Psychoanalytic Psychology 2000, Vol. 17, No.

4, 651-666

Copyright 2000 by the Educational Publishing Foundation 0736-9735/00/$5.00 DOI: 10.1037//0736-9735.17.4.651

The Writing and Interpretation of Dreams

Harold P. Blum, MD
New York University College of Medicine

Freud's (1900/1953a) magnum opus, "The Interpretation of Dreams," largely based on the self-analysis of his own dreams, incorporated a wide variety of source material. Concerned about exposure and discretion, he nevertheless published his dreams with many personal associations and revelations. Despite the self-analytic, research, and educational value of his written dreams, Freud paradoxically devalued written dreams in clinical psychoanalysis. Written dreams can be preserved, collected, compared, and reexamined. Writing dreams protects against forgetting the dream with its unconscious representations. Written dreams of patients are not simply resistance or enactments, but analytic communications with transferencecountertransference significance. A clinical vignette exemplifies use of the written dream in attempted ego mastery of unconscious trauma and conflict. This is the centenary of Freud' s ( 1900/1953 a) "Interpretation of Dreams," in its day a revolutionary treatise, now one of the great books of the ages. The book was a landmark, inaugurating psychoanalysis, as well as a landmark in the history of ideas. Freud, in what is generally regarded as his masterwork, altered the way people understand dreams, themselves, and human nature. The book was also a major contribution to the history

Harold P. Blum, MD, Department of Psychiatry, New York University College of Medicine. Correspondence concerningthis article shouldbe addressedto Harold P. Blum, MD, 23 The Hemlocks,RoslynEstates, New York 11576. Electronic mail may be sent to haroldpblum@cs.com.

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of ideas--"We are such stuff as dreams are made on" (Shakespeare, "The Tempest," Act 4). Dreams were reported and deemed to be significant from the beginning of recorded time. The oral and written communication of dreams is part of ancient history as well as the history of psychoanalysis. In antiquity, dreams were given special significance as messengers from the Gods, divine omens with prophetic and clairvoyant powers. The dream as a vivid visual hallucination was endowed with the conviction of reality that sometimes persisted into waking life as a mystical influence. The first known recorded dream dates from about 2500 BCE in Mesopotamia, and there are also dreams dating from ancient Egypt. The supreme importance attributed to dreams and the idealization of dream interpretation was apparent in ancient Greece. Dreams were brought to the Delphic oracle, the renowned motto of which was "know thyself." Dreams were associated with healing as in the cult of Aesculapius. The Temple of Aesculepius at Epidaurus had votive tablets that described the cure effected by the particular dream. Aristedes, an afflicted devotee of the healing cult of Aesculapius, left a record of 200 dreams. He contacted Aesculapius in a dream and, pertinent to this article, he was ordered to create a journal of dedication: The most important ancient dream book was that of Artemidorus (2nd century CE). This book of dream analysis, to which Freud referred, was also written as instructed in a dream (Kilborne, 1987). Dream interpretation had social, medicinal, prophetic, and religious importance with implications for self-knowledge. The interpretation of dreams could be used for diagnosis, prognosis, and proper treatment. Thus, although dreams in antiquity were often idealized, they could also be devalued as nonsensical. Aristotle (350 BCE) was among later writers who considered dreams as natural rather than supernatural phenomena. The tendency toward the idealization and devaluation of dreams continued as dreams were considered by many scientists and physicians prior to Freud as being babble, the irrational product of a sleepy mind in a sleeping brain. Since the publication of the "Interpretation of Dreams," which first appeared on November 4, 1899, dreams were given an exceptional position by Freud and the pioneer analysts. The dream in the "id phase," the childhood of psychoanalysis, was the preeminent path to achieving the analytic goal of making the unconscious conscious. Freud, however, would soon caution about the analytic abuse of dreams, writing about dreams as resistance and as an art for art's sake. Many theoretical and technical developments were yet to be formulated. In the recent past the exalted position of dreams would be challenged. In the era of ego psychology, some analysts considered dreams of no more value

