Scherner connects no useful function with the activity of the symbolising phantasy in dreams. In the dream the psyche plays with the stimuli at its disposal. One might presume that it plays in an improper manner. One might also ask us whether our thorough study of Scherner's dream theory, the arbitrariness and deviation of which from the rules of all investigation are only too obvious, can lead to any useful results. It would then be proper for us to forestall the rejection of Scherner's theory without examination by saying that this would be too arrogant. This theory is built up on the impression received from his dreams by a man who paid great attention to them, and who would appear to be personally very well fitted to trace obscure psychic occurrences. Furthermore it treats a subject which, for thousands of years, has appeared mysterious to humanity though rich in its contents and relations; and for the elucidation of which stern science, as it confesses itself, has contributed nothing beyond attempting, in entire opposition to popular sentiment, to deny the substance and significance of the object. Finally, let us frankly admit that apparently we cannot avoid the phantastical in our attempts to elucidate the dream. There are also phantastic ganglia cells; the passage cited on p. 63 from a sober and exact investigator like Binz, which depicts how the aurora of awakening flows along the dormant cell masses of the cerebrum, is not inferior in fancifulness and in improbability to Scherner's attempts at interpretation. I hope to be able to demonstrate that there is something actual underlying the latter, though it has only been indistinctly observed and does not possess the character of universality entitling it to the claim of a dream theory. For the present, Scherner's theory of the dream, in its contrast to the medical theory, may perhaps lead us to realise between what extremes the explanation of dream life is still unsteadily vacillating.
(h) Relations between the Dream and Mental Diseases.—When we speak of the relation of the dream to mental disturbances, we may think of three different things: (1) Etiological and clinical relations, as when a dream represents or initiates a psychotic condition, or when it leaves such a condition behind it. (2) Changes to which the dream life is subjected in mental diseases. (3) Inner relations between the dream and the psychoses, analogies indicating an intimate relationship. These manifold, relations between the two series of phenomena have been a favourite theme of medical authors in the earlier periods of medical science—and again in recent times—as we learn from the literature on the subject gathered from Spitta, Radestock, Maury, and Tissié. Sante de Sanctis has lately directed his attention to this relationship. For the purposes of our discussion it will suffice merely to glance at this important subject.
In regard to the clinical and etiological relations between the dream and the psychoses, I will report the following observations as paradigms. Hohnbaum asserts (see Krauss, p. 39), that the first attack of insanity frequently originates in an anxious and terrifying dream, and that the ruling idea has connection with this dream. Sante de Sanctis adduces similar observations in paranoiacs, and declares the dream to be, in some of them, the "vraie cause déterminante de la folie." The psychosis may come to life all of a sudden with the dream causing and containing the explanation for the mental disturbances, or it may slowly develop through further dreams that have yet to struggle against doubt. In one of de Sanctis's cases, the affecting dream was accompanied by light hysterical attacks, which in their turn were followed by an anxious, melancholic state. Féré (cited by Tissié) refers to a dream which caused an hysterical paralysis. Here the dream is offered us as an etiology of mental disturbance, though we equally consider the prevailing conditions when we declare that the mental disturbance shows its first manifestation in dream life, that it has its first outbreak in the dream. In other instances the dream life contained the morbid symptoms, or the psychosis was limited to the dream life. Thus Thomayer70 calls attention to anxiety dreams which must be conceived as equivalent to epileptic attacks. Allison has described nocturnal insanity (cited by Radestock), in which the subjects are apparently perfectly well in the day-time, while hallucinations, fits of frenzy, and the like regularly appear at night. De Sanctis and Tissié report similar observations (paranoiac dream-equivalent in an alcoholic, voices accusing a wife of infidelity). Tissié reports abundant observations from recent times in which actions of a pathological character (based on delusions, obsessive impulses) had their origin in dreams. Guislain describes a case in which sleep was replaced by an intermittent insanity.
There is hardly any doubt that along with the psychology of the dream, the physician will one day occupy himself with the psychopathology of the dream.
In cases of convalescence from insanity, it is often especially obvious that, while the functions of the day are normal, the dream life may still belong to the psychosis. Gregory is said first to have called attention to such cases (cited by Krauss). Macario (reported by Tissié) gives account of a maniac who, a week after his complete recovery again experienced in dreams the flight of ideas and the passionate impulses of his disease.
Concerning the changes to which the dream life is subjected in chronic psychotic persons, very few investigations have so far been made. On the other hand, timely attention has been called to the inner relationship between the dream and mental disturbance, which shows itself in an extensive agreement of the manifestations occurring to both. According to Maury, Cubanis, in his Rapports du physique et du moral, first called attention to this; following him came Lelut, J. Moreau, and more particularly the philosopher Maine de Biran. To be sure, the comparison is still older. Radestock begins the chapter dealing with this comparison, by giving a collection of expressions showing the analogy between the dream and insanity. Kant somewhere says: "The lunatic is a dreamer in the waking state." According to Krauss "Insanity is a dream with the senses awake." Schopenhauer terms the dream a short insanity, and insanity a long dream. Hagen describes the delirium as dream life which has not been caused by sleep but by disease. Wundt, in the Physiological Psychology, declares: "As a matter of fact we may in the dream ourselves live through almost all symptoms which we meet in the insane asylums."
The specific agreements, on the basis of which such an identification commends itself to the understanding, are enumerated by Spitta. And indeed, very similarly, by Maury in the following grouping: "(1) Suspension or at least retardation, of self-consciousness, consequent ignorance of the condition as such, and hence incapability of astonishment and lack of moral consciousness. (2) Modified perception of the sensory organs; that is, perception is diminished in the dream and generally enhanced in insanity. (3) Combination of ideas with each other exclusively in accordance with the laws of association and of reproduction, hence automatic formation of groups and for this reason disproportion in the relations between ideas (exaggerations, phantasms). And as a result of all this: (4) Changing or transformation of the personality and at times of the peculiarities of character (perversities)."
Radestock gives some additional features or analogies in the material: "Most hallucinations and illusions are found in the sphere of the senses of sight and hearing and general sensation. As in the dream, the smallest number of elements is supplied by the senses of smell and taste. The fever patient, like the dreamer, is assaulted by reminiscences from the remote past; what the waking and healthy man seems to have forgotten is recollected in sleep and in disease." The analogy between the dream and the psychosis receives its full value only when, like a family resemblance, it is extended to the finer mimicry and to the individual peculiarities of facial expression.
"To him who is tortured by physical and mental sufferings the dream accords what has been denied him by reality, to wit, physical well-being and happiness; so the insane, too, see the bright pictures of happiness, greatness, sublimity, and riches. The supposed possession of estates and the imaginary fulfilment of wishes, the denial or destruction of which have just served as a psychic cause of the insanity, often form the main content of the delirium. The woman who has lost a dearly beloved child, in her delirium experiences maternal joys; the man who has suffered reverses of fortune deems himself immensely wealthy; and the jilted girl pictures herself in the bliss of tender love."
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