Thursday, March 5, 2009

For Therapists: Behavioral Work with a Dream

Chapter 3 of Clara Hill’s book Dream Work in Therapy (2003) delineates the third stage of her Cognitive-Experiential Model of working with dreams. Her first two stages—Exploration and Insight—are followed by the Action Stage. The action stage is designed to help a client make a good decision about what, if anything they want to do in response to a dream. The therapist’s role is to help the client establish and/or clarify intentions to carry out a plan of action.

Change the Dream
The first avenue of exploration for a client in the Action Stage is to change the dream. The client can change the dream in fantasy. The therapist could ask the client, “Are there any changes you would like to make in the way you handled the situation with XYZ in your dream?” The goal is for the client to feel playful with the dream. For instance, if a client did not like how she handled interacting with a dream character, she can talk and fantasize aloud how she might change that, what she might say or do differently. If the dreamer seems stuck with coming up with ways to change it, Hill (2003) recommends making a suggestion by saying, “If it were my dream, I might change it by….” The author cautions us in that dreamers who think their dream is a message from a Higher Power may not want to change their dream. In that case, creating a sequel might be more appropriate.

Create a Sequel
A sequel to the dream involves continuing the dream and giving it a different ending. A client used this technique with a particularly poignant dream she had. At the end of her dream, she regretted a lack of exchange between her and a professor she admired. In her fantasy sequel, she changed the ending, and had a conversation with him, seeking a blessing from him.

Conjure Up A Dream Helper
Hill (2003) recommends that if the dreamer was helpless in the dream, he or she can conjure up a dream helper. I use this method when working with children who have particularly frightening dreams.

Nightmare Sufferers
Changing the dream is especially helpful for people who suffer from nightmares. There are several ways to work with a nightmare. The therapist asks the client visualize the nightmare and stop it before it becomes too frightening. Then the therapist guides the client in relaxing to reduce anxiety with a mantra, progressive body relaxation, or focused breathing. Whenever intrusive thoughts return, the client can use the relaxation to calm his or her anxiety. The therapist then helps the client change the nightmare into a more positive outcome using the Neurolinguistic Programming Swish Technique. This requires rehearsal, but the idea is to replace the upsetting and anxiety-producing image with a positive image in waking life so that it can then have a positive effect on the dreamer and the dream. Since there is something to be learned from a nightmare, it is helpful for the client to both battle and befriend the frightening dream image. The client can rehearse asking the frightening dream image, “Who are you?” “What do you want from me?” “Why are you here?”

Translating Changes to Waking Life
Another way the therapist guides the client in taking an action in response to the dream is facilitating a discussion (which may come naturally out of the conversation anyway) about translating the changes in the dream to changes in waking life. See what the client comes up with, naturally. The therapist can help the client rehearse behavioral changes, give feedback, and reinforce what the client has learned regarding different behavior.

Ritual as Response
One of my favorite rituals is to honor the dream through a symbolic act. A simple act can be a response to a dream. For instance, one client dreamt a powerful dream that included the color orange. Her response to the dream was to purchase an orange candle to put on her nightstand. Another woman dreamt about cooking a chicken. Her response was to make chicken soup. It can be that simple. The act honors the dream.

Get Creative
Another way to respond to the dream is to draw it, start a dream journal, or do something creative with the dream images. I often will write a poem because the imagery in dreams is perfect for poetry. After the creative response is complete, the client should note his or her reactions to the task.

Summarize the Action Plan
The therapist can help the client in the action phase by summarizing the discussion, helping the client integrate his or her ideas. Questions like, “What are your thoughts about taking an action in response to your dream?” “Are there any changes you’d like to make in your life?” “What specifically do you want to do?”

Give the Dream a Title
A final task in the action phase, tying all of the strings together, is to give the dream a title if the client has not already done so. The title may have to do with the action that the client feels he or she needs to take.


Katherine said...

Great suggestions all - makes dreaming so interactive!

Dr. Deb said...

What a great resource this post is.

Laura said...

Dr. Deb and Katherine,

I'm glad you like the post and I hope that this kind of information is helpful. Dr. Deb, do you work with dreams in your practice?