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Dream Consciousness and the Brain: Relevance to Psychopathology

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Sleep and Neuropsychiatric Disorders

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Abstract

Dreaming has progressively been marginalized in modern clinical approaches to the mental health and psychopathology. Scientific interest in dreams survived, only partially in the field of sleep and consciousness research, where the study of subjective experiences when the brain is disengaged from environmental stimuli may contribute to investigate the neural correlates of consciousness. Nonetheless, progression of knowledge on the dreaming brain/mind was recently employed to model pathological mental phenomena such as psychosis. Indeed, a phenomenological overlap between dreams and psychosis has been described since antiquity. The loosening of associations and disorganization of speech, the pervasiveness of one's hallucinatory experience and lack of insight on the internal origin of incoherent and incongruous mental contents are among several shared phenomena between dreams and psychosis. Bizarreness quantified in dream and fantasy reports was found to be inversely proportional to the neural response of a right fronto-temporal network activated during the script-driven recall of these experiences in healthy volunteers, suggesting a role for these circuits in the dreamlike bizarreness of psychotic patients’ waking mentation. Other available neuroimaging studies also suggest that self-monitoring failure experienced during dreams and lack of insight in psychosis share the disengagement of the same frontal circuitry. However, incorporation of consciousness, psychosis and dream research in a “neuro-phenomenological” or “multi-level” framework remains speculative, and further work is needed to overcome many methodological limitations and to rigorously approach this fascinating field of enquiry.

“If we could imagine a dreamer walking around and acting his own dream as if he were awake, we would see the clinical picture of dementia praecox” (Carl Gustav Jung, The psychology of dementia praecox, 1909).

“The modalities of thinking of schizophrenic subjects are very similar to dreaming”.

“Most of the characteristics of schizophrenic thinking (particularly delusional thinking) are explained by the differences between the dreaming and the wakefulness way of thinking” (Eugen Bleuler, Dementia praecox or the group of schizophrenias, 1950).

“In spite of a lifetime of discriminating between dreams and reality, we can make the discrimination only after awakening. Identifying the neural substrates that are responsible for critical self reflection during wakefulness, and that fail us while dreaming, is a major challenge for sleep and dream research” (Allan Rechtschaffen and Jerome Siegel, Sleep and dreaming in Principles of Neural Science, 2000).

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Authors and Affiliations

  1. Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, Salzburg, Austria

    Renata del Giudice

  2. Department of Mental Health and Addiction, San Paolo University Hospital, Milan, Italy

    Renata del Giudice, Simone Cavallotti & Armando D’Agostino

  3. School of Psychology, University of Glasgow, Glasgow, UK

    Alejandro Serrano Saunders

  4. Department of Health Sciences, Università degli Studi di Milano, Milan, Italy

    Armando D’Agostino

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  1. Renata del Giudice
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  2. Alejandro Serrano Saunders
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  3. Simone Cavallotti
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  4. Armando D’Agostino
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Correspondence to Armando D’Agostino .

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Editors and Affiliations

  1. Department of Psychiatry and Division of Sleep Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

    Ravi Gupta

  2. Department of Psychiatry, Johns Hopkins Medical School, Baltimore, MD, USA

    David N. Neubauer

  3. Somnogen Canada Inc., Toronto, ON, Canada

    S. R. Pandi-Perumal

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del Giudice, R., Saunders, A.S., Cavallotti, S., D’Agostino, A. (2022). Dream Consciousness and the Brain: Relevance to Psychopathology. In: Gupta, R., Neubauer, D.N., Pandi-Perumal, S.R. (eds) Sleep and Neuropsychiatric Disorders. Springer, Singapore. https://doi.org/10.1007/978-981-16-0123-1_5

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