are a polysemantic context. We have already seen that it is impossible to analyse in detail why and how one person loves, or doesn’t love, another.
Yet the right hemisphere is not only predisposed to perceive the polysemy of emotional expression. It develops and advances under the influence of emotional links with loved ones, under the influence, too, of the infant’s own emotional reactions, expressed in gesture and non-verbal behaviour. For this reason, a deficiency of emotional contacts (when parents deprive a child of emotional support) and restricted emotional self-expression (for example, tight swaddling or chastisement for every attempt to react emotionally) lead to underdevelopment of thinking in images, an inability to create a polysemantic context, an unformed self-image. Later, as the child begins to develop, he will come under ever increasing pressure from our left-hemisphere oriented civilization. In school every effort is made to activate logical thinking alone, and computer games reinforce this trend. If these tendencies are not counterbalanced by an already developed reserve of emotional contacts and artistic interests and activities, thinking in images will be more and more suppressed and the conditions created for neurotic and psychosomatic disorders.