ABSTRACT This article charts a psychoanalytic-literary itinerary that clarifies Bion’s theory of dreaming by harnessing the evocative power of fiction. The reader is guided through three emblematic texts, each embodying a different modality of oneiric experience. Juan Rulfo’s Luvina represents absolute wakefulness: a concrete state in which β-elements remain undigested and meaning erodes. The prison cell in Nabokov’s Invitation to a Beheading illustrates absolute dream, where an unbridled α-function spawns an excess of symbols and dissolves psychic boundaries until waking intervenes. The shoreline of Virginia Woolf’s The Waves exemplifies the dialectical dream: an intersubjective flow in which consciousness and the unconscious co-construct experience – the ideal described by Bionian Field Theory. By juxtaposing these landscapes, the study offers a heuristic for identifying concrete, excessive, and balanced dreams in clinical practice, showing how literature illuminates a mind that dreams itself into being.

Dreaming is theorized to regulate waking affect via fear extinction learning, similar to exposure therapy. We tested whether fear in dreams was associated with lower negative affect (NA) and higher positive affect (PA) on subsequent mornings and whether these effects were moderated by emotion regulation strategies or mixed dream emotion states. Additionally, we examined whether individuals with higher average dream fear showed more adaptive emotion regulation. We employed a natural language processing tool and Bayesian multilevel modeling using online daily survey data in a community sample (n =536; 85.6% women; Mage = 39.3 ± 17.3; days = 4715). Frightening dreams were associated with more negative affect the following morning (+7% NA, pd = 100%), which was amplified for individuals with more adaptive emotion regulation (+3% NA, pd = 98.69). Dreams concurrently high in fear and joy were related to 20% higher odds of zero NA the next morning (pd = 97.82%). Higher average dream joy was related to 9% higher morning PA (pd = 98.79%). Individuals with higher average dream fear showed greater adaptive emotion regulation (β = 0.18, pd = 99.93%). Findings supported affect continuity from dream to wake, yet affect regulation at the individual level. Frightening dreams were related to worse morning affect, with a more pronounced effect among high-regulation individuals. High-regulation individuals tended to experience more fearful dreams. Mixed dream emotions were related to mornings without NA, and dream joy was related to higher morning PA. Our findings suggest adaptive, though dynamic, effects of dream emotions on psychological functioning.

Dream tyranny: Hyperonirism diagnostic criteria.

Long before the emergence of modern psychology, Abu Yūsuf Yaʿqūb ibn Isḥāq al-Kindī has already developed a comprehensive philosophical account of the human soul that continues to offer valuable insights into mental health, cognition, and well-being. As the earliest philosopher of the Islamic tradition, al-Kindī reinterpreted Greek metaphysics and psychology through an Islamic monotheistic framework, laying intellectual foundations that shaped later falsafa and informed early conceptions of the self. This study revisits al-Kindī’s thought to examine its relevance for contemporary psychological discourse. Employing a conceptual, interpretive, and historical-philosophical methodology, the analysis draws on close readings of al-Kindī’s primary texts and a thematic synthesis of major secondary scholarship. A comparative analytical lens is used to explore al-Kindī’s ideas on the soul, cognition, emotion, and ethical self-cultivation and selected themes in modern psychology, without imposing contemporary models onto classical sources. The study highlights al-Kindī’s distinctive account of the soul as an immaterial, rational, and immortal substance whose perfection requires intellectual discipline, ethical refinement, and the governance of bodily faculties. His writings provide early formulations of concepts related to cognitive appraisal, emotional regulation, habituation, psychosomatic interaction, and the integration of spiritual and psychological well-being. The paper also examines al-Kindī theories of sleep and dreams, vision, and the imaginative faculty, as well as his influence on later thinkers such as al-Balkhī. By synthesizing these insights, the study demonstrates how al-Kindī’s philosophical psychology contributes to contemporary efforts to articulate an Islamically grounded, holistic framework for understanding human nature, mental health, and psychotherapy.

