The dream specimen in psychosomatic medicine in the light of clinical observations.

The author attempts to demonstrate a relationship between dreams and symptom formation in the psychosomatic patient. The egos of many patients predisposed to psychosomatic illness have shown a deformation of a defensive nature because of early impingement of the protective shield (a maternal function) which caused a precocious development of a false-self in Winnicott's sense. In a series of dreams the failure of one or more dream functions became evident. Such failures are often found in patients with psychosomatic symptoms and depend on the severity of illness and preillness factors such as personality, body image and type of object relationships. The dream functions identified were the traumatolytic, the wish-fulfilling, the symbolizing and the integrating ones. The author further speculates on the relationship between the physical symptom, the failure of a particular dream function, the physiological correlates of the manifest versus the latent content of the dream, the breakdown of the process of symbolization and the activation of an archaic body image representation.