Analysis reveals fascinating insights into client and therapist personalities and psychotherapy process

During this study in Psychotherapy Research, the authors set out to interpret the content and consequences of client's dreams about their therapists and vice versa. The analysis reveals some fascinating insights into client and therapist personalities, therapeutic relationships, and the psychotherapy process.

The study took 63 adults from a psychology department clinic at a large public US university. Each client had 20 plus sessions, each with one of 13 doctoral students, over a 2 year period. Clients, typically experiencing interpersonal problems, were videotaped during their 45-60 minute consultations and asked to report on dreams about their terapists at the end of the treatment.

Only 2 clients reported dreams about therapists, however clients did not keep dream journals  and were not prompted to talk about their dreams during sessions. At the end, dreams may have faded from memory and perhaps clients were so focussed on their own problems that the therapists did not enter their thoughts outside of therapy. 

Therapists, on the other hand, spend a lot of time evaluating clients in order to help them.

Therapists recorded dream journals during the study and were interviewed by co-authors on salient dreams about clients. Quantitative and qualitative analysis of dreams revealed 9 therapists dreamt about 19 clients. 

Some of the dreams depicted helpless clients, some unusual situations with clients, client aggression, and ethical dilemmas with a client. The feelings represented in the dreams included fear, embarrassment, and guilt; largely negative emotions. 

Therapists reported that the dreams reflected a lack of connectivity with clients, difficulty with a client, or personal issues in their own lives, which all seemed to trigger the dream; "the dreams depicted the struggles of the therapy, whether with the client, with the therapy overall, or with their own developmental challenges as new therapists". 

Despite this, therapists were able to use the insights helpfully to understand more about themselves and to further develop their ongoing clinical work.

The authors urge supervisors of trainee therapists to actively encourage discussion about client dreams to foster even greater understanding.