Each of us has an intimate yet elusive relationship with dreaming. We ask ourselves, on waking, what it means that we’ve just dreamed of being with another partner, that we’ve returned to a high school classroom, or flown above some alien landscape as if we could shed our earthbound physicality like a veil. We wonder if these fleeting images are a key to our most deeply held hopes, fears and longings, or if they are merely an elaborate form of mental fireworks.
Humans have always struggled to find meaning in their dreams. The earliest civilizations considered them harbingers and omens, and some American Indians built whole cosmologies around the phenomenon (among the most common tribal definitions of shaman is “one who dreams”). Even today, with the tools of psychology and science at our disposal, dreaming remains a mystery, a part of ourselves that we see only in glimpses, and never fully comprehend. What are our dreams trying to tell us? Or are they trying to tell us anything at all?
Rosalind Cartwright, director of the Sleep Disorder Service and Research Center at Rush-Presbyterian-St. Luke’s Medical Center, thinks she has some answers to those questions, and she wants to spread the news. Her most recent inquiry into the relationship between dreams and depression, an area she has been investigating for 24 years, has reinforced her ideas about the role of dreams in our emotional lives and their potential to help depressed people recover.
Sitting in her office under a large, Pop Art poster of “The Sleeping Brain” showing various wild animals tangled together within a sleeper’s head, she outlines her findings with an enthusiasm that belies her 77 years.
“It looks gorgeous,” she says about the data from her latest study. “It’s preliminary, but it’s so exciting.”
Cartwright has a simple theory about dreaming: that it acts as an inner therapist helping us to preserve, or repair, our self-image by offering a kind of mental forum where we play out and resolve our experiences and emotions. She agrees with Shakespeare’s notion that sleep “knits up the raveled sleave of care.”
“Dreaming,” Cartwright says, “is a time when your mind is going back in time and forward, and you review and rehearse. What you’re doing is saying, ‘Who am I now? Who do I want to be, and what do I have to do to get there?’ This is the emotional homework of the night, the feeling of, ‘Am I OK?’ My belief–and I now have enough evidence to back it up–is that dreaming is an emotional information-processing system for mood regulation. If you go to bed worried, upset, anxious, you should wake up feeling better, if the dream process is doing what it should.”
That’s a bold statement for a leading researcher on dreaming, a largely uncharted territory that has long resisted definitive scientific conclusions, much like the brain itself. In the more than 100 years since Sigmund Freud first published “The Interpretation of Dreams,” the field has gone through several cycles in which each new theory seems to simultaneously refute and expand upon previous work.
For the last quarter-century, the research landscape has been dominated by the “activation-synthesis” model of dreaming, first developed in 1977 by Harvard researchers J. Allan Hobson and Robert McCarley. This biological interpretation of dreaming suggests that dreams are little more than the brain’s attempts to make sense of random neurological impulses. However, there remains a substantial network of researchers who, like Cartwright, continue to view dreaming as connected to emotions and our waking lives.
“Activation-synthesis is popular because people have some notion that biology determines behavior, rather than psychology,” says Milton Kramer, professor of clinical psychology at New York University and a longtime Cartwright associate. “But while you have to be alive in order to dream, it’s more than that.”
Cartwright has been dealing with these issues–“mapping the geography of the night,” in her words–since before most contemporary dream theorists were born. Her decades of painstaking studies, involving hundreds of interviews in the middle of the night with groggy volunteers awakened in her sleep lab, have helped keep Chicago a center of dream research.
In many ways, Cartwright’s career parallels that of modern dream research, which began in 1953 at the University of Chicago when William Dement identified REM (rapid eye movement) as the stage in the sleep cycle when most dreams happen. Until then, researchers had no idea how long dreams lasted or how often they occurred. It is now well-documented that throughout the night, we experience several episodes of non-REM and REM sleep, the former deeper and more physiologically restorative, the latter essential for formulating dreams.
