"Long before it's in the papers"
July 28, 2009

RETURN TO THE WORLD SCIENCE HOME PAGE

“Dream therapy” set for a comeback?

July 28, 2009
Courtesy European Science Foundation
and World Science staff

Si­m­i­lar­i­ties in brain ac­ti­vity be­tween a spe­cial dream­ing state and some forms of men­tal de­range­ment sug­gest “dream ther­a­py” may be ripe for a come­back in psy­chi­at­ric treat­ment, a Eu­ro­pe­an Sci­ence Founda­t­ion work­shop has con­clud­ed.

This idea is strength­ened by the po­ten­tial ev­o­lu­tion­ary rela­t­ion­ship be­tween dreams and psy­cho­sis, ac­cord­ing to the group.

Lu­cid dream­ing – a state in which you are aware you are dream­ing – is a hy­brid state be­tween sleep­ing and be­ing awake. It cre­ates dis­tinct pat­terns of elec­tri­cal ac­ti­vity in the brain with si­m­i­lar­i­ties to pat­terns made by psy­chot­ic con­di­tions such as schiz­o­phre­nia, char­ac­ter­ized by a loss of tou­ch with real­ity, ac­cord­ing to re­search­ers.

The work­shop sci­en­tists say that con­firm­ing links be­tween lu­cid dream­ing and psy­chot­ic con­di­tions of­fers po­ten­tial for ther­a­pies based on how healthy dream­ing dif­fers from the un­sta­ble states as­so­ci­at­ed with brain dis­or­ders.

New da­ta af­firms the con­nec­tion by show­ing that while dream­ing lu­cidly the brain is in a “dis­so­ci­at­ed” state, ac­cord­ing to Ur­su­la Voss of the Un­ivers­ity of Frank­furt in Ger­ma­ny. Dis­socia­t­ion in­volves los­ing con­scious con­trol over men­tal pro­cesses, such as log­i­cal think­ing or emo­tion­al re­ac­tion. In some psy­chi­at­ric con­di­tions this state is al­so known to oc­cur dur­ing wak­ing. 

“In the field of psy­chi­a­try, the in­ter­est in pa­tients’ dreams has pro­gres­sively fall­en out of both clin­i­cal prac­tice and re­search. But this new work seems to show that we may be able to make com­par­isons be­tween lu­cid dream­ing and some psy­chi­at­ric con­di­tions that in­volve an ab­nor­mal dis­socia­t­ion of con­sciousness while awake, such as psy­cho­sis, de­per­son­alisa­t­ion and pseu­do­seizures.” said the work­shop’s con­ven­or Sil­vio Scarone, from the Un­iver­sità degli Studi di Mi­la­no in Mi­lan, It­a­ly. 

Mean­while, the pre­vi­ously dis­cred­ited idea of treat­ing some con­di­tions with dream ther­a­py has at­tracted in­ter­est from clin­i­cians, mem­bers of the group said. An ex­am­ple is that peo­ple suf­fer­ing from night­mares can some­times be treated by train­ing them to dream lu­cidly so they can wake them­selves up.

“On the one hand, bas­ic dream re­search­ers could now apply their knowl­edge to psy­chi­at­ric pa­tients with the aim of build­ing a use­ful tool for psy­chi­a­try, re­viv­ing in­ter­est in pa­tients’ dreams,” con­tin­ues Scarone. “On the oth­er hand, neu­ro­sci­ence in­ves­ti­ga­tors could ex­plore how to ex­tend their work to psy­chi­at­ric con­di­tions, us­ing ap­proaches from sleep re­search to in­ter­pret da­ta from acute psy­chot­ic and dis­sociated states of the brain-mind.”

The ex­ist­ence of such psy­chot­ic con­di­tions may be root­ed in the ev­o­lu­tion­ary role of dreams, re­search­ers said. One the­o­ry holds that dream­ing emerged to ena­ble early hu­mans to re­hearse re­sponses to the many dan­ger­ous events they faced in real life. De­vel­oped by Antti Revon­suo at Un­ivers­ity of Tur­ku in Fin­land, if this “threat sim­ula­t­ion” the­o­ry is cor­rect dream­ing may have ori­gins far back in ev­o­lu­tion, giv­en that oth­er mam­mals such as dogs al­so ex­hib­it the char­ac­ter­is­tic elec­tri­cal ac­ti­vity of dream­ing. 

Re­search­ers al­so looked at the idea that par­a­noid delu­sions and oth­er hal­lu­ci­na­tory phe­nom­e­na oc­cur when the dis­sociative dream­ing state in­volv­ing re­play of threat­en­ing situa­t­ions is car­ried through in­to wake­ful­ness. 

