Dreaming Vol. 11, No. 2, 2000
of outcome of dream interpretation sessions:
Volunteer client characteristics, dream characteristics,
and type of interpretation
Clara E. Hill, Frances A. Kelley, Timothy L. Davis, Rachel E. Crook, Leslie E. Maldonado, Maria A. Turkson, Teresa L. Wonnell, V. Suthakaran, Jason S. Zack, Aaron B. Rochlen, Misty R. Kolchakian, and Jamila N. Codrington
volunteer clients completed single sessions of dream interpretation using the
Hill (1996) model, with half randomly assigned to waking life interpretation
and the other half to parts of self interpretation in the insight stage of the
Hill model. No differences were
found between waking life and parts of self interpretations, suggesting that
therapists can use either type of dream interpretation.
Volunteer clients who had positive attitudes toward dreams and
presented pleasant dreams had better session outcome; in addition, volunteer
clients who had pleasant dreams gained more insight into their dreams.
Results suggest that therapists doing single sessions of dream
interpretation need to be cautious about working with dreams when volunteer
clients have negative attitudes toward dreams and present unpleasant dreams.
Words: dream interpretation, attitudes toward dreams, dream valence,
waking life, parts of self
of outcome of dream interpretation sessions:
Volunteer client characteristics, dream characteristics,
and type of interpretation
many theories of dream interpretation have been developed, minimal empirical
research has been conducted on dream interpretation until recently.
Several studies have now investigated the Hill (1996)
cognitive-experiential dream interpretation model in single sessions as well
as within brief therapy. One of
the most impressive and consistent outcomes is that volunteer clients have
reported higher session quality and gained more insight from dream
interpretation sessions than from regular therapy sessions (Cogar & Hill,
1992; Diemer, Lobell, Vivino, & Hill, 1996; Heaton, Hill, Hess, Hoffman,
& Leotta, 1998; Heaton, Hill, Petersen, Rochlen, & Zack, 1998; Hill,
Diemer, & Heaton, 1997; Hill, Diemer, Hess, Hillyer, & Seeman, 1993;
Hill et al., 2000; Rochlen, Ligiero, Hill, & Heaton, 1999; Wonnell &
Hill, 2000; Zack & Hill, 1998). For
example, in Hill et al.’s (2000) study where clients with recent losses and
troubling dreams received brief therapy (8-10 sessions) involving at least
five sessions of dream interpretation or at least five sessions of a focus on
their loss, clients in the dream condition rated the session process (depth,
working alliance, exploration-insight gains, and action gains) significantly
higher throughout the therapy than did clients in the loss condition.
that dream interpretation seems to be effective in terms of positive session
quality and gains in insight, a next step is to identify predictors of session
outcome. Determining the
predictors of outcome in dream interpretation sessions is important so that
therapists can make informed decisions about with whom and how to do dream
interpretation. In this study, we
were interested in investigating client characteristics (need for cognition
and attitudes toward dreams) and dream characteristics (valence, distortion,
vividness, and recency) in relation to session outcome.
In addition, we were interested in investigating the effects of waking
life versus parts of self interpretations on session outcome.
terms of client characteristics, we were first interested in need for
cognition. Therapists have
reported that it is easier to conduct dream interpretation sessions with
clients who enjoy thinking about their dreams and are psychologically minded
(e.g., Wonnell & Hill, 2000), but previous attempts to relate the
client-rated outcome of dream interpretation to client self-report measures of
psychological mindedness have not yielded significant results (Cogar &
Hill, 1992; Diemer et al., 1996; Hill et al., 1997).
We wondered if perhaps a measure of need for cognition would be more
likely to tap the relevant client characteristic than measures of
psychological mindedness. Hence,
for the present study, we used the Need for Cognition Scale (Cacioppo, Petty,
& Kao, 1984), which assesses one’s tendency to engage in and enjoy
second client variable that might influence the session outcome of dream
interpretation is attitudes toward dreams.
Using a sample of undergraduate students who had completed a number of
psychological measures for course credit, Hill et al. (1997) found that
students who volunteered for a dream interpretation session (not for course
credit) had more positive attitudes toward dreams than those who did not
volunteer. However, among those
volunteers who actually participated in dream interpretation sessions,
attitudes toward dreams did not correlate with session outcome, perhaps
because of limited variability of attitudes in the sample.