At the time of Dement’s discovery, Cartwright was doing psychotherapy work at the university, and, as she admits, the discovery’s significance was initially lost on her. “My secretary was dating Bill Dement,” she laughs. “She later married him. One day, she came into my office and said, ‘Do you realize the eyes move when you dream?’ I said, ‘That’s interesting. Go back to work.’ “
It wasn’t until the early 1960s, when a friend asked her to conduct clinical studies on a hallucinogen he had synthesized for the Air Force, that Cartwright began to think seriously about the meaning of dreams. She gathered a group of volunteers and tested their reaction to the drug. “As I listened to their experiences, I started to think, ‘These are like waking dreams.’ I wondered, ‘If you dream during the day, do you have to dream as much at night? And is the material the same?’ So I thought, ‘Well, I need to build a dream lab.’ “
Seeking clues about dreaming in wide-awake hallucinations is indicative of Cartwright’s innovative approach. Soon after her inquiry into dreams and psychedelics ended inconclusively, she launched another study in which she showed people pornographic films before sleep to see if the images would affect their dreams. The experiments might seem sensationalistic, but they were solid science, says Kramer. “What Roz did with her porn study was to ask a couple of basic questions: Are your thoughts connected to your body? Is dreaming responsive to experience? She just did it in an unusual way.”
Cartwright brings her iconoclastic sensibility not only to her dream work, but also to research into sleep disorders. In the early 1980s, she was among the first sleep specialists to look at the role of body position in the onset of sleep apnea (a factor that’s now considered critical), despite having been derided at the time. “Things that other people dismiss, she sees as possible,” says Dr. Edward Stepanski, laboratory director at Rush’s Sleep Disorders Center. “She has very original ideas.”
A decade ago, she even looked into working with “lucid dreaming,” a state in which people become aware that they are dreaming and can, while still asleep, control the way the dream unfolds. It was thought that depressed people might be helped if they could learn to script more positive outcomes to their dreams, but Cartwright soon dropped the effort as unworkable.
Her latest research builds on her work since 1977, five studies involving hundreds of people in which she has sought to find a relationship between dreams and emotional well-being.
She found that the delicate balance between REM and non-REM sleep tends to break down in depressed people. For most of us, there are four or five instances of REM during the night, and they grow longer and more encompassing as sleep goes on. The first period may last only a few minutes, and involve relatively understated eye movements, which indicates a fairly mild dream. But by the end of the night we can dream for as long as an hour, with eye movements that are increasingly intense, as if we have to race to keep up with the flood of images projected by the brain.
But for the depressed, the first REM period comes sooner than it does with well-adjusted people, and it’s more active. “The eye movements are too dense, and the progression is not normal,” Cartwright says, meaning that the dreams often become more negative as the night progresses. With normal subjects, dreams become more positive and the emotional issues more resolved. Another finding, she says, was that the severely depressed don’t remember dreams very well. “When you wake them up, they say, ‘I don’t know, I don’t think I was dreaming.’ They don’t feel much about the dream.” This, too, is in contrast to the normals, who often experience profound emotions in their dreams.
These findings alone are medically significant: The differences between normal and depressed dreamers provide clinical markers that can help doctors determine if a patient is suffering from depression. But even more remarkable was that Cartwright’s data could predict, with 82 percent accuracy, which of her patients would recover from their depression based on the dream patterns.
Tore Neilsen, director of the Dream and Nightmare Laboratory at Montreal’s Sacred Heart Hospital, says the results help establish that “there is a relationship between psychology and physiology, that the way we process information affects the way we feel.”
Of course, the idea that dreams reflect emotions is hardly new. Most people have a sense that some dreams speak directly to unresolved relationships and responsibilities, to anxieties and desires. It’s what G. William Domhoff, professor of psychology at the University of California at Santa Cruz, calls the “continuity hypothesis,” the belief that our dreams are continuous with who we are when we’re awake.
For Cartwright, though, continuity is just a starting point from which to look at the emotional center of the brain. In her view, even dreams that seem unrelated or nonsensical may be linked in ways we can’t immediately understand. “I think of mental life as operating on parallel channels all the time,” she says. “There are things you focus on in the reality of this moment, and below that are associations you’re not particularly conscious of.”
She believes that in dreams we revisit our unfinished emotional business, first in fairly clear, representational images and then, as the night continues, through less obvious, even abstract visions that may seem to have little in common with the dreamer’s emotional life. Joining everything is a subtle emotional state, what Cartwright labels “an affective thread that runs throughout the night.”
The scientific problem with trying to trace this emotional thread is that it relies on the gathering of dream content, which is a subjective enterprise at best. Even in the Rush sleep lab, where dreamers are wired to computers that measure their brain waves, muscle movements and heart rate, the only available method of dream collection is to awaken them during the REM period, before they move into non-REM sleep and lose recall of the dream. Such a system is, with some refinements, the same one used a century ago by Freud and Carl Jung.
