Dissociation And The Traumatic Dream In Vietnam Veterans (derealization, Depersonalization, Combat, Ptsd).

Abstract

The purpose of this research was to study the relationship between dissociation at the time of a traumatic event and the form, sense of reality and focus of attention of the subsequent dreams of that event. Hypotheses stated that (1) Dissociation was a commonly experienced form of defensive functioning in Vietnam combat. (2) Where overwhelming external stress was experienced in a dissociated state, the subsequent dream will be of the undisguised trauma reenactment type. (3) Where a trauma is experienced in a dissociated state, the sense of reality will be reversed between event and dream; what was experienced as unreal at the time of the trauma will be experienced as real in the dream. (4) Where a trauma has been experienced in a dissociated state with the cathexis in the observing ego, the dream of the event will tend to place the cathexis in the experiencing ego. Twenty-seven Vietnam combat veterans identified as disturbed dreamers were interviewed and administered the Horowitz Impact of Event Scale. Traumatic event accounts were coded for degree of dissociation; associated traumatic dream accounts were coded for degree of dream disguise. Sixty-nine percent of the combat events reported were experienced with evidence of dissociated perception at the time, with depersonalization, derealization or a combination of the two as most frequent. Dissociation was found to be significantly (.05) correlated with (low) dream disguise in the highest dissociating group. However, dissociation was not found to be a better predictor of dream disguise than was the measure of subjective stress of the event. Whereas the reversal in sense of reality from unreal in the event to real in the dream was true of the group as a whole, it was not more characteristic of the high dissociators. Two-thirds of those who placed attention cathexis in the observing ego in the traumatic event, placed attention cathexis in the experiencing ego in the dream of that trauma. A theoretical link was proposed between dissociation and the traumatic dream based on a concept of the dream as the product of an ego reorganized to serve survival rather than wish fulfillment.