Moreover, Zack and Hill (1998) found that volunteer clients who had
moderate attitudes toward dreams had better session outcomes than those with
very positive attitudes, who in turn had better session outcomes than those
with very negative attitudes. Because
of the somewhat conflicting findings between the previous studies and because
both of these studies used small samples, we wanted to study the relationship
between attitudes and session outcome again with a larger sample.
expected that characteristics of dreams would influence the outcome of dream
interpretation sessions. The
first dream characteristic of interest was valence, or the pleasantness of the
dream. Zack and Hill (1998) found
better session outcome for moderately unpleasant and extremely pleasant dreams
than for neutral, moderately pleasant, or extremely unpleasant dreams.
In this study, we wanted to see if we could replicate Zack and Hill’s
findings, especially since they had a small sample size.
were also interested in distortion, or how discrepant the dream is from what
one might commonly experience in waking life.
We speculated that dreams that were less distorted, or closer to waking
life, might be easier for clients who have a low need for cognition to
understand because they could be clearly linked to waking life. If a client is worried about an exam and dreams that she is
taking an exam, it may be easy for the client to understand the meaning of the
dream. On the other hand, we
speculated that clients who have a high need for cognition would profit more
from working with distorted dreams because they would find them to be puzzling
and intriguing. A dream about
cows dancing on a suburban front porch would be more discrepant with common
experience and might make clients with a high need for cognition want to
vividness and recency of dreams made sense as predictors of the outcome of
dream interpretation sessions. In
our clinical experience, clients have an easier time working with vivid dreams
because it is easier to remember the details and reexperience the emotions.
Similarly, it is often easier to remember the details of recent dreams.
The only study (Wonnell & Hill, 2000) that included recency of
dreams as a predictor of session outcome found that it was easier for clients
to develop plans for waking life changes with more recent dreams.
(1996) proposed that during the insight stage of her three-stage model of
dream interpretation (exploration, insight, action), therapists and clients
can work collaboratively to construct an interpretation of dreams from one of
several perspectives. In a
previous study (Hill et al., 1997), clients most often reported gaining waking
life and parts of self insights from dream interpretation, so we focused on
these two interpretation types for this study.
A focus on waking life assumes that dreams reflect current waking life
issues and is supported by research indicating that dreams are related to
waking life (see review in Hill, 1996).
For example, if a client dreams of being attacked, the therapist might
focus on whether the client felt attacked in waking life.
A focus on parts of self is based on Jungian theory (Jung, 1974) and
Gestalt theory (Perls, 1970), which suggest that people incorporate
representations of significant others into themselves but that these parts of
self are often not integrated into a cohesive sense of self.
Hence, the dreamer projects onto others what are actually parts of his
or her self. For example, if a
client dreams of a lazy person being berated by a tyrannical boss, the
assumption is that both the lazy person and the tyrannical boss are parts of
the client. Hence, we wanted to
examine the effects of the type of interpretation on the outcome of dream
thought that type of interpretation might interact with need for cognition.
Our clinical experience in conducting dream interpretation is that
clients who have low need for cognition prefer waking life to parts of self
interpretations because they can readily understand how dreams reflect waking
life but have a hard time understanding how dream images reflect parts of
themselves. On the other hand,
clients who have a high need for cognition seem to like and profit from both
waking life and parts of self interpretations.
of the Present Study
first purpose of this study was to examine the relationship of volunteer
client characteristics (need for cognition, attitudes toward dreams) and dream
characteristics (valence, distortion, vividness, recency) with the outcome of
dream interpretation sessions. We
hypothesized that need for cognition, attitudes toward dreams, dream valence,
dream vividness, and dream recency would be positively related to session
outcome. Furthermore, we
hypothesized an interaction between distortion and need for cognition, such
that the best session outcomes would be obtained when volunteer clients with a
low need for cognition presented undistorted dreams and when clients with a
high need for cognition presented distorted dreams.
second purpose of this study was to examine the effects of type of
interpretation (waking life or parts of self) on session outcome.
We hypothesized an interaction between type of interpretation and need
for cognition, such that waking life interpretations would result in better
session outcome than parts of self interpretations for clients low in need for
cognition but that there would be no differences between conditions for
clients high in need for cognition.
assessed session outcome in terms of volunteer client perceptions of depth
(quality) of the session, overall insight gained in sessions, and changes in
insight into the presented dream from pre to post-session, all of which have
been used in previous studies of dream interpretation.
We used single sessions of dream interpretation because possible
confounding variables (e.g., stage of therapy, length and type of treatment)
could be controlled. In addition,
we did not want to use volunteers for dream interpretation because Hill et al.