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than any other analytic data, now a time-worn debate (cf. Blum, 1976; Brenner, 1976; Greenson, 1970). Different from other data, dreams often have special access to unconscious fantasy. Unconscious fantasy in general later became a central focus of interpretation (Arlow, 1979). Freud identified with the biblical Joseph who interpreted dreams of prophetic importance and who was duly elevated and rewarded for his dream analysis. Joseph achieved the prestige and position accorded to analysts in the post-World War II era of idealization. Although Freud (1923/1961) later warned against the overvaluation of dreams and their technical misuse, he always returned to dreams as having personal importance to him. It is known that he created a scrapbook of dreams in his childhood and wrote dream fragments on scraps of paper, a process that continued before and after his writing "The Interpretation of Dreams." Freud's early notebooks on dreams were either lost or destroyed, but he kept notes of his own dreams during medical school. Writing to his future bride, Martha Bernays, on July 19, 1883, he mentioned a blissful dream of a landscape, "which according to the private notebook on dreams which I have composed from my experience indicates traveling" (Jones, 1953, pg. 351). About 225 dreams are reported in "The Interpretation of Dreams," of which only about 50 are Freud's. However, it is Freud's dreams that are most intensively and extensively discussed and analyzed. Freud later made this observation: I soon saw the necessity of carrying out a self-analysis and this I did with the help of a series of my own dreams which led me back through all the events of my childhood and I am still of the opinion today that this kind of analysis may suffice for someone who is a good dreamer and not too abnormal. (Freud, 1914/1957, p. 20) Freud had reclaimed dreams from popular beliefs, magic, and mysticism. He made the interpretation of dreams a point of differentiation between those who had become or could become psychoanalysts, and those for whom dreams remained incomprehensible. In the preface of the second edition of the dream book (which appeared in 1908), Freud stated, "it has always been the interpretation of dreams that has given me back my certainty" (Freud, 1900/1953a, p. XXI). He later asserted (Freud, 1913/ 1958a, p. 170) that "dream interpretation is the foundation stone of psychoanalytic work." He referred to the dream as a "sheet-anchor" and stated, "Whenever I began to have doubts of the correctness of my wavering conclusions, successful transformation of a senseless and muddled dream into a logical and intelligible and mental p r o c e s s . . , would renew my confidence of being on the right track" (Freud, 1933/1964, p. 7).

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Freud may have been in transient altered states of consciousness during his work on the dream book. He wrote to Fliess, "I shall force myself to write the dream in order to come out of it" (Masson, 1985, p. 278). Immersed in writing "The Interpretation of Dreams," Freud wrote to Fliess (Masson, 1985, p. 305), "I can compose the details only in the process of writing." A "writing cure" has been suggested (Mahony, 1994), emphasizing the importance writing had for Freud. Freud attributed writing his dreams to the dictation of the unconscious, although his own inner self-reflection, his vast reading, and his intellectual inquiry are evident throughout the book. "The Interpretation of Dreams" was contemplated for years, was written over more than a year's time, and was subjected to successive later revisions. New material and footnotes were introduced in every new edition; the largest of the additions pertained to symbolism. Unfortunately, the original manuscript of "The Interpretation of Dreams" was discarded, lost to posterity like so many of Freud's manuscripts. Ever passionate about books and publications, Freud did not hesitate to correct page proofs or to demand royalties from the publishers of the subsequent editions of the dream book. Freud's dreams recalled and his writings of dreams were already a translation of his own memories, self-observation, and inner speech. He had the facility for recalling the dream imagery and for organizing the visual images into meaningful pattems. Freud had been interested in language development and disorder long before--for example, having published "On Aphasia" in 1891 (Freud, 1891/1953b). He had noted that dreams in some respects are closer to hieroglyphics and a rebus than to actual written verbal language. One may conclude that Freud's symbolic processes were especially well endowed in pictorial, iconic, and linguistic intermodal capacities. The interpretation of dreams required the capacity to think and remember pictorially, to understand unconscious symbols and their perceptual referents, and to be able to freely translate from the pictorial to linguistic symbols and back again from linguistic symbolic processes to the visual imagery of the dream. Freud's eidetic, remarkable memory potentiated the synthesis of retrieved, isolated memories and their integration into reconstructions of his childhood. The writing block Freud experienced as he proceeded with his dream work became an incentive to self-analysis, the inhibition gradually subsiding during further self-analysis. The writing block was overdetermined by a number of unconscious childhood conflicts connected with Freud's need to communicate. This need as well as the capacity to communicate are evident in Freud's voluminous scientific papers and documents and his

