Dreams and dreaming in relation to trauma in childhood.

Mrs C experienced two types of repetitive dream linked with childhood trauma. The first type consisted of primal scene experience expressed in images utilizing typical primary process organization, i.e. condensation, displacement, symbolization and representation in visual or auditory imagery. Associated anxiety was intense but relieved with awakening. The second type of repetitive dream was an experience 'beyond anxiety', 'like being buried in a wave' and was without remembered imagery. The overwhelming anxiety did not dissipate with awakening and only gradually receded over succeeding days. It is hypothesized that these two types of dream are derived from quite different forms of mental organization. The former is linked to typical primary process organization, requiring representational thought, the capacity to manipulate mental images. Condensation, displacement, and symbolization are defining aspects of early forms of representational thought. Piaget has demonstrated that this capacity for manipulation of mental images begins at about 15-24 months. The second type of dream, with imageless terror and diffuse feelings of loss and emptiness, was derived from trauma Mrs C sustained at 2 years of age. It is suggested that this form of dream makes use of sensori-motor organization of mental experience and is similar to phenomena described by Lewin and Isakower. Vignettes from three additional analyses are presented as further examples of dream formation following childhood trauma. Piaget's findings concerning early forms of mental organization are briefly considered. These discoveries are helpful in understanding phenomena derived from early childhood experience.