Thursday, February 19, 2009

For Therapists: Tips for Exploring a Client's Dream

In chapter one of Dream Work in Therapy (2003) Clara Hill delineates five steps for the exploration of a dream with a client. Hill's kind of dream work is collaborative. The therapist is not the "dream expert." Together client and therapist figure out the meaning of the dream. I like this approach, because it gives the power and ultimate meaning-making to the client. The dreamer's associations to the elements of a dream take priority. And oftentimes the meaning of a dream comes as a pleasant surprise to both the client and the therapist.

STEP ONE: The client tells the dream to the therapist in first-person, using the present tense. The therapist takes notes, just a word to record 5-10 objects, people, actions, thoughts, and feelings from the dream. If a client brings in a written copy of the dream, it is okay for the client to review it once; however, it is best to tell the dream from memory. This helps the dreamer move into the dream space. If the dream is overly long, ask the client to pick the section of the dream that seems most salient. According to Hill (2003), it is okay to present any dream, no matter how old, as long as it is vivid and the client is motivated to work on it. Find out if the dream is a recurring one and how recent it is.

STEP TWO: The therapist helps the client to become immersed in the feelings connected with the dream.
  • "How did you feel during the dream?"
  • "How did you feel when you woke up from the dream?"
  • "How are you feeling now, as you retell the dream?"

These questions can help the client reconnect with the dream and build arousal and motivation for change.

STEP THREE: The client explores the dream, chosing five to ten images with which to work: an object, person, action, thought, or feeling using DRAW for each.

Describe the dream image in-depth. The therapist can facilitate this with questions like:

  • "Describe the dream image to me as if I were from another planet..." (Delaney, 1988).

Re-experience the image.

  • "What are the feelings at that particular moment in the dream?"
  • "Go back into the image and relive it, stating the feelings as you go through the image."

The therapist can do a little Gendlin-like work (feeling the experience and sensation in the body) or Gestalt empty chair technique.

For people with nightmares the therapist can help the client with a little breathing and relaxing to ground themselves so that they can manage their anxiety.

Associate to the dream image by searching memories, experiences, thoughts, and knowledge that relates to the image. The therapist can facilitate that by asking question like:

  • “What else do you think of when you think of (the image)?”
  • “What is the first thing that comes to mind?”
  • “Tell me more about that.”
  • “What does that mean for you personally?”
  • “What is the purpose of a (image)?”
  • “Any particular memories associated with (image)?”

Waking life. Ask the client to explore waking life triggers for each image.

STEP FOUR: The therapist summarizes the dream for the client. Sometimes hearing the dream and associations repeated back in a succinct manner helps the client put it all together and figure out the meaning; however, if the summary takes the flow away from the client, or if the exploration process has been long, the therapist can gently move the client into the insight stage.

2 comments:

Lisa Marie said...

Thank you very much for your comments. It's good to know that it's not uncommon to shy away from eye contact while discussing painful experiences. I thought I was the only one.

Genie said...

I really need to make more time to read your blog. You have the most interesting information!