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almost unsurpassed quantity of letters. He abjured dictating to impersonal secretaries and later to the use of the typewriter and preferred writing by hand. His correspondence was answered promptly and meticulously with the use of a ledger. One of his many complaints about America after his 1909 visit to Clark University was that his handwriting had deteriorated. Writing was associated with the flow of body fluids, with procreation, fertility and creativity, and with the conflicts of all developmental phases. His writings were influenced by his real and transference relationship to Fliess, as well as by anxieties connected with writing his dreams and his associations for publication. As a transference figure, Fliess represented Freud's childhood object representations, especially an initially idealized parent. In reality, Fliess was granted an intimacy and authority to which Freud adapted in degree, the relatively "secret sharer" of his ideas and propositions. Perhaps another transference figure would have been found if the Fliess relationship had never evolved. Yet Freud was his own analyst and patient and progressed with and without Fliess, helped and hindered by the external collaboration (Blum, 1990). As Freud's brainchild, psychoanalysis was a narcissistic object, and this would become a problem for those of his followers who were identified with his person rather than his analyzing functions and his quest for analytic mastery. The idealization of the dream in analysis was also an idealization of Freud. Editorially influenced by Fliess, "The Interpretation of Dreams" was to be ready for publication on the birthday of Fliess. It was to be a birthday present celebrating the birth of psychoanalysis. Similarly, Freud had referred to his pregnant wife's own birthday celebration in his write-up of the initial specimen dream, now called "The Irma Dream"; Freud identified with the pregnant mother and with creative individuals. Fliess had a paucity of publications, and the dream book would far surpass Freud's previous prolific and influential writings. (Mahony, 1994) All of Freud's teachers are referred to in his dreams, but it is Freud who is there as the teacher, narrator, and explorer of the forbidden and alluring unconscious mind. In the dream book Freud's life and work coalesce. Why did Freud use his own dreams and exhibit to the world so much of his own private life? One can have only partial answers. It is known from his publications and his private correspondence that the issues of private versus public were highly conflicted. Freud (1900/1953a, p. 104) remarked about the difficulties he had to overcome within himself: "natural hesitation about

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revealing so many intimate facts." Readers would be initially interested, Freud thought, in the indiscretions which I am bound to make . . . . I am obliged to add however. . . . that in scarcely any instance have ! brought forward the complete interpretation of one of my own dreams, as it is known to me. I have probably been wise in not putting too much faith in my reader's discretion. (Freud, 1900/1953a, p. 105) So much is concealed, and so much is revealed, and so much continues to be unearthed despite Freud's reluctance and decision against full disclosure. Subsequent generations of analysts and historians have made Freud an icon, an exceptional object of investigation. Freud had already destroyed many of his documents in 1885 and 1907 and again when departing from Vienna in 1938. He indicated that he intended to make things difficult if not impossible for biographers. In contrast to his scientific papers, Freud's correspondence was never intended to be public. In the correspondence, Freud still consciously and unconsciously selected and edited his material. In the dream book Freud engages his reader, inviting and exciting the reader's curiosity. His own dreams and those of the others in the book are used as teaching tools for the edification of the public and the education of future psychoanalysts. Was Freud's personal exposure a form of self-sacrifice? He had frequent dreams of appearing naked in public. Exhibitionism was sublimated and transformed in his mature desire to disseminate his discoveries and to achieve scientific success, fame, and fortune. He was willing to courageously confront scorn and derision in the service of his scientific and scholarly objectives. Although infantile narcissistic motives can be discerned in Freud's wish for his book to be recognized as a stunning achievement and a revolutionary new humanistic psychology, similar motives are present in virtually every revolutionary thinker. Confronting the unconscious and the infantile, "The Interpretation of Dreams" does in fact remain a masterpiece of education, exposition, clarification, and insight. In 1931, in the preface to the third revised English edition, Freud stated of the dream book, "It contains even according to my present day judgment, the most valuable of all the discoveries that it has been my good fortune to make. Insight such as this falls to one's lot but once in a lifetime" (Freud, 1900/1953a, p. XXXII). Noting that the same piece of dream content may conceal different meanings in different people in different contexts, Freud was led to his own dreams because they

