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创伤后噩梦作为所有梦境的范例:一种关于梦的本质与功能的新方法。

Nightmare after trauma as paradigm for all dreams: a new approach to the nature and functions of dreaming.

作者信息

Hartmann E

机构信息

Tufts University School of Medicine, Boston, MA, USA.

出版信息

Psychiatry. 1998 Fall;61(3):223-38. doi: 10.1080/00332747.1998.11024834.

DOI:10.1080/00332747.1998.11024834
PMID:9823032
Abstract

Nightmares, far from being unsuccessful dreams or exceptions to rules about dreams, can be considered paradigms for all dreaming. They allow us to follow exactly how a disturbance or perturbation is handled by the processing systems in our minds. The data considered here consists of dream series in the weeks and months immediately following trauma in adults--in other words, nightmares and dreams occurring as the trauma resolves. It appears the traumatized person may dream first about the actual trauma (though not always), then, very quickly, the dreams appear to deal with the dominant emotion. Dreams of being overwhelmed by a tidal wave or being swept up by a whirlwind are common after almost any trauma. Clearly, such dreams are not about the sensory input from the actual trauma. Rather, the dreams are about the dominant emotion. The dreams contextualize (find a picture context for) the emotional concern. After trauma, the dominant emotion is usually first terror and fear, then often followed by guilt (such as survivor guilt). This too is pictured in the dream series. The same pattern of contextualizing an emotional concern can be seen in stressful situations, in pregnancy, or in patients whose lives are dominated by one emotion. This pattern is paradigmatic for all dreams, but it may be difficult to detect in "ordinary" dreams, because there may be a number of other relatively smaller emotional concerns present, as opposed to the one clear-cut dominant one (as after trauma). A theory of dreaming is sketched out based on these data which suggests that overall dreaming makes connections more broadly than waking in the nets of the mind, and that the connections are not made randomly but guided by the dreamer's emotional concerns. It is also suggested that the making of connections may be functional for the organism in the sense of "weaving in," or integrating, new material.

摘要

噩梦远非不成功的梦或梦境规则的例外情况,而是可以被视为所有梦境的范例。它们使我们能够确切地追踪我们大脑中的处理系统是如何应对干扰或扰动的。这里所考虑的数据包括成年人在创伤后的数周和数月内的梦境系列——换句话说,就是随着创伤的缓解而出现的噩梦和梦境。似乎受过创伤的人人人人可能首先会梦到实际的创伤(尽管并非总是如此),然后,很快,梦境似乎就开始处理主导情绪了。几乎在任何创伤之后,被海啸淹没或被旋风卷走的梦都很常见。显然,这样的梦并非关于实际创伤的感官输入。相反,这些梦是关于主导情绪的。这些梦将情感关切情境化(找到一个画面情境)。创伤后,主导情绪通常首先是恐惧和害怕,然后常常是内疚(比如幸存者内疚)。这在梦境系列中也有所体现。在压力情境、孕期或生活被一种情绪主导的患者中,也能看到同样的将情感关切情境化的模式。这种模式是所有梦境的范例,但在“普通”梦境中可能难以察觉,因为可能存在许多其他相对较小的情感关切,而不像创伤后那样只有一个明确的主导情感。基于这些数据勾勒出了一种梦境理论,该理论表明,总体而言,做梦在大脑网络中建立的联系比清醒时更广泛,而且这些联系不是随机建立的,而是由做梦者的情感关切引导的。还表明,建立联系可能对生物体具有功能性,即在“编入”或整合新材料的意义上。

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