15 the Neuropsychology of Dreams: A Clinico-Anatomical Study

7/25/2019 15 the Neuropsychology of Dreams: A Clinico-Anatomical Study

1/4

This article was downloaded by: [Gazi University]On: 18 August 2014, At: 06:24Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: MortimerHouse, 37-41 Mortimer Street, London W1T 3JH, UK

Neuropsychoanalysis: An Interdisciplinary Journal

for Psychoanalysis and the NeurosciencesPublication details, including instructions for authors and subscription information:http://www.tandfonline.com/loi/rnpa20

The Neuropsychology of Dreams: A Clinico-

Anatomical StudyRamon Greenberg M.D.

a

a11 Waverly Street, Brookline, MA 02146, e-mail:

Published online: 09 Jan 2014.

To cite this article:Ramon Greenberg M.D. (1999) The Neuropsychology of Dreams: A Clinico-Anatomical Study,Neuropsychoanalysis: An Interdisciplinary Journal for Psychoanalysis and the Neurosciences, 1:1, 128-130, DOI:

10.1080/15294145.1999.10773253

To link to this article: http://dx.doi.org/10.1080/15294145.1999.10773253

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the Content) containedin the publications on our platform. However, Taylor & Francis, our agents, and our licensors make norepresentations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose ofthe Content. Any opinions and views expressed in this publication are the opinions and views of the authors,and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be reliedupon and should be independently verified with primary sources of information. Taylor and Francis shallnot be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and otherliabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to orarising out of the use of the Content.

This article may be used for research, teaching, and private study purposes. Any substantial or systematicreproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in anyform to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions

7/25/2019 15 the Neuropsychology of Dreams: A Clinico-Anatomical Study

2/4

128

that Schacter is unaware of this, it gets scanted in

the main part of

Searching

r

Memory

and is not

adequately brought to bear in TheMemory Wars.

The case for therapeutically recovered memories

pales compared to the case against them. His cautions

notwithstanding, Schacter's arguments of doubt are

more than convincing to me, and can be made even

stronger by including the role of social forces in influ

encing memory. His efforts to identify shades of

gray (p. 277) seemmore rhetorical than real, and the

middle ground (p. 277) he hopes to mark out, more

virtual than real.

Searching

r

Memory

is a magnificent book. Schacter

draws from a richly textured and vast pallet of often

conflicting information to paint a wonderfully detailed

panorama

of

memory, the mind, and the brain

as

seen

in the advances of the last several decades. His love

for his subject, as well as his extraordinary erudition,

are unmistakable. Judged from the standard

of

how

many references I checked off to locate and read, it

is a treasure trove. I only wish he had stated his perva

sive doubts about the recovered memory issue less

ambiguously, and hope I have not overestimated his

skepticism in the process.

References

Andreason,

N

(1995), Posttraumatic stress disorder: Psy

chology, biology, and the Manichaean warfare between

false dichotomies.

Amer.

Psychiatry

152:963 965

Southwick, S., Morgan, A., Nicolaou, A., & Charney,

D

(1997), Consistency

of

memory for combat-related trau

matic events in veterans of Operation Desert Storm.

Amer. Psychiatry

154:173 177

Brooks Brenneis Ph.D.

2700 Marshall Court

Madison Wisconsin 53705

e mail: [email protected].

The Neuropsychology Dreams: A Clinico Ana-

tomical Study by arkSolms. Hillsdale,

NJ:

Law

rence Erlbaum, 1997, 292 pp., 55.95

This book is a goldmine, full of many deep veins al

though it also has a few shallow ones. The author

provides an extremely rich view and review of the

Book Reviews

role of the cerebral cortex in dreams. He does this in

three parts: (1) a comprehensive review

of

neurologic

literature from the nineteenth century to the present;

(2) his own study of 361

cases with cerebral lesions

and a group of symptomatic controls without CNS

pathology; and (3) a series of hypotheses he develops

which weave through the clinical material and help

keep a focus on the meaning of the findings. The major

impact

of

this book is how clearly the author demon

strates the crucial role played by a number

of

telence

phalic structures in the generation of dreams. This

convincingly contradicts the long accepted notion that

REM sleep and therefore dreaming is mainly the result

of

pontine activity. The pontine theory has contributed

to the belief that dreams are inherently meaningless.

For psychoanalysts such an idea should not make

sense. Indeed, this reviewer's sense, as an analyst, that

dreams could not be purely based on pontine activity

led to a study (Greenberg, 1966) showing the im

portant role of the visual association cortex in the pari

etal area in the generation of the eye movements in

REM sleep. At the same time animal studies also

showed the cortical contributions (Jeannerod, Mouret,

and Jouvet, 1965). Nonetheless, the belief in the cen

tral role of the pons persisted. Solms' book should put

an end to such thoughts as he shows, both in his review

of

the literature and from his own cases, the essential

role

of

the cerebral cortex in the generation

of

and

quality of dreams.