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offer a copious and convenient material, derived from an approximately normal person . . . . No doubt I shall be met by doubts of the trustworthiness of self-analyses of this kind; and I shall be told that they leave the door open to arbitrary conclusions. (Freud, 1900/1953a, p. 104) Dreams were found in normal persons; everyone dreamt, although it was not then known that everyone dreams several times during every night. Freud relied more on his own dreams than any other source of material. He was probably more confident in his self-knowledge acquired by his selfanalysis than he was in the more superficial and shorter analyses of patients prior to his writing the dream book. His own written dreams could be preserved, collated, compared, and later reexamined by himself and others. Freud's interpretation of his own dreams is sometimes concentrated in one section of the dream book, as in the specimen dream (Irma dream). References to his dreams are scattered throughout the dream book and are used to illustrate different dream mechanisms and meanings. Although the diffusion of comments about his dreams may have served greater anonymity, it also placed a confident Freud throughout his magnum opus. At times Freud later revealed that an anonymous dream was his own, as in the dream that the Pope was dead (Freud, 1900/1953a, p. 232; GrubrichSimitis, 1996). Freud's initial work on dreams may also have been facilitated because dreams are relatively ego alien compared with waking thoughts and fantasies. They are perhaps first easier to contend with as foreign phenomena, yet harder to understand as strange, perplexing productions. Many persons feel more responsible for their daydreams than their dreams, and indeed Freud recorded 10 times as many of his dreams as his daydreams. Dealing with more unconscious, primary process derivatives, Freud's self-dissection of his dreams resulted in troubling insights that were lost and found again, isolated and reintegrated (Rangell, 1987). Freud asked not only the indulgence but also the intense interest of the reader in his dreams and in their dreamer. This made Freud the object of analytic inquiry that he simultaneously disclaimed. He stated And now I must ask the reader to make my interest his own for quite awhile, and to plunge along with me, into the minutest details of my life; for a transference of this kind is peremptorily demanded by our interest in the hidden meaning of dreams. (Freud, 1900/1953a, pp. 105-106) This invitation was bound to be frustrating because some details were withheld, that is, censored. Even while he lifted the censorship from the

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meanings of dreams, Freud exercised selective censorship and permitted Fliess to be an external censor and editor. Identifying the readers with himself and his mentors, Freud attempted to overcome doubts and to open the readers' minds and lift the tendency to censor his own and their own fantasy life and unconscious conflicts. Freud took pride in his own composition, accomplishment, and radical creativity. Like so many artists, he has provided a great selfportrait. As Freud attained an analytic identity, a transformation was also occurring in the history of ideas and in the way people think about their thoughts and feelings. Dreams were used to illustrate the relationship of the dynamic unconscious to consciousness and the unseen relationships between dreams, neuroses, and the structure of the human mind. The manifest content of both dreams and symptoms hid and disguised repressed wishes. Repressed wishful fantasy was further obscured by the primary process mechanisms of condensation, displacement, and symbolization. The surface of dreams is a variably disguised facade, a compromise formation with deeper significance representing wishes and motives derived not from mature adult life but from childhood and infantile life. Although Freud allowed for a different mechanism for traumatic dreams and nightmares, he generally attempted to subsume the variety of frightening, punitive, and persecutory dreams under the rubric of disguised and prohibited wish fulfillments. He identified with Moses, a prophet presenting a new message and a new method for the comprehension of humans' most primitive impulses, conscious and unconscious moral principles, and cultural values. For Freud, derivates of unconscious fantasy emerged in transference, and pictorially in dreams. One picture could be worth a thousand words. " 'The Interpretation of Dreams' is the royal road to a knowledge of the unconscious activities of the mind." (Freud, 1900/ 1953a, p. 608) The road was not only a path to the exploration of primary relationships and primal scenes, but an unconscious return to or merger with the maternal body, the ineffable navel of the dream. The navel was unfathomable and may also have meant the undifferentiated psyche and the nascent mind. He wrote to Fliess on August 6, 1899 (Masson, 1985, p. 365), "The whole thing is planned on the model of an imaginary walk." The royal road was the great analytic journey through the different phases of development and of life, recapitulated in dreams. The dream represents past and present, childhood and current conflict. The dream itself is a metaphor for the forward journey through adulthood and the analytic as well as regressive journey of the dream back into childhood. The dream