Hailey–Hailey disease (HHD) is a rare autosomal dominant skin disorder caused by mutations in the ATP2C1 gene [1]. It presents as a painful, recurrent blistering disease that severely impacts quality of life. Conventional therapies often provide inadequate relief, prompting patients to seek alternatives. Use of low-dose naltrexone (LDN) became popularized on social media platforms through patient success stories, with subsequent case reports and small case series further supporting use of the treatment for HHD [2]. We conducted a focused literature review to assess the current evidence on the use of LDN in HHD. A comprehensive search of PubMed, Embase, and Scopus was performed on May 20, 2025. Search terms included: (“Hailey–Hailey disease” OR “Hailey Hailey disease” OR “benign familial pemphigus” OR “familial benign pemphigus” OR “Hailey disease”) AND (“naltrexone”), identifying 53 published cases that met inclusion criteria (Supplementary Table available via Mendeley, doi: 10.17632/6xz5sjpyg4.1). The mean age of patients was 54.5 ± 13.6 years, with a female predominance (n = 35, 66.0%). Among these, 37 of 53 patients had an initial LDN dose ≤ 4.5 mg/day. Most patients achieved improved response (n = 46, 86.8%). No response was observed in 7 patients (13.2%). Most patients remained stable during follow-up (n = 30, 57.7%), while 16 patients (30.8%) experienced relapse and 6 patients (11.5%) discontinued treatment (Table 1). Logistic regression analysis showed no significant association between initial dose and response (odds ratio [OR] = 1.33, p = 0.389) after adjusting for patients' age, gender, and disease severity, while higher maximum doses showed a negative association with clinical clearance (OR = 0.908, p = 0.044). Disease severity was quantified by affected body surface area and the Dermatology Life Quality Index (DLQI), which was only available in 28 patients. Adverse events were rare (n = 8, 15.1%) and showed no significant association with either the initial dose (OR = 1.110, p = 0.639) or the maximum dose received (OR = 1.090, p = 0.291). Among the 53 patients, 2 (3.8%) experienced vivid dreams, 5 (9.4%) reported dizziness, and 1 (1.9%) developed loose stool. Twelve patients (22.6%) received systemic concomitant therapy alongside LDN, while the remaining 41 (77.4%) patients were treated with LDN monotherapy. In the overall cohort, lower doses (maximum dose ≤ 4.5 mg/day) showed a trend toward reduced relapse compared with those on higher doses (OR = 0.133, p = 0.109). Similar trends were observed in the monotherapy subgroup, with higher maximum doses associated with reduced clinical clearance (OR = 0.892, p = 0.058), and lower doses with reduced relapse (OR = 0.116, p = 0.085) (Table 2). These results indicate LDN offers a potentially useful treatment in HHD. However, results demonstrate that dose escalation may not confer therapeutic benefit. While potential publication bias and lack of controls should be considered in evaluating overall efficacy, the lack of response to dose increases suggests maximal therapeutic benefit at low doses. The therapeutic mechanisms of LDN in HHD may be associated with its anti-inflammatory and immunomodulatory properties. LDN intermittently binds to opioid receptors found in the skin layers [1], producing a rebound increase in endogenous opioids (e.g., β-endorphins and opioid growth factor [OGF]) and increased expression of mu, delta, and OGFr receptors [3], resulting in reduced pain, pruritus, and increased epithelial repair. LDN also antagonizes Toll-like receptor 4 (TLR4), which promotes the production of proinflammatory mediators in keratinocytes and macrophages [4, 5], ultimately reducing epidermal stress responses and HHD flare severity. Although LDN does not directly fix the calcium pump defect in HHD, it may improve cell adhesion by modulating intracellular Ca2+ signaling, reducing calcium influx, and supporting calcium redistribution required for desmosome assembly [1]. Further studies should elucidate its dose-dependent biologic effects and therapeutic potential. The authors have nothing to report. This study was considered exempt from the formal approval of the Institutional Review Board. K.T.A. has received research support from Astra Zeneca and Sanofi. The data that support the findings of this study are available from the corresponding author upon reasonable request.

