The Ontology and Phenomenology of Dreaming in Psychosis: A Group-Analytic Approach With a Neuropsychological Perspective

Abstract

The present study further explores the idea presented first in my book Dreams in Group Analysis (Koukis, 2004), i.e., that group-analytic psychotherapy can help patients suffering from psychosis to reconstruct their ability to dream, thereby easing their symptoms. It demonstrates the way in which patients with psychosis transform what Freud (1900) described as the archaic ontological nucleus of dreams—a crude representation of the fantasy of the primal scene that prevails in psychotic dreaming to the detriment of its phenomenology—into a good enough phenomenology, as usually expressed in the dreams of patients suffering from neuroses. To do this, the study uses a systematic analysis of dreams as they evolved during the patients’ group-analytic psychotherapy, following the three phases of the group from its primordial/archaic (or oral-sadistic) stage, to the intermediate level of bodily and mental images (or paranoid-schizoid position), and to the level of reality (or depressive position), according to Foulkes (1964), Klein (1946), and Bion (1992) respectively. The study likewise indicates the directions in which the deficit in the phenomenology of dreaming in psychosis, especially the attempt to reconstitute it through group analysis, could be investigated by exploring the neuronal correlates of dreaming on the structural and functional level through neuropsychological research.