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book has manifold references to parent and child, adult and infant, birth and death. Freud's capacity to interpret dreams and his special gift of correlating so many different forms of symbolic processes were probably unique. Even today little is known about such exceptional persons with special endowments, special motivation, and fortuitous development that facilitates originality and creativity. Freud was a visionary, and "The Interpretation of Dreams" his vision. As a dreamer, he has had a profound influence, and psychoanalytic thought has permeated virtually all aspects of culture while becoming the basis of all rational psychotherapies. The dreamers and visionaries who are truly creative are ordinary mortals in life, although immortals in their work. They have to deal with their own conflicts about being so original, with infantile omnipotence supported by reality. They are so different and yet in so many ways ordinary people with ordinary frailties. The command or urge to write the dream appears to be connected to the search for power, mastery, and significant communication with oneself or others. The written dream was to be read and understood, increasing self-knowledge, with psychoanalytic insight eventually replacing the ancients' foresight. The regressive narcissistic omnipotence of the ordinary dreamer could be projected onto the dream or the childhood objects in the dream, transferred to the gods or figures in the external world. Through this process the dream in ancient times acquired a grandiose and divine significance. A century after Freud, with less narcissistic investment in that first journey into the dream world, it is known there is no royal road without resistance. The dream book itself remains far more complicated and profound than it may superficially appear, even to the informed reader. Current neurophysiology is consistent with much of Freud' s dream theory, and it appears that infantile emotional memories may be permanently registered in the brain (Le Doux, 1996). Dreams, despite their more recently elaborated psychology and neurobiology, still retain some of their mystery. "The Interpretation of Dreams" will be periodically reinterpreted and revised in its timeless journey. Despite its research importance in the development of psychoanalysis, the written dream was soon designated as acting out and as a resistance in the analytic situation. Freud paradoxically adopted a negative attitude toward the written dream in psychoanalytic treatment. Despite his own use of the written dream, and apparently recommending it to Anna Freud, he stated

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Even if the substance of a dream is in this way laboriously rescued from oblivion, it is easy enough to convince oneself that nothing has thereby been achieved for the patient. The associations will not come to the test, and the result is the same as if the dream had not been preserved. (Freud, 1911/1958b, p. 96) Abraham (1913) regarded the patients writing down their dreams as departing from the fundamental rule of psychoanalysis. He emphasized the return of the resistance in attempts to salvage the dream because the writing was either illegible, discarded, or nonproductive of usable associations. Psychoanalytic writing about written dreams, other than Freud's own, has been sparse. Whitman (1963) dissented from the dismissive attitudes of Freud and Abraham and suggested that for some patients the written recording of dreams is definitely useful in psychoanalytic treatment. He theorized that dream forgetting is due not so much to resistance as to a functional demand that the ego cannot meet. On awakening, the confrontation with reality results in shifts to secondary process thinking, to external perception, and to motor activity that is incompatible with the dream state. According to Whitman, the patient may find it helpful to record a fraction or all of the dream, thereby overcoming the tendency to forget the dream. In my experience, some patients do not remember dreams or are little attuned to dreams or both. Writing them may be an initial effort to make them available for analytic work. Both dream reporting and the writing down of dreams will be influenced by the analyst directly conveying an interest in dreams or urging the patient to try to recall or to write down the dream. A patient may spontaneously write a dream or dreams just as a patient may spontaneously bring diaries or other personal documents into the analytic work. The analyst need make no specific interdiction against writing, and any written dream can be handled analytically in the context of its spontaneous production. As noted by Lipschutz (1954), the written dream will prove to have a powerful transference significance. Although any dream may be designed to please or placate, confuse or deceive the analyst, putting the dream in writing may be an attempt to confer upon it special authority and endurance. The fact that the dream has been written and the surrounding circumstances must be considered analytically in addition to the analysis of form, content, and associations. In addition to the function of preventing forgetting, multiple unconscious meanings are associated with the writing of the dream. It should be emphasized that the dream may signify any object, part object, narcissistic object, or body process or product. Thus the written dream may have in

