Psychologist and client understandings of the use of dream material in psychotherapeutic settings

Consistent with the marginalisation of dreams in contemporary clinical practice, the few studies conducted on the use of dreams in therapy report that therapists do not feel confident or competent in responding to their clients’ introduction of dream material in therapy. This raises a number of potential consequences, such as a negative impact on the therapeutic alliance, the possible misinterpretation of a therapist’s rejection of a dream narrative as a disinterest in the client’s inner life, and possible questioning of psychologists’ expertise arising from mismatched expectations between the psychologist and client. The relative and significant gap in the literature around the direct lived experience of psychologists and clients working with dreams in therapy points to a need for further research of real life experiences and perceptions of dreams in psychological practice. The aims of this research were to identify and understand the experiences and understandings of psychologists and clients around dreams in contemporary Australian psychological practice. The specification of the sample population arose from the adoption of an Interpretative Phenomenological Analysis (IPA) approach, which emphasises the role of context in the examination of how people perceive or subjectively experience the world. The findings of the research are also contextualised through the lenses of existing research literature, theoretical frameworks, and the researcher’s perspectives. The first study analyses the transcripts from semi-structured interviews with sixteen psychologists. The findings of this first study demonstrate the diversity in psychologist experiences of dreams in psychological practice. Participants vary in the frequency of dream work, the way they use or do not use dreams in their work, and their feelings and opinions about dreams. Overall, this study illuminates the taboo and associated sense of disquiet around dreams, and attempts to reconcile dream work with being a ‘good psychologist’. This is expressed through discussions about credibility, imposter syndrome, the lack of a script for dream work, and low confidence levels around dream work. While many of the participants value the role dreams play in their practice, overall dreams are positioned as having an uncomfortable boundary role in contemporary Australian psychological practice at ‘whole-profession’ and public levels, despite the considerable variation at an individual level. With limited training around dreams, psychologists must negotiate multiple, sometimes conflicting, influences on their everyday practice, including the therapeutic alliance, which was identified as core to both dream work and psychological practice in general. These findings can inform the development of training and practice guidelines around responding to dream material and other examples of complexity in clinical psychology and psychology training in general. Additionally, it highlights the need for continued improvements in critical reflexivity and diversity within psychological research, training and curriculum, and the psychologist community. The second study analyses transcripts from semi-structured interviews with five psychology clients. The first theme emerging from the analysis clusters around participants’ experiences (with emotions ranging from feeling pressured, frustrated or vulnerable, to feeling relief or validation). The participants’ experiences are diverse and they vary in emotional tone, vary from one experience of therapy to the next, and are influenced by the stage of therapy. The second theme focusses on the participants’ underlying assumptions or rules, around what to share (or not share) with whom, and when. The participants’ explanations for their experiences and opinions reflect their underlying individual and socio-cultural understandings of both psychotherapy and dreams, with references made to dream beliefs, the stage of therapy, and psychologist cues. The participants all express the opinion that dreams have at least some relevance to therapy, although dreams are not always the sole or even a major focus of therapy. They describe multiple ways in which they and their psychologists have used dreams in psychological practice, and emphasise that dream sharing often reflects trust and the desire to engage deeply with psychologists, as sharing a dream can be a very risky and vulnerable experience. The findings of this second study highlight the value of approaching therapy (and dream sharing in therapy) from a social/cultural practice framework. This framework understands interactions or exchanges between psychologists and clients as being influenced by a range of cultural assumptions, which both parties bring into the therapy room with them. This research makes three significant contributions to knowledge. Firstly, it adds to the growing body of literature focusing on the application of socio-cultural theories to understanding the practice of professionals (and particularly practicing psychologists). Secondly, it increases knowledge around psychologists’ and clients’ understandings of their experiences of dream work in therapy and of the role of dreams in contemporary Australian psychological practice. Thirdly, this research can inform the development of training and practice guidelines around responding to dream material and other examples of complexity in clinical psychology and psychology training in general.