“Ex­po­sure to real threat­en­ing events sup­posedly ac­tivates the dream sys­tem, so that it pro­duces sim­ula­t­ions that are realis­tic re­hearsals of threat­en­ing events in terms of per­cep­tion and be­haviour,” said Scarone. “This the­o­ry works on the ba­sis that the en­vi­ron­ment in which the hu­man brain evolved in­clud­ed fre­quent dan­ger­ous events that posed threats to hu­man re­pro­duc­tion. These would have been a se­ri­ous se­lec­tion pres­sure on an­ces­tral hu­man popula­t­ions and would have fully ac­tivated the threat sim­ula­t­ion mech­a­nisms.”

How­ev­er, many re­search­ers be­lieve dream­ing probably did­n’t evolve purely to rec­re­ate threats. It may al­so have a role in the learn­ing pro­cess, ac­cord­ing to Al­lan Hob­son, a psy­chi­a­trist and dream re­searcher re­cently re­tired from Har­vard Un­ivers­ity. Con­tents are added while you are awake and in­te­grat­ed with the au­to­mat­ic pro­gram of dream con­sciousness dur­ing sleep. This works with ob­serva­t­ions that day­time learn­ing is con­sol­i­dat­ed by night-time sleep­ing, lead­ing to the find­ing that peo­ple re­mem­ber facts bet­ter the day af­ter they have learnt them than at the time.

* * *

Similarities in brain activity between a special dreaming state and some forms of mental derangement suggest “dream therapy” may be ripe for a comeback in psychiatric treatment, a European Science Foundation workshop has concluded. This idea is strengthened by the potential evolutionary relationship between dreams and psychosis, according to the group. Lucid dreaming – a state in which you are aware you are dreaming – is a hybrid state between sleeping and being awake. It creates distinct patterns of electrical activity in the brain with similarities to patterns made by psychotic conditions such as schizophrenia, characterized by a loss of touch with reality, according to researchers. The workshop scientists say that confirming links between lucid dreaming and psychotic conditions offers potential for therapies based on how healthy dreaming differs from the unstable states associated with brain disorders. New data affirms the connection by showing that while dreaming lucidly the brain is in a “dissociated” state, according to Ursula Voss of the University of Frankfurt in Germany. Dissociation involves losing conscious control over mental processes, such as logical thinking or emotional reaction. In some psychiatric conditions this state is also known to occur during waking. “In the field of psychiatry, the interest in patients’ dreams has progressively fallen out of both clinical practice and research. But this new work seems to show that we may be able to make comparisons between lucid dreaming and some psychiatric conditions that involve an abnormal dissociation of consciousness while awake, such as psychosis, depersonalisation and pseudoseizures.” said the workshop’s convenor Silvio Scarone, from the Università degli Studi di Milano in Milan, Italy. Meanwhile, the previously discredited idea of treating some conditions with dream therapy has attracted interest from clinicians, members of the group said. An example is that people suffering from nightmares can sometimes be treated by training them to dream lucidly so they can wake themselves up. “On the one hand, basic dream researchers could now apply their knowledge to psychiatric patients with the aim of building a useful tool for psychiatry, reviving interest in patients’ dreams,” continues Scarone. “On the other hand, neuroscience investigators could explore how to extend their work to psychiatric conditions, using approaches from sleep research to interpret data from acute psychotic and dissociated states of the brain-mind.” The existence of such psychotic conditions may be rooted in the evolutionary role of dreams, researchers said. One theory holds that dreaming emerged to enable early humans to rehearse responses to the many dangerous events they faced in real life. Developed by Antti Revonsuo at University of Turku in Finland, if this “threat simulation” theory is correct dreaming may have origins even further back in evolution, given that other mammals such as dogs also exhibit the characteristic electrical activity of dreaming. Researchers also looked at the idea that paranoid delusions and other hallucinatory phenomena occur when the dissociative dreaming state involving replay of threatening situations is carried through into wakefulness. “Exposure to real threatening events supposedly activates the dream system, so that it produces simulations that are realistic rehearsals of threatening events in terms of perception and behaviour,” said Scarone. “This theory works on the basis that the environment in which the human brain evolved included frequent dangerous events that posed threats to human reproduction. These would have been a serious selection pressure on ancestral human populations and would have fully activated the threat simulation mechanisms.” However, many researchers believe dreaming probably didn’t evolve purely to recreate threats. It may also have a role in the learning process, according to Allan Hobson, a psychiatrist and dream researcher recently retired from Harvard University. Contents are added while you are awake and integrated with the automatic program of dream consciousness during sleep. This works with observations that daytime learning is consolidated by night-time sleeping, leading to the finding that people remember facts better the day after they have learnt them than at the time.