To normalize the process as much as possible, Cartwright brings her subjects in for two consecutive nights, the first to get them comfortable with the sensors and the wires and the unfamiliar setting, and the second to do the research. She also makes sure that when she or her assistants wake the dreamers, they do so in a neutral fashion, asking, “What was going through your mind just before I called you?” They don’t use the word “dream,” Cartwright explains, “because maybe it isn’t. Maybe it’s a thought. Maybe it’s a worry, or a muse, or a pondering, not a visual fantasy experience.”
All of this is fairly standard procedure in dream research, but Cartwright added her own, somewhat controversial twist by asking subjects to assess their dreams at the end of the report. “I want to know what they use as dream language, to know what they feel about the dream,” she says. It seems to be only common sense to ask a dreamer what he or she is feeling. Yet Cartwright’s willingness to open up her investigations makes some researchers wary because it adds another layer of subjectivity to the process.
One skeptic is Harvard’s Hobson. “If you look at a dream report,” he says, “it seems coherent. But the mind is an integrator. It looks for meaning. The problem is the attribution of significance.” Proving that dreams have meaning is a difficult problem for dream researchers, who are often accused of “soft science.” Cartwright strives to make her research scientifically rigorous, using clinical as well as psychological testing, and control groups to establish a larger context for the findings.
While Cartwright acknowledges her critics’ reservations, she believes there’s much to be gained by examining a subject’s dream interpretation. If nothing else, she argues, the way a researcher analyzes data may be too limited, too much a consequence of personal bias, to reflect accurately how a dreamer processes a dream.
As an example, she cites a man who, in the midst of a troubled relationship, dreamed he was in a hotel room looking at another woman when his girlfriend came by and shut the door. On the surface, there’s nothing either good or bad about these images, but the subject read the dream as negative and highly emotional, an indication that he felt his problems with his girlfriend would never be resolved. But in that moment, Cartwright says, he reported beginning to come to terms with his situation, and as the night went on, his dreams grew more positive, as if he had somehow worked it through. That, she says, is a classic illustration of the regulatory function of dreams in action, of what Kramer calls “the central role of emotion in determining dream content.”
Cartwright’s latest study underlines the importance of the patients’ dream reports. It stems from an earlier study in which Cartwright noticed that, for some depressed subjects, REM deprivation led to increased mood regulation and an eventual end to their depression. “I began to wonder about that,” she recalls. “If they needed REM time to mood-regulate, why were they mood-regulating with REM interruption?” She began to think that REM deprivation might somehow “jazz up” subsequent REM cycles, pushing depressed people to have more emotionally charged dreams.
The earlier study looked at patients for only one night, and Cartwright’s latest research explored the effects of REM interruption in more detail over eight months. Of her 12 depressed patients, nine reported increased negative dream content in the fourth month of the study, followed by marked improvement in the fifth, as if, having bottomed out on all that negative emotion, their dreaming began to help resolve it. After the fifth month, the same nine subjects were, by several standardized measures, no longer clinically depressed.
Besides supporting Cartwright’s theory about dreams as mood regulators, the study strongly suggests that external manipulation–that is, active intervention in dreaming by the lab’s researchers–might help break the malfunctioning dream cycle and, in effect, reprogram the brain’s neural pathways by redirecting the dream content.
“Why is this working?” Cartwright asks. “I’m not sure. But what I think I’m doing is interrupting these negative dreams before they finish. I’m not letting them run their course. Somehow or other, you force the associative pathway not to be in a negative, repetitive groove.”
While it’s too soon to know if Cartwright’s findings could lead to new diagnostic tools and treatments for depression, the National Institutes of Health have approved funding for further research involving an additional 20 subjects.
Cartwright is excited about the prospect of completing her work, but she still laments the lingering focus on biology-based dream studies. “We lost 20 years of research,” she says. “From 1977, when activation-synthesis was first presented, until very recently, the emphasis has been on neurobiology and not psychology.” In the last five years, however, with PET scans and other new technology in brain imaging demonstrating a relationship between dreaming and emotional states, all that has started to change. Even Hobson, the skeptic at Harvard, now acknowledges emotion as a component of dreaming.
“When activation-synthesis was first put forward,” he says, “we didn’t know anything about what the upper brain was doing with lower brain material, but now we know that the emotional brain is selectively activated in the dream state, which suggests that emotion may well be in the driver’s seat.”
Cartwright takes such comments as a sign that dream research may, at long last, come around to accepting what she has said all along: “The mind in sleep is a window into our behavior. Every experience has an emotional charge.”