Introduction: Rapid eye movement sleep behavior disorder (RBD) represents a parasomnia marked by impaired muscle inhibition during REM sleep, commonly manifesting as vivid dream enactment with potentially violent movements. Its strong association with neurodegenerative diseases, particularly α-synucleinopathies such as Parkinson’s disease (PD), has drawn increasing attention. This study presents a bibliometric overview of global RBD research from 2010 to 2025. Methods: We analyzed 4,204 publications from the Web of Science Core Collection and Scopus databases. Tools including CiteSpace, VOSviewer, Python, R (bibliometrix), Excel, and Charticulator were used to examine publication trends, geographic and institutional distribution, author influence, journal preferences, co-citation networks, and keyword evolution. Results: RBD-related publications increased steadily, with a marked rise after 2015. The USA, China, and Canada were leading contributors, and institutions such as the University of Toronto, Mayo Clinic, and Peking University showed strong productivity and collaboration. Key researchers included Schenck CH, Boeve BF, and Postuma RB. Top journals were Sleep, Neurology, and Movement Disorders. Research has shifted from clinical characterization to biomarker identification and early intervention. Recent themes include α-synuclein pathology, prodromal PD, and melatonin therapy. Conclusion: RBD research has progressed toward translational approaches focused on early detection and neurodegenerative risk prediction, supported by global collaboration and growing interest in mechanistic insights.

Propranolol, a beta-adrenergic blocker, is commonly used for migraine prophylaxis and other indications. While its side effects include fatigue, dizziness and sleep disturbances, vivid dreams and oscillopsia are rarely reported. This case report describes two instances of vivid dreams and oscillopsia in patients prescribed propranolol for migraine management. The cases highlight the need for heightened awareness of such adverse effects, especially in long-term therapy.

Statins inhibit 3-hydroxy-3-methylglutaryl CoA reductase to reduce cardiovascular risk, but may induce neuropsychiatric adverse effects. Sleep disturbances, especially insomnia and vivid dreams, are frequently reported, particularly with lipophilic statins that cross the blood-brain barrier (BBB). However, randomized trials often show minimal objective effects, highlighting the need for integrated evidence. This narrative review synthesized data from human clinical trials, pharmacovigilance databases, animal studies, and molecular investigations to clarify the relationship between statin lipophilicity and sleep outcomes. The evidence remains mixed. Objective polysomnography trials generally show minimal adverse effects or slight improvements in sleep continuity, particularly with the use of hydrophilic statins. In contrast, real-world data and case reports indicate higher rates of insomnia and nightmares with lipophilic agents, particularly simvastatin, likely reflecting pharmacokinetic differences and possible nocebo effects. Lipophilic statins may influence brain cholesterol metabolism and neurotransmission, contributing to subjective sleep disturbances, whereas hydrophilic statins appear to be sleep-neutral. BBB penetration is a key determinant. Future head-to-head trials and individualized prescriptions may optimize the benefit-to-risk balance.

Rapid-eye-movement sleep behavior disorder(RBD) is a parasomnia characterized by the loss of normal muscle atonia during rapid eye movement (REM) sleep, leading individuals to physically act out vivid, often intense or violent dreams, which may result in self-injury or harm to others. In recent years, RBD has become a prominent research focus. The bibliometrics can clearly and intuitively display the research profile, relationships, and clustering within the field. This study examines the development of RBD research using bibliometric analysis. As of 18 January 2026, articles on RBD in the Web of Science Core Collection (WoSCC) were collected. CiteSpace is utilized to analyze and visualize the attributes of the articles, including number of publications, institution, journals, authors, keywords, from the 4,229 publications obtained. The leading institution in this field was McGill University, and the most cited journal was NEUROLOGY. The most common keywords were "Parkinson's disease" and "rem sleep behavior disorder." The study conducted a bibliometric analysis of over 37 years of RBD research, identifying the authors, institutions, keywords, journals, and publications involved in this field. The findings provide a comprehensive overview of RBD research.

