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Dream-Based Interventions and Post-Traumatic Stress Disorder

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Dream-Based Interventions and Post-Traumatic Stress Disorder Running head: DREAM-BASED INTERVENTIONS 1 Dream-Based Interventions and Post-Traumatic Stress Disorder A Literature Review Presented to The Faculty of the Adler Graduate School ____________________ In Partial Fulfillment of the Requirement for The Degree of Master of Arts in Adlerian Counseling and Psychotherapy ____________________ By Kurt Pope ____________________ Chair: Rachelle J. Reinisch, DMFT Reader: Meghan Williams, MA ____________________ July, 2017 DREAM-BASED INTERVENTIONS 2 Abstract With the vast amount of conceptual frameworks and research on dreams, datum suggests that dream-based interventions can be effectively utilized in clinical mental health settings. Additionally, a paradoxical relationship exists between dreams and trauma, so dream-based interventions could be of value when implemented in post-traumatic stress disorder (PTSD) treatment protocol. Integration of current dream-based interventions in conjunction with Individual Psychology could produce a protocol to target re-experienced PTSD trauma-related dreams. Attending to trauma-related dreams from a cognitive, emotional, and social perspective could have an impact on the treatment of concurrent waking-life symptoms of PTSD. Keywords: dreams, PTSD, Individual Psychology DREAM-BASED INTERVENTIONS 3 Acknowledgements Genuine thanks to my family, friends, David Thompson, John Reardon, Erin Rafferty- Bugher, Dr. Rachelle Reinisch, and Nikhil Kaistha for knowledge, guidance, and patience. DREAM-BASED INTERVENTIONS 4 Dream-Based Interventions and Post-Traumatic Stress Disorder Copyright © 2017 Kurt Pope All rights reserved DREAM-BASED INTERVENTIONS 5 Table of Contents Dream-Based Conceptual Frameworks .......................................................................................... 8 Freudian Framework ................................................................................................................... 8 Jungian Framework ................................................................................................................... 10 Narrative Therapy Framework .................................................................................................. 12 Adlerian Framework ................................................................................................................. 14 Individual Psychology .................................................................................................................. 16 Lifestyle .................................................................................................................................... 16 Private Logic ............................................................................................................................. 18 Significance, Belonging, and Social Interest ............................................................................ 20 Post-Traumatic Stress Disorder .................................................................................................... 22 Current Treatment and Interventions ........................................................................................ 24 Mindfulness-based stress reduction. ..................................................................................... 24 Cognitive processing therapy. ............................................................................................... 25 Prolonged exposure therapy. ................................................................................................. 25 Trauma management therapy. ............................................................................................... 26 Complementary and eclectic treatments. .............................................................................. 27 Trauma and Dreams ...................................................................................................................... 28 Content of Trauma-Related Dreams ......................................................................................... 29 Effect of Trauma-Related Dreams ............................................................................................ 31 Purpose of Trauma-Related Dreams ......................................................................................... 31 Emotional processing. ........................................................................................................... 31 Memory assimilation. ........................................................................................................... 32 Threat simulation theory. ...................................................................................................... 33 Current Use of Dream Work ......................................................................................................... 34 Discussion ..................................................................................................................................... 38 Implications for Practice ........................................................................................................... 41 Introduction. .......................................................................................................................... 41 Record and share the dream. ................................................................................................. 42 Exploration of dream content................................................................................................ 43 Meaning and metaphor. ........................................................................................................ 43 Reconstruct and reprocess..................................................................................................... 45 DREAM-BASED INTERVENTIONS 6 Create an action-based plan. ................................................................................................. 45 Conclusion .................................................................................................................................... 47 References ..................................................................................................................................... 49 DREAM-BASED INTERVENTIONS 7 Dream-Based Interventions and Post-Traumatic Stress Disorder Post-traumatic stress disorder (PTSD) is a stress-related disorder that results from exposure to a traumatic event (American Psychiatric Association, 2013). The intrusive symptom of recurring trauma-related dreams has a significant negative impact on the functionality of an individual on an emotional, cognitive, and social level. Recurring dreams as a re-experiencing of the initial traumatic event can be a predictor of more severe symptoms of PTSD (Mellman, David, Bustamante, Torres, & Fins, 2001). Research on treating the symptoms of trauma-related dreams is uncommon in the mental health field, and conducted studies have included small sample sizes and differing theoretical orientations. While most treatments such as the cognitive-behavioral therapy approach, reduce specific symptoms of PTSD, an effective approach to address a number of complex symptoms (i.e., emotional distress, negative thinking patterns, and isolation) of PTSD has not yet been developed (Hill & Knox, 2010). Complementary treatments are effective when used individually, but research suggests that when used together, effectiveness is not increased because the treatments address the same symptom, just in different theoretical fashions (Foa et al., 2005; Foa et al., 1999; Paunovic & Ost, 2001). Conceptual frameworks regarding the use of dreams have been developed by the most prominent names in the field of psychotherapy, such as Freud, Jung, and Adler. Additionally, dream-based interventions are currently being used in a clinical setting to address the symptoms of various forms of psychopathology (Hill & Knox, 2010). It may be possible that by drawing on past conceptual frameworks and integrating them with effective and empirically-supported dream-based interventions utilizing the most current clinical datum, a clinical protocol that encompasses all symptoms of PTSD could be developed. By targeting specific symptoms of DREAM-BASED INTERVENTIONS 8 trauma-related dreams with effective dream-based interventions and a theoretical perspective that addresses the emotional, cognitive, and social elements of mental health, other significant symptoms of PTSD, such as isolation, may be treated. Dream-Based Conceptual Frameworks Dreams are an essential part of the human experience and have fascinated people for centuries (Givrad, 2016). According to Dallett (1973), the practicality of using dreams in a psychotherapeutic setting has been highly debated for quite some time. In fact, the use of dreams as a therapeutic intervention has been met with skepticism and scrutiny. Dallett stated that Freud’s conception of dream theory is the most widely used theory of dream work, second only to scientific approaches (e.g., the study of neuroscience). Differing conceptual frameworks exist regarding dream work from some of the most well-known names in psychology. For example, mental health professionals are familiar with the work of Sigmund Freud, Carl Jung, and Alfred Adler; however, most favor Freud’s psychoanalytic conceptual framework (Dallett, 1973). Freudian Framework Sigmund Freud theorized that access to the unconscious tendencies of an individual would allow for insight and healing (Montenegro, 2015). The concept of the unconscious is of utmost importance in Freud’s model of dream
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