(1997) found that volunteers for dream interpretations sessions had higher
attitudes toward dreams than nonvolunteers.
Hence, we used introductory psychology students who participated for
research credit because we thought that they would have a larger range of
attitudes toward dreams and type of dreams than volunteers.
therapists (7 female, 5 male; 9 Caucasian, 1 African American, 1 Hispanic
American, 1 Asian American; 11 doctoral students in counseling psychology, 1
counseling psychology professor), ranging in age from 22 to 50 (M =
31.25, SD = 8.14), participated in this study.
The graduate students were all enrolled in a dream interpretation
seminar with the professor, and all were authors of the study. All
had received previous training in the Hill model of dream interpretation and
had completed at least two semesters of practica in a counseling psychology
doctoral program. Experience since beginning training as a therapist averaged
5.42 (SD = 7.66) years, and number of individual dream interpretation
sessions conducted previously averaged 18.92 (SD = 26.67).
Using three 5-point scales (1 = low, 5 = high), therapists indicated
that they believed in and adhered to the techniques of humanistic/experiential
therapy 3.92 (SD = .67), psychoanalytic/psychodynamic 3.50 (SD =
1.24), behavioral/cognitive-behavioral 2.92 (SD = 1.08), and the Hill
model of dream interpretation 4.75 (SD = .45).
undergraduate students (62 female, 43 male; 57 White American, 20 African
American, 15 Asian American, 6 Hispanic American, 7 other), ranging in age
from 18 to 26 (M = 19.27, SD = 1.59), served as volunteer
clients (52 in the waking life condition and 53 in the parts of self
condition). Participants were not aware of the hypotheses of the
study and received course credit for their participation.
judges (5 undergraduates and 2 graduate students; 6 Caucasian, 1
Asian-American, ranging in age from 21 to 26) rated insight in dream
interpretation. Three other
judges (2 undergraduates and 1 graduate student; 1 female, 2 male; 1
Caucasian, 1 African American, 1 Asian-American; ranging in age from 21 to 34)
read the dreams and rated level of distortion in the dreams.
Five other judges (4 undergraduate, 1 graduate student; all female; 2
Caucasian, 1 African-American, 1 Asian-American, 1 Latina; ranging in age from
21 to 40 yrs) listened to excerpts of the insight stage and judged which of
the two conditions was being delivered. The
four graduate student judges were team leaders of their respective rating
teams and were also therapists and authors of the study.
for Predictor Variables
Therapists indicated their age, race, gender, experience as a therapist
in general and with dream interpretation, and theoretical orientation.
Clients indicated their age, race, and gender.
Need for Cognition Scale (NCS; Cacioppo, Petty, & Kao, 1984) is a
trait measure of an individual’s tendency to engage in and enjoy thinking.
The NCS has 18 items using 5-point Likert scales (0 = extremely
uncharacteristic; 4 = extremely characteristic).
Sample items are, “The notion of thinking abstractly is
appealing to me, “ and “I like to have the responsibility of handling a
situation that requires a lot of thinking.”
Items are summed for a total score.
The reliability and validity are well established (Cacioppo &
Petty, 1982). Item-total
correlations ranged between .52 and .80 (Cacioppo & Petty, 1982) and the
theta coefficient (a maximized alpha coefficient) was .90 (Cacioppo et al.,
1984). College students scoring
high on the NCS reported enjoying a complex mental task more than a simple
task, In addition, university faculty scored higher on the NCS than
assembly-line workers. Internal
consistency (Cronbach’s alpha) for the present study was .90.
Toward Dreams-Revised (ATD-R)
is an 9-item self-report measure of how a person feels about dreams.
Participants respond to all items on a 5-point Likert scale (1 = not at
all, 5 = very). The ATD was
originally constructed by Hill et al. (1997) by combining 7 true-false items
from Cernovsky (1984), 3 items (two using 4-point Likert scales, 1 using a
yes-no format) from Robbins and Tanck (1988), and 1 item using a 5-point
Likert scale that the authors created. A
factor analysis on the 11 items yielded a single factor accounting for 36% of
the variance with all items loading above .40 and an internal consistency
alpha of .79. In the Hill et al.