Solms begins his presentation by describing the

Charcot-Wilbrand syndrome based on case reports by

Charcot and Wilbrand. These turn out to be two differ

ent disorders although they have been lumped together

as one. In the Charcot form the patient loses visual

dreaming although dreams continue in other modal

ities. Such patients also suffer from visual irreminis

cence, a condition in which they lose all visual

imagery in waking life. The Wilbrand variant seems

to have complete cessation of dreaming. Interestingly,

the lesions in these two forms of disorder are in differ

ent locations and have differing waking symptoms.

Charcot's variant and subsequent cases like it seem to

have bilateral lesions in the medial occipital temporal

areas, while Wilbrand's variety is most clearly the re

sult of

bilateral lesions in the medial basal frontal ar

eas. As Solms provides his extremely comprehensive

review one learns that lesions in a number of other

cortical and subcortical areas can affect the subjective

experience of dreaming. He describes increases in in

tensity, decreases in intensity, and loss of some sen

sory modalities in dreams. He clearly demonstrates

how the effects on dreams are not the result of primary

7/25/2019 15 the Neuropsychology of Dreams: A Clinico-Anatomical Study

3/4

Book Reviews

sensory region impairment but are the result of dam

age to areas where perceptions are integrated and pro

cessed. The import is that dreams develop from the

inner and private life

o the mind, drawing on stored

rather than currently impinging sensations. To put it

succinctly, what the mind cannot experience, cannot

be dreamed about. For those more interested in this

aspect o dreams see Greenberg (1966) and Greenberg

and Liederman (1966). Solms describes in great detail

the many different areas o the brain where damage

affects dreaming and where the defect in waking men

tal life is clearly reflected in the disordered dreaming.

This is a major observation which those interested in

dreams must keep in mind, and the author provides

ample evidence for this statement. In fact he provides

more than he realizes, for there is another side to this

connection between waking and dreaming mentation:

the emotional life

o

the patient. While the author ac

knowledges that some o the changes in dreams may

be funct ional, I feel he doesn't fully present the

possibility that nightmares, o increased or decreased

intensity, or even in some cases cessation o awareness

o dreams may stem from patients' reactions to the

effects

o

their cortical lesions on their lives. As he

described the sudden and traumatic occurrences, I

found it hard to ignore this factor in the changes in

patients' experience o their dreams. Adding this fac

tor does make somewhat fuzzy the purity o the effect

o the brain lesions. However, we must learn to deal

with this additional complexity.

Solms presents two other trains o thought which

should be o interest to psychoanalysts. One that really

impressed me followed his discussion o the move

ment in dreams from abstract thought to concrete im

ages. It brought to my mind Freud's (1900) discussion

in chapter 7 o the regression in the perceptual system

involved in the generation o dream images. Sure

enough, Solms quoted this very passage on the next

page. On the other hand, Solms would like to have us

believe, on the basis o his findings, that dreams really

are the guardians o sleep. It is with regard to this that

I find the main shallow vein in this book. The discus

sion o REM sleep research is limited to four pages

plus interpolated referrals to REM studies in parts o

the book. In many ways it is not fair to ask more o

the author o such an encyclopedic book. However, I

am afraid that while Solms clearly suggests further

important REM sleep studies that still need to be done,

he has failed to integrate many existing REM sleep

studies. These make a strong case for the need for

REM sleep and support the idea that sleep may be the

29

guardian o dreams. Furthermore, I think the absence

o the consideration

o

a large body o REM sleep

research has led to the author's too ready dismissal

o any higher level functions for the dream process

(Greenberg and Pearlman, 1993). Thus, in what is a

superb contribution to our appreciation

o

the role

o

a complex cortical system to dreaming, we find the

author falling into the camp

o

what Freud called the

,'physiologists who minimized the meaning and the

function o dreams.

To summarize, this is a superb book. Despite the

enormous amount o detail involved in describing

many different case reports, the book holds together

because o the way Solms connects the findings with

his hypotheses about the roles o different areas o the

brain. The major areas that he pinpoints

as

playing

crucial roles are the medial temporal occipital, the me

dial basal frontal, and the lower parietal convexity.

The book will be a major source for anyone interested

in knowing about the role o the cortex in dreams.

The book also points toward further research on the

connections between REM sleep and dreaming and

fits nicely with more recent work demonstrating brain

activity by using PET scans (Hong, Gillin, Dow, Wu,

and Buchsbaum, 1995). The findings show clearly the

elaborate networks in the brain that are involved in

dreaming. For me this book reinforces Freud's recog

nition that the study o dreams clearly reveals mind

and brain connections.

References

Freud,

S

(1900), The Interpretation o Dreams.

Standard

Edition

4 5. London: Hogarth Press, 1953.

Greenberg, R. (1966), Cerebral cortex lesions: The dream

process and sleep spindles.

Cortex 2:357 366.

Liederman, H (1966), Perceptions, the dream pro

cess and memory: An up-to-date version

o

Notes

o

a

Mystic Writing Pad.

Comprehen. Psychiatry 7:517 523.

Pearlman, C. (1993), An integrated approach to

dream theory: Contributions from sleep research and

clinical practice. In:

h Functions Dreaming

ed. A.