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addition to its function of protection against loss of the dream the unconscious protection against loss of whatever memories and objects or aspects of the self the dream represents. As with all dreams, the form, style, content, complexity, length, quantity, and so forth of written dreams are significant. The manifest content may be more or less a translucent envelope, a surface that may reveal, conceal, or both. Some dreams are passively given to the analyst without interest or effort at further inquiry by the patient. The patient's associations, a knowledge of the patient's life, the phase of treatment, the state of the transference, and the particular ability of the patient and the analyst to engage the dream in the context of the analysis are all important considerations. The written dream is not necessarily an impediment but can be addressed as an analytic communication in all its aspects (Blum, 1968). The conflicting opinions of Freud himself and those of later analysts concerning the written dream indicate the importance of clinical exploration. Using the following clinical vignette, I consider many of the controversial issues regarding the written dream and its meanings in the analytic process. A female patient in her second analysis rarely brought dreams to her analytic sessions. Although she had briefly kept a childhood diary, she had never before in her analysis come with any written material, nor had the analyst ever suggested that she record her dreams. After 3 years she walked in and handed the analyst a piece of paper announcing that she had had a sleep disturbance. She woke recalling the dream, and immediately decided to write it down before it would be forgotten. The written dream was as follows: Was in house which was attached to other houses almost like apartments. Heard series of blasts--one of which tore down one of my walls. I ran into garage as place of safety. Next running in street looking for somebody--later thinking it may have been children. I asked policeman what it was all about. Policeman said we were being bombed. Later I didn't recall asking the policeman; I seem to feel I may have imagined loud noises. She originally told the dream in the morning to her children who were under active consideration for psychotherapy. The children were underachieving in school and manifesting behavioral disturbances. The patient had an obsessional character, her spastic colitis was active, and in her associations she proceeded to blast friends for being selfish and indifferent to her difficulties. She had argued with her husband about money at breakfast. The analyst interpreted her hidden aggression in the analytic situation and her avoidance of argument with the analyst. The

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patient immediately recalled that she had intended to bring in the check for analytic payment but had forgotten. She was always angry that she had to pay. The police represented arrest and punishment for attempted robbery as well as protection from her aggression and fear of retaliation. The analyst pointed out that she had written the dream instead of the check, she had brought in the written dream instead of bringing in the forgotten check. Although the dream was an apparent gift, it was covert withholding. Associations further led to the analyst handing her a written piece of paper, the bill, which contributed to this exchange of notes. She had been handed a written bill, and in turn handed the analyst the written dream. Her written dream was therefore also a mocking, hostile identification with the analyst rendering the bill. In writing the dream she guarded against forgetting the dream and turned her hostility into the passive aggressive forgetting of the check. The patient was actually quite ambivalent to her children, projecting her own infantile demands onto them. After payment of the bill she was frequently irritable with the children, arguing over extra cookies, unable to be loving and giving. Afterward, guilty over her witholding and provoking, she would overindulge the children. She developed cramping diarrhea and felt empty and depressed with thoughts of "I would rather die than pay." Not acknowledging her own greed, envy, and spiteful withholding, she felt that she was being castrated and robbed of food and body contents. One difference in her second analysis was that she was presented with a written bill, whereas her first analyst had invited her to tally her own sessions and to pay accordingly without receiving a bill. They colluded in avoiding "the fight over the fee." With frequent associations and analytic observations, patterns of withholding and reluctantly giving emerged; she then revealed that her husband had cheated his analyst by continuing to pay a markedly reduced fee long after his income had greatly increased. She was therefore also identifying with her husband. Her husband had urged her not tell her analyst their true income and attempted to financially obstruct the analysis. Having cheated his analyst, her husband's premature ejaculation continued after his analysis possibly as a basic form of cheating and withholding from the partner. While consciously annoyed at her husband's symptomatic dishonesty, she was unconsciously pleased by her feelings of superiority. He represented the men in the family whom she wished to humiliate and have arrested and punished for what she thought was their mistreatment of her. The communication of the dream to her children was a desire to provide police protection from her aggression toward them as well as to

