| Summary: | Dreams about the patient, sometimes called countertransference dreams, have received little attention in the literature and have rarely been discussed in the context of psychotherapy as opposed to psychoanalysis. This study explored the experience of dreaming about the patient in two groups of psychoanalytically-oriented psychotherapists. Data were gathered through in-depth interviews with 11 psychotherapists, with follow-up approximately one year later, and through a survey of a larger group of 79 psychotherapists. The experience of dreaming about the patient was quite common and varied in these samples. Approximately 80 to 90% of therapists could recall dreaming about a patient at least once over the course of their careers. Typically, therapists recalled having such dreams at least once or twice per year, although many reported dreaming of patients as frequently as once per month. The settings and themes of dreams were observed to vary widely. Therapists described a range of emotional reactions to dreaming about the patient, including positive and welcoming feelings as well as discomfort tinged with a sense of the forbidden. In contrast to the emphasis in the literature, therapists observed such dreams to arise in a variety of treatment environments, not only those characterized by subjective distress in the clinician. Therapists made use of the dreams as tools for discovery, drawing insight or discerning "news" from them. The news played the role of clarifying, affirming, or newly identifying dynamics in the treatment. Most therapists incorporated dreams into the treatment indirectly, through affective shifts or changes in their listening stance or behavior, rather than telling patients directly of their dreams. Some therapists noted that their fears concerning the propriety of dreaming about the patient could interfere with their ability to have, remember, and examine such dreams, as well as with their ability to share the dreams in wider professional forums. Given the gains associated with exploring dreams about the patient, the study concludes that it is important to shape environments to further encourage the examination of such dreams, in part through representing their role not as indicators of deficient practice but of an ongoing search for understanding.
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