Expert annotation of free-text descriptions of dream enactment behaviours associated with REM sleep behaviour disorder.

Beta‐adrenergic blockers are effective in migraine prevention but can induce neuropsychiatric side effects, including vivid dreams and nightmares. Their lipophilicity allows penetration of the central nervous system, where β1‐adrenergic blockade may disrupt REM sleep, alter noradrenergic activity, and suppress melatonin secretion, contributing to emotionally intense dreams. While reported in cardiovascular patients, this adverse effect remains underrecognized in migraine therapy. Adult patients were identified from those seen in the outpatient department of the Clinical Hospital of University of Chile in Santiago between 2022 and 2024. We present three cases of patients with episodic migraine with aura who developed distressing, recurrent nightmares after initiating propranolol, or metoprolol. Symptoms emerged shortly after treatment initiation and resolved upon discontinuation. Nightmare content involved emotionally distressing themes, leading to significant psychological discomfort. Clinicians should be aware of vivid nightmares as a potential adverse effect of lipophilic beta‐blockers in migraine prevention. Understanding this may enable patients to tolerate the symptom. If it impacts adherence and/or quality of life, a treatment change will be needed.

This paper aims to delve deep into whether or not blind people dream and have visual imagery. The researchers also aim to analyze the differences of dreams in blind individuals, individuals with sight impairment and people with sight abilities while also analyzing whether the three groups experience different ways of visual imagery in dreams. The answer for all three research questions is yes and will be explained deeper in the paper based on findings from past studies. To further illustrate, this paper has explained dreams in blind individuals physiologically and through Freud’s psychodynamic theory of dream. As such, these insights indirectly contributed in understanding the best intervention that is possible to be implemented like utilizing advanced technology to ease the everyday routine of blind individuals especially students. For a better understanding as a Muslim, the researchers have provided valuable insight by looking at dreams and blindness disability from the Islamic standpoint. Future research should focus on studying neuroimaging by utilizing technologies like fMRI to bridge the gaps

Substance addiction is defined as a chronic and relapsing disorder in which the individual persistently engages in drug-seeking and drug-using behaviors despite harmful consequences. One of the most common challenges in the treatment process is relapse, which frequently occurs as a result of intense craving for substance use. In recent years, the concept of "drug dreams" has come to the forefront as a potential indicator that may contribute to the clinical monitoring of such cravings. These dreams, which often appear during periods of abstinence, contain various themes involving the use or attempted use of the addictive substance. The book “Drug Dreams” by Claudio Colace systematically addresses drug-related dreams from phenomenological, clinical, and theoretical perspectives. The author initially began examining these dreams—first noticed during psychotherapy sessions with heroin-dependent patients—with clinical curiosity and later deepened his investigation on both psychoanalytic and neuropsychoanalytic levels. The book is divided into three main sections: the first part discusses the definition, prevalence, and content of drug dreams; the second part explores their clinical use and prognostic value; and the third part offers theoretical evaluations in light of Freud’s dream theory and contemporary neuropsychoanalytic approaches. The book “Drug Dreams”stands out as a valuable resource that offers significant contributions to addiction treatment from both psychodynamic and neuropsychiatric perspectiv. It provides a unique and comprehensive perspective for clinicians working in addiction treatment and for those interested in dream studies. This article aims to present a comprehensive review of the aforementioned book.