Moffit, M. Kramer,

R

Hoffman. Albany: New York

State University Press.

Hong, C. C., Gillin,

J

C., Dow,

B

M., Wu, J.,

Buchs

baum, M.

S

(1995), Localised and lateralized cerebral

glucose metabolism associated with eye movements dur

ing REM sleep and wakefulness: A positron emission

tomagraphy (PET) study.

Sleep 18:570 580.

7/25/2019 15 the Neuropsychology of Dreams: A Clinico-Anatomical Study

4/4

130

Jeannerod, M., Mouret , J., & Jouvet, M. (1965), Etude de

Ia mortricite oculaire au cours de Ia phase paradoxale du

sommeil chez Ie chat.

Electroenceph. Clin. Neurophys-

io1

18:554 566.

Ramon Greenberg M.D.

11 Waverly Street

Brookline MA 02146

e mail:

r m o n ~ r e e n e r g

hms.harvard.edu

The Symbolic Species: The Co Evolution Lan-

guage and the Brain

by Terence Deacon. New York:

Norton, 1997, hardcover 29.95, paperback

15.95

A few years ago the UCLA neuroanatomist and psy

chologistHarry Jerison asked, What is so great about

being smart? with the implication that in our species'

history, it is hard to conclude that our intelligence and

our capacity for complex symbol use has done us more

good than harm. What is ironic and prophetic, as Ter

ence Deacon shows us in his extraordinary text, is that

symbol use itself may be the only means available for

shifting the balance toward a kind

of

positive outcome

for ourselves, if not for the planet. The more we under

stand about the nature and origin

of

our symbolic ca

pacities, he claims, the better we can regulate our

enormous cognitive potential. He wrote his mystery

novel, as he calls it, with this goal of increasing our

understanding about how symbol reference and lan

guage came about, and ultimately,

of

who we are.

For about a year several UCLA linguists, psycho

analysts, and psychologists and I met weekly, reading,

discussing, and debating The Symbolic Species:

The Co Evolution Language and the Brain. We all

concluded that this is a profound work, remarkable

for its scholarship and extreme detail, and deserving

dedicated study. Here, I will sketch out a broad and

oversimplified overview

of

Deacon's complex evolu

tionary scenario, and then discuss a few of his essen

tial arguments.

Somewhere in our fuzzy past there were groups

of australophithescines who had already been bipedal

for some time and who could communicate with con

text-bound gestures and sounds. These foraging homi

nids lived in the savannas of eastern and southern

Africa. We can only marvel that they survived at all

in what must have been a continuously perilous envi

ronment. Except for their nascent evolutionary edge

of symbolic reference, we might very well not be here,

or might not know it. The time was about 2 million

years ago; it had taken several more million years to

get to that point from the great bifurcation that split

Book Reviews

man-to-be from the great apes. Then, something very

strange happened. A shift in cognition, specifically in

abstracting capacities and learning by logical and se

mantic categorization, began to dominate the experi

ence

of

these individuals and groups, which hitherto

had been limited by mental representations

of

stimu

lus-response associations to the mostly local context

of

rewards and punishments. Environmental events al

ways had signal value about how to react for all ani

mals, but if a new waterhole was associated with the

possibility

of

reduced thirst, the only condition that

guided the approach behavior of prehominids was the

appraisal of immediate safety. But with a doubling of

brain size in what was to be a shift from australo

pithescines to true hominids like Homo habilis (tool

man), a new condition and option became possible.

With improved cognitive hardware the hominid could

apply a system

of

divergent ideas and images based

on principled rules. Homo habilis felt the urge to ap

proach water, but instead of drinking, might con

sciously wait for an animal to drink first, then follow

the animal to see

if

the water was deadly or safe to

drink. A logical theory had been conceptualized and

tested. Many of his or her vertebrate ancestors could

learn the stimulus-response associations that, together

with instinctual responses, made survival possible. But

this hominid and his kind also could learn

the

system

of relationships of which these correlations were a

part. If this individual's logical experimentation al

lowed for survival and offspring later on, he or she

could then carry the gradually developing genetic pre

disposition for flexible rule-guided behavior into the

next generation. Remarkably, in the initial nonre

sponse, the stimulus to approach water was intention

ally used against itself. He or she delayed gratification

conditional upon reasoning, thinking, planning, vicari

ous trial-and-error, long-term memory all

of these

nonautomatic capacities. This was possible because of

a simple but effective gestural and guttural system

of

rule-based and communicated labels for objects and

actions developed within groups

of

individuals. The

neurobiological substrate for this advance in everyday

experience of early hominids was actually not new;

many primates can do a bit

of

this

if

given enough

training and exposure in a controlled setting. But for

more advanced hominids, it became a primary prob

lem-solving tool and the natural thing to do. In its

fullest developments it would provide humans with

an

unprecedented sort of autonomy or freedom from

the constraints of concrete reference.

The neurobiological cause and consequence for

this symbolizing capacity, according to Deacon, is the

property of an expanded prefrontal cortex (PFC) in