Dream a Little Dream

Business Logo for Psychological and Neuropsychological IssuesIs dream interpretation an important component of psychotherapy?  The answer to this question depends on what school of thought the psychotherapist holds most dear.  Behaviorists of the B. F. Skinner tradition regard dreams as a largely useless substance leaking from the black box of the brain.  Psychotherapists within the Freudian tradition will sit on the edge of their chairs at the mere mention of a dream.  There is a huge chasm of belief that divides the conception of dream content, and its importance within the psychotherapeutic context.  Different schools of psychotherapy regard dreams differently, and all the schools believe they are correct.  The very existence of these “schools” of psychological thought is part of the problem.

Most psychologists are painfully aware that physicists and biologists do not subscribe to different “schools” of thought within their fields.  Thinking within the hard sciences changes in relation to empirical (experimental) evidence.  There is typically a “school” of theoretical belief within the hard sciences, but a belief is not typically accepted as factual without experimental justification.  In clinical psychology, theoretical “schools” of thought are often taken as factual, even if the experimental evidence is not particularly supportive.

Behaviorism is the most empirically driven of all the psychotherapeutic schools of thought.  Its deceptively simple design lends itself well to the experimental process.  While behaviorists may regard dreams as a useless epiphenomenon of the mind, their elegant experiments do not actually disprove the importance of dreams.  On the other hand, behaviorists have proven that human behavior may be modified without the use of dream interpretation.  To their credit, the various offshoots of Freudian psychotherapy have become more empirical in the last twenty years.  Neo-Freudian research has yet to prove that dreams are indispensable to a favorable psychotherapeutic outcome.  Neither “school” of thought has convincingly proved its theoretical stance to be absolute.

The use of illegal medicines find out my pharmacy order cheap cialis affect the sexual power in men. Therefore, if cialis 40 mg you have been taking certain medications continually, speak to your doctor. So due to the online sale of cialis 10 mg to be aware of fake products. viagra pills from india So, it is better to take herbal treatment to beat impotence has now proved to be the most trusted drug for erectile dysfunction. Interestingly, neither the behaviorist or Neo-Freudian has been quick to adopt the insights of biological and neuropsychological research.  Dreams appear to be an emergent phenomenon of normal brain function.  The brain cleans away the detritus between the neural synapses at night, after being cluttered with the litter of thought during the day.  The wash and spin cycle of the brain produces images, sensations and emotions as a consequence of its self-care.  It is true that memories appear to consolidate after a nights sleep, but this may be another emergent property of brain housekeeping.  Arousal, attention and memory are reinvigorated after a good night’s sleep.  On the other hand, a person’s cognitive abilities will decline progressively with each episode of REM sleep that is missed.  There is ample hard scientific proof of the cognitive deterioration that ensues from REM deprivation.  The survival of the organism is clearly the most important function of REM sleep, and dreams emerge as a consequence of this survival mechanism.

Psychological assessments of brain function, in general, need to pay more attention to the influence of sleep.  A scientifically informed psychological assessment will measure the patient’s cognitive status.  Next, the factor or factors that have affected cognitive functioning will be examined.  Impoverished dreaming is rarely mentioned as an important factor.  It’s influence on cognition is often under-appreciated by the best of clinicians.  Poor REM sleep may have negative consequences that are within the current scope of psychological treatment.  A person’s job and relationships may be negatively affected by poor attention, arousal and memory.  The content of the dream is of secondary importance to the cognitive status of the patient, and its influence on their waking life.

Perhaps the Neo-Freudians will prove that the interpretation of dream content is essential to psychotherapy.  Perhaps the behaviorists will prove that dreams have no bearing on the modification of human thoughts and behavior, whatsoever.  Current psychological beliefs tend to ignore the evidence before our very faces.  Whether we dream is very important, but the importance of what we dream is still a matter of opinion.

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categories Psychology | | datetime January 21, 2012 6:20 pm | comments Comments (1)

Delirium Generis

Business Logo for Psychological and Neuropsychological IssuesDelirium is a term that has gained acceptance within the medical community.  Twenty years ago, a clinician could be maligned for using the term in a clinical setting.  Many providers consider it a popsy, imprecise, if not inappropriate term.  Delirium is actually a precise clinical term that may have profound consequences for the afflicted.  It is a cognitive state in which the person is unable to focus their immediate attention.

Schizophrenics are often incorrectly labelled as being in a delirium.  Their stream of thought is bizarre and often not pertinent to the immediate situation.  While their attention is reduced by the automatic thoughts, schizophrenics are rarely delirious.  Similarly, people who suffer with mania or are highly anxious may be labelled with a delirium, but this is also a rare situation.  While automatic and unwanted thoughts decrease their attention, these unfortunate individuals are still able to focus their attention at a reduced level.

Individuals suffering with a delirium have an impairment of immediate attention.  The attentional deficit far surpasses that observed in people with an Attention-deficit Disorder, which is typically a disorder of sustained attention-not immediate attention.  It is not a dream world, since this presupposes the sustained attention to be consistently unrealistic.  It is an acute condition that is typically caused by a metabolic or an infectious process.  Delirium is more a sign of medical illness than psychological distress.  A person immersed in a delirium may incur increasing organic damage the longer they remain in this state.  Urinary infections, severe dehydration, head injury, stroke and an elevated intracranial pressure may produce a state of delirium.  Psychoactive drug use and allergic reactions may also produce a state of delirium.  Alcohol and tranquilizer withdrawal are two of the more common causes of delirium.

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Managing a person suffering with a delirium is best accomplished with a smile.  Since their attention is too impoverished to comprehend well, the patient will tend to focus on the examiner’s facial expression.  Gentle physical guidance is almost always required, secondary to the poor aural comprehension.  The main task of the caregiver is to protect the person from accidental harm until medical services can intervene.  It is not suggested to wait for the delirium to pass, since there may be increasing organic damage without the appropriate treatment for the underlying condition.  Even if the caregiver knows that severe dehydration if causing the delirium, convincing the person to drink voluntarily is nearly impossible.  If a person was able to understand the caregiver’s concern and act accordingly, this would be proof enough that the person is not in a state of delirium.

No matter how skilled the caregiver, delirium presents an emergency that requires coordinated medical care.  A highly skilled caregiver is apt to know their limitations and seek timely medical intervention.  Less skilled caregivers may wait for the condition to pass.  Even worse, the caregiver may perceive the patient’s delirium as a personal commentary on their skill as a caregiver.  Be a skilled caregiver and seek medical intervention as soon as possible.

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categories Neuropsychology | | datetime January 7, 2012 12:09 pm | comments Comments Off on Delirium Generis

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