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PTSD & other Traumas: Ethical Issues in Using Recall
3 CEUs PTSD & other Traumas: Ethical Issues in Using Recall

Section 4
Sleep Paralysis and Dream Interpretation in PTSD

Question 4 | CE Test | Table of Contents | PTSD CEU Courses
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In the last section, we discussed facilitated communication and its possible misuse with autistic children and allegations of sexual abuse.

In this section we will examine using dream interpretation and sleep paralysis as a mode of recovering repressed memories of trauma and ethical issues.

♦ #1 The Ambiguity of Dream Interpretation
For thousands of years, people have been trying to find meaning through interpretation of their dreams. However, over the centuries, the symbols have changed dramatically. For instance, the Egyptians put symbolic authority into such things as, "If a he-goat couples with her, she will die promptly." In the second century, Artemidorus interpreted a foot as a slave and a head indicated a father. Much later, as you know, Freud gave even more weight to dreams when examining them for sexual messages and sexual abuse.

For example, a skyscraper represented a penis. The dilemma, of course, in dream interpretation is that there is little known about dreams at all. Even renowned dream researchers, who awake clients and ask them what they were experiencing as their REM indicated an active dream state, hardly know how the mind uses dreams.

♦ #2 Implantation of Sexual Abuse Dreams
Today, modern trauma therapists may ask their clients to keep an eye out for any dreams that could be interpreted as a sexual abuse memory trying to surface. Not surprisingly, soon after such advice, the client receives such a dream. For example, Ann, age 34, had this to tell to her therapist, "Oh, my god! It's all true! In my dream last night, my Dad and uncle were taking turns having sex with me. And I was just a little kid!"

However, there is evidence that may suggest that this kind of interpretation is much like hypnotism, in which the stress of the possibility of abuse implanted in the mind of the client will occupy their dreams. Calvin Hall, author of The Meaning of Dreams, states "It has been fairly well-established that some aspects of the dream are usually connected with events of the previous day or immediate past."

A Scenario to Consider
A client is told in therapy that she might be a survivor of sexual abuse. She decides to read up on abuse itself. She rents out descriptive literature about abuse and every day, her thoughts are consumed with images. Soon, her entire day is devoted to thinking about incest. That night, she has an incestuous dream. Her fears are suddenly realized as her therapist had told her to be aware of any dreams that might indicate childhood abuse.

However, if what Hall stated about dreams is true, then her salacious, sensual, dream is most likely the result of her obsession over incest, not the reality of the abuse. This is known as the "response expectancy theory" and Kirsch explains how "When we expect to feel anxious, relaxed, joyful, or depressed, our expectations tend to produce these feelings."

This creates the ethical dilemma of misinterpretation of data. Section 06 of the American Psychological Association Ethical Principles of Psychologists and Code of Conduct states, "When interpreting assessment results, including automated interpretations, psychologists take into account the purpose of the assessment as well as the various test factors, test-taking abilities, and other characteristics of the person being assessed, such as situational, personal, linguistic, and cultural differences, that might affect psychologists' judgments or reduce the accuracy of their interpretations. They indicate any significant limitations of their interpretations." When a client has undergone external influence from literature or suggestions from other therapists, interpretations of their dreams might be tainted.

♦ #3 Clients Edit their Testimonies
In addition to "response expectancy," clients may purposefully edit their dream reports to match what they believe the therapist wants to hear. Jerome Frank, author of Persuasion and Healing, notes that clients routinely give their therapists the dreams they feel their therapists expect.

He states, "The dream the therapist hears is, of course, not necessarily the one the client dreamed since considerable time has elapsed between the dream and its report. One study compared dreams reported immediately upon awakening with the versions unfolded before a psychiatrist in a subsequent interview. Any material the patient anticipated would not be approved of by the therapist was not recalled."

Obviously, if the dream is not being reported accurately, accurate interpretations cannot be produced. This makes the method of dream interpretation not only a difficult and unreliable one, but needless to say an ethical dilemma.

♦ #4 Sleep Paralysis
Another form of dream interpretation is sleep paralysis. Sleep paralysis typically takes place between sleeping and waking. During sleep paralysis, clients are known to have striking visions, and some of these are interpreted as sexual abuse memories.

The process follows as such:
1. First, a hallucination always occurs just before or after falling asleep;
2. Second the hallucinator is paralyzed or has difficulty moving;
3. Third the hallucination is usually bizarre;
4. Finally, the hallucinator is unalterably convinced of the reality of the entire event.

Normally, the content of the vision is somehow related to the hallucinator's current concerns. Like hypnosis and dream interpretation, sleep paralysis is not a proper vehicle for recovering repressed memories as the client has been too much pervaded by outside influences.

Any memory at all that might have been a real account of abuse may have been overwhelmed by false memories unknowingly implanted by the therapist. As a result, the treatment may not be focused on the true and real events, but on the false memories, consequentially mistreating the client.

In this section we examined using dream interpretation and sleep paralysis as a mode of recovering repressed memories and ethical considerations.

In the next section, we will examine the issues of flashbacks and bodily reactions to supposed repressed memories.

Peer-Reviewed Journal Article References:
Ellis, L. A. (2016). Qualitative changes in recurrent PTSD nightmares after focusing-oriented dreamwork. Dreaming, 26(3), 185–201. 

Parker, J. D., & Blackmore, S. J. (2002). Comparing the content of sleep paralysis and dream reports. Dreaming, 12(1), 45–59. 

Schredl, M. (2010). Reading books about dream interpretation: Gender differences. Dreaming, 20(4), 248–253.

A client suspects that she might have been the survivor of childhood sexual abuse. After weeks of research, she has an incestuous dream and comes to the conclusion that her theories were correct. What is this client suffering from? To select and enter your answer go to CE Test.

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