Évolution et actualité des considérations sur le rapport rêve–psychose en psychanalyse

Abstract

AimThis article reviews the evolution of historical and current discussions, as well as the etiological relationships between dreams and psychoses, within psychoanalytic clinical work and within classical and contemporary psychiatry. MethodsThe dreams-psychoses relationship is studied through a critique of the DSM-IV perspective (nightmares, night terrors, and sleep-walking) and through contemporary psychoanalytic theses. In this article, the reader will also find two case studies: a case of schizophrenia in which the use of dreams stabilized the delirious metaphor, and a second one showing veritable analytical work on dreams in a case of paranoia. ResultsAccording to the psychoanalytic paradigm and by stating differences between analytical and clinical work, with C.S. Peirce's notion of index, dreams can become a key tool for the treatment of psychoses. DiscussionWithin the dreams-psychoses relationship, there is a distinction to be made between index-dreams and signifier-dreams. Dreams in psychoses can become an index of an encounter of the subject with the Real. ConclusionThe connection of dreamlike phenomena with those of psychoses highlights that the work of dreams is not reserved only for neuroses. In this case, the clinician can expect much more than a simple classification, testimony, or observation of surprising facts. Dreams can thus provide material for analytical work capable of participating in the production of a lasting change of the patient's subjective position.