Abstract INTRODUCTION: Progressive supranuclear palsy (PSP) is a neurodegenerative disorder that affects movement, gait, balance, speech, and swallowing. Nonmotor symptoms (NMSs) are well recognized in atypical parkinsonism. However, owing to the rarity of these disorders, descriptions of NMSs in atypical parkinsonism remains limited. The aim of this study was to assess the frequency of NMSs in PSP and compare it with that in Parkinson’s disease (PD). METHODS: Forty consecutive patients with PSP were recruited over a period of 8 months. NMSs were assessed using the NMS Questionnaire. These patients were compared with 40 age- and gender-matched individuals with PD. RESULTS: In the PSP group, 67.5% of patients were men. The average age of participants was 61.2 ± 6.7 years, with a mean age of symptom onset at 58.4 ± 6.6 years. All patients reported at least one NMS. Falls and somnolence were significantly more prevalent in PSP (p < 0.001), as were sialorrhea (p = 0.002) and dysphagia/dysarthria (p = 0.002). In contrast, vivid dreams were significantly more common in PD (p < 0.001), along with incomplete bowel emptying (p = 0.036). There was no significant difference in the NMS score between patients with PSP (8.4 ± 4.2) and those with PD (7.7 ± 4.3). CONCLUSIONS: The spectrum of NMSs varied between PD and PSP. However, there was no overall difference in NMS scores between patients with PD and those with PSP. Further large-scale studies are warranted to investigate the distinct profiles of NMSs in PSP and PD.

The enigma of the dream: Laplanche’s mission to ‹set Freud back to work› What is Jean Laplanche’s contribution to the psychoanalytic theory of dreams? Laplanche regarded it as his mission to rethink Freud’s oeuvre and to ⟨set Freud back to work⟩ by applying the psychoanalytic method in a radically critical manner—not to clinical practice, but to Freud’s own texts. This article examines the ways in which Laplanche reinterpreted Freud’s dream theory. Attention is given to the place of the dream in the Vocabulaire, the making of the French translation of the Interpretation of Dreams, and his critique of intersubjective and Lacanian conceptions of dreaming. Laplanche also underscores that the analyst listens to dreams differently than to other associations. He approaches Freud’s theory of dreams primarily through his own theory of generalized seduction. His model of the psychic apparatus can be seen as both a reworking and an extension of Freud: the dream appears as an enigmatic message that addresses the dreamer, calls for translation, remains partially untranslatable, and yet persistently demands further attribution of meaning.

The effects of RBD medications on dream content: A critical review of evidence.

BackgroundEvidence suggests that dreaming is subserved by the default mode network (DMN) (Domhoff, 2022. The Neurocognitive Theory of Dreaming). β‐amyloid plaques and phosphorylated tau (p‐tau) protein tangles accumulate and contribute to abnormal functionality in the DMN long before clinical Alzheimer's disease, and similarly early abnormal DMN functionality is shown by apolipoprotein E (APOE) gene ε4 allele carriers. Given this, we reasoned that dream recall in cognitively normal older adults may be associated with blood p‐tau levels, APOE ε4 carriage, and future cognitive decline.MethodData were for 1049 cognitively unimpaired individuals (mean age=74.7 years; 64% women) in the Spanish Vallecas Project. Dream recall was ascertained by asking “Do you remember your dreams?” (yes/no). Blood p‐tau217 levels >0.247 pg/mL were considered high, and ≥1 ε4 alleles indicated APOE ε4 carriage. Cognition was assessed with a modified Preclinical Alzheimer Cognitive Composite (PACCm) annually over 10 years, with z‐scores <‐1 considered relatively low baseline cognition. Our analyses used general linear models, as well as a linear mixed‐effect model to compare the longitudinal cognitive trajectories of dream recallers and non‐recallers. Analyses were controlled for factors including sleep characteristics, medications, depression, and memory test scores.ResultThirty‐one percent of participants did not remember dreams. Higher p‐tau217 levels and APOE ε4 carriage were both associated with a lower likelihood of remembering dreams (OR=0.52, 95%CI=0.35‐0.79, p = .002 and OR=0.61, 95%CI=0.43‐0.86, p = .006, respectively), independently of memory test scores. Further, individuals who did not remember dreams at baseline showed faster decline in PACCm scores (βnon‐DR=‐0.03) over 10 years than dream recallers (βDR=‐0.02; βAge*Dream Recall=0.011, SE=0.005, p = .036), despite dream recall status not being associated with relatively low cognition at baseline (OR=0.94, 95%CI=0‐60‐1.48, p = .788).ConclusionDream recall status was associated with blood p‐tau217 levels, APOE ε4 carriage, and future cognitive decline among older individuals cognitively healthy at baseline. Not remembering dreams in later life may be an early indicator of neurodegeneration in the DMN. This would help explain an unexpected and overlooked finding more than 30 years ago that lower dream recall frequency predicted incident dementia (Persson & Skoog, J Geriatr Psychiatry Neurol 1992;5:172‐178), a decade before the DMN was discovered.