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attack them. One child unconsciously represented an ambivalently regarded deceased brother, and the other, herself. By going into treatment they would create financial difficulties and possibly bomb her out of her own analysis. The bombing and looking for the children is consistent with the written message as an ambivalent gift of feces and baby, also representing doing and undoing, birth and death. She also withheld her infantile aggression and longing for love. Much more could be said about the relationship of this written dream to traumatic experiences of childhood illness and object loss. Suffice it to say that childhood conflict linked to the patient's adult character and symptoms were related to her need to protect and defend against renewed loss and injury and to obtain reparations and revenge for her troubled life. The writing of the dream obviously defended against forgetting, which could represent loss at all phases of development (Kanzer, 1955, 1959; Lewin, 1953). Her preoccupations with overeating and dieting, constipation and diarrhea, and in analysis with silence and speech were all related to problems of separation-individuation with preoedipal issues of receiving and withholding, give and take. Reverberations of separationindividuation conflict could be inferred from the dream. The collapsed wall referred to the patient's anxiety about loss of ego boundaries, separation anxiety, anger, and oscillating between dependent and independent strivings. During latency the patient's problems gave rise to a learning block and difficulty in doing her homework, in completing writing assignments. Her written dream was therefore also a disguised communication to the analyst concerning the revival and resolution of her learning block in analysis and her ongoing use of analytic reeducation. Perhaps the converse of slips of memory and of the pen, her written dream was a form of homework that took the place of direct analytic work in the analytic situation. She wanted the approval of her parents for completing a homework assignment. Analytic work continued in the session while avoiding the oral report of the manifest dream. The writing of her dream imagery superimposed an advanced form of secondary process thought, and a secondary elaboration of the immediately remembered dream. It could also be understood as an attempt at mastery of trauma, restoring the dreamer's sense of reality, control, and ego organization. The writing externalized on paper her frightening thoughts, feelings, and dream fantasy. In her manifest dream, she "ran into the garage as a place of safety," and in the written dream she took refuge from a fantasized attack and counterattack superficially represented by the analytic "battle of the bill."

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Writing her dream may also have represented an ambivalent attachment to the writing analyst who writes papers and discussions, stimulating the patient's admiration, envy, and criticism. The patient wanted and feared to be included in the analyst's writings. The written dream has aspects of a dream from above (Freud, 1923/1961). It is variously controlled, censored, and communicated in a form that lacks the rich variety of associations and accompanying nonverbal communications of the orally verbalized dream in the analytic situation. It has intense transference and countertransference implications. Any departure from the usual framework invites the analyst's collusion in possibly subverting the analytic process. In the person with creative endowment, the written dream may become a form of active ego mastery of conflict and trauma that leads to sublimation. Kafka, for example, was a novelist who wrote his dreams, used them as a source of creative inspiration, and wove them into his literary activity. The elaboration and communication of the written dream in literary art permits the sharing of forbidden fantasies with the reader. The writing out of the dream should not be regarded simply as an acting out. It may also serve containment, control, and regulation of tendencies to act out. The written word may suppress and substitute for the concrete deed. A private nightmare can then be converted into socially approved and interesting fiction. The writing and presentation of the dream is an attempt to preserve object relations and communication. Choosing the written rather than the oral mode of presenting the dream to the analyst has multiple meanings, both conscious (e.g., in order not to forget) and unconscious. The written dream may particularly convey an edited version of earlier conflicts concerning reading and writing, silence and enactment. Written to be read by analyst and analysand, it converts monologue into dialogue and interpretive discourse. Freud's writing "The Interpretation of Dreams" was such a dialogue with the reader. References Abraham, K. (1913). Shouldpatients write down their dreams?In Clinical papers and essays on psycho-analysis (pp. 33-35). New York: Brunner Mazel. Arlow, J. (1979). The genesis of interpretation. Journal of the American Psychoanalytic Association, 27(Suppl.), 193-206. Blum, H. (1968). Notes on the written dream. Journal of Hillside Hospital, 2 & 3, 67-68. Blum, H. (1976). Dreams and free association. International Journal of PsychoAnalysis, 57, 315-324.

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