The clinical and predictive value of the initial dream of treatment.

The authors collected the initial dreams of treatment from 63 patients and independently evaluated the manifest dream report (MDR). Variables included: Affect and Valence of Affect; Associations; Psychodynamic Theme; Psychodynamic Theme as Predictor of Core Psychodynamic Issues; Transference; Gender; Psychodynamic Theme Categories; Clinical Progress in relation to Psychodynamic Theme Categories and Transference. The initial MDR invariably contains Affect that is frequently Negative. The Psychodynamic Themes of MDRs are dependable predictors of Core Psychodynamic Issues that emerge during treatment. Transference is evident in a significant number of MDRs and is often Negative. Gender of the majority of MDRs is predictable. The most frequent Psychodynamic Themes of initial MDRs fall into Relational and Injury Categories. Relational and Injury Themes, as well as Positive and Negative Transference, are associated with clinical progress. This study confirms that the initial MDR of treatment provides a significant amount of clinical and predictive information.