Lorlatinib is the preferred first-line treatment for patients with ALK+ metastatic non-small cell lung cancer. However, this drug carries high rates of neurocognitive adverse events. This study further characterized these neurocognitive adverse events, examined risk factors, and, for the first time, explored social support as a mitigation strategy. The Mayo Clinic medical record was interrogated for patients prescribed lorlatinib between July 2017 and May 2022, and medical records were reviewed in detail. Sixty-three patients were prescribed lorlatinib (median age: 59years (range: 37-82); 31 (49%) men). Twenty-five (40%) developed a neurocognitive adverse event, which had been characterized as follows: "hallucinations," "noise confusion," "obtunded," "memory loss," "trouble doing simple tasks," "mental fogginess," "vivid dreams," and "nightmares." In univariable analyses, age, gender, prior brain metastases, concomitant CYP3A inducers or inhibitors, and married/partner status were not statistically significantly predictive of the neurocognitive adverse event. In multivariable analyses, older age (≥ 65years) was predictive (HR: 2.6 (95% CI: 1.09, 6.26); p = 0.03). Notably, 3 of 14 married/partnered patients (21%) and 5 of 6 non-married/partnered patients (83%) were hospitalized for a neurocognitive adverse event (p = 0.02, Fisher's Exact test). Medical record content corroborated the importance of married/partnered ("spouse is very supportive") and of non-married/partnered status ("patient lives alone" and "children some distance away"). This study further characterized lorlatinib-associated neurocognitive adverse events and confirmed older age as a risk factor. Importantly, social support may prevent hospitalization for a neurocognitive adverse event, and, thus, merits further study, perhaps in older patients.

BackgroundNarcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness and, in the case of narcolepsy type 1, cataplexy. Patients may also experience various sleep disturbances, including hallucinations, sleep paralysis, and vivid dreaming. Beyond its clinical symptoms, narcolepsy impacts aspects of daily life, social functioning, emotional well-being, and overall quality of life. Despite the substantial burden associated with the disorder, qualitative research exploring the emotional burden of individuals with narcolepsy is limited.MethodsA qualitative study was conducted using narrative semi-structured interviews with 25 individuals diagnosed with narcolepsy. The interview framework was validated by a multidisciplinary panel of experts to ensure methodological rigor. Interviews were conducted either in the patients’ homes or hospital settings, transcribed verbatim, and then analyzed inductively to develop a comprehensive codebook. A thematic analysis was then performed to identify key patterns and insights into the lived experiences of individuals with narcolepsy.ResultsIn-depth patient interviews revealed key themes related to the emotional burden of narcolepsy. The onset of symptoms was identified as particularly distressing, evoking feelings of shame, embarrassment, and fear. Symptom manifestation also affected self-perception and important roles in life. Additionally, patients’ experiences of daily life, along with their future aspirations and expectations, contributed to a comprehensive understanding of the challenges associated with narcolepsy.ConclusionThe impact of narcolepsy is linked with the emotional experiences and self-perception of patients, influencing their quality of life. This burden may also contribute to potential diagnostic delays and hinder the timely initiation of treatment.

Efficacy and safety of varenicline for electronic cigarette cessation: A systematic review and meta-analysis.