(1997) study, ATD was related positively to the NEO Openness Scale (Costa
& McCrae, 1992), estimated
dream recall, and diary dream recall. The
ATD also predicted whether participants volunteered for dream interpretation
sessions, providing some evidence of validity.
the present study, we revised the ATD so that all items used 5-point scales,
reversed the wording of half of the items so that all items were not scored in
the same direction, and added one new item (“I value my dreams”) that
seemed important for the measure. We administered the original ATD and the ATD-R
to a sample of 26 upper level undergraduates (not the participants from the
main part of the present study) and readministered the ATD-R to them two weeks
later. We found a high
correlation, r(24) = .91, between the ATD and ATD-R.
Preliminary examination indicated three items that did not correlate as
highly as other items with the total score; consequently, these three items
were dropped. Internal
consistency (Cronbach’s alpha) for the remaining 9 items was .93. A 2-week test-retest reliability of .92 was found for the
9-item ATD-R with the same 26 students. We
conducted a factor analysis on the 9-item measure for the 105 participants in
the present study and found that a single factor (eigenvalue = 4.60) accounted
for 51% of the variance, with all items loading .50 or higher on the factor.
Internal consistency (Cronbach’s alpha) on the ATD-R for the 105
participants in the present study was .88.
Scores were determined by summing the ratings (after reversing the
negatively worded items) and dividing by the total number of items.
of the dream was
assessed through the Semantic Differential Measure of Emotional States (Mehrabian
& Russell, 1974). This
measure includes 18 pairs of bipolar adjectives on 9-point scales assessing
valence (happy-unhappy, pleased-annoyed, satisfied-unsatisfied,
contented-melancholic, hopeful-despairing, and relaxed-bored), arousal
(stimulated-relaxed, excited-calm, frenzied-sluggish, jittery-dull,
wide-awake-sleepy, and aroused-unaroused), and dominance
(controlling-controlled, influential-influenced, in control-cared for,
important-awed, dominant-submissive, and autonomous-guided).
Half of the items in each factor have the order of the scoring reversed
and all of the items are presented in a random order. Responses are averaged across the six items of each
dimension. High scores indicate
pleasant dreams, and low scores indicate unpleasant dreams.
In a factor analysis of the 18 items, Mehrabian and Russell reported
three factors, accounting for 62% of the variance.
Factor loadings ranged from .79 to .92 for valence, .75 to .82 for
arousal, and .46 to .79 for dominance. We
dropped the dominance score as suggested by Lang, Greenwald, Bradley, and Hamm
(1993) and Russell (1978) because the factor loadings were low and
participants find these items hard to rate.
We also dropped the arousal scores, because Zack and Hill (1998) found
that arousal was not significantly related to outcome of dream interpretation
sessions. The internal
consistency (Cronbach’s alpha) for valence was .90 in both Zack and Hill
(1998) and the present study.
of dreams refers to the
degree to which people or objects in the dream appeared or behaved in ways
that would seem uncommon in waking life.
This scale was created for the present study because we did not find an
appropriate scale in the literature.
Distortion was rated by trained judges using a 9-point Likert scale (1
= not at all distorted, e.g., “I dreamed about the test I actually took
yesterday,” 9 = very distorted, e.g., “Aliens were coming out of the space
ship, and then a purple cow flew over the moon.”)
Interrater reliability (Cronbach’s alpha) for the three judges in the
present study was .72.
of the dream was rated
by volunteer clients on a 9-point Likert scale (1 = not at all vivid, vague,
unclear, indistinct; 9 = vivid, clear, distinct, strong, intense).
This scale was created for the present study because we did not find an
appropriate scale in the literature.
Recency of the dream was also assessed by volunteer clients on a
5-point Likert scale (1 = last night, 2 = within the last week, 3 = within the
last month, 4 = within the last year, and 5 = several years ago).
outcome was assessed with three measures.
The Depth Scale of the Session Evaluation Questionnaire-Form 4
(Stiles & Snow, 1984) is a widely-used, valid, 5-item, bipolar,
adjective-anchored, self-report measure used by volunteer clients to evaluate
the quality of counseling. High
scores indicate high levels of perceived quality of the session.
Stiles and Snow reported high internal consistency (alpha = .87).
Internal consistency (alpha) for the present study was .89. The Mastery-Insight
Scale of the Therapeutic Realizations Scale (Kolden, 1991) assesses the
level of mastery and insight gained by clients in sessions and can be
completed by clients or therapists. Kolden
formed the Therapeutic Realizations Scale from the Therapy Session Report (Orlinsky
& Howard, 1975), using face validity and internal consistency estimates.
The 5 items of the Mastery-Insight Scale (e.g., "I feel I got more
understanding of the reasons behind my thoughts and feelings") are rated
by clients or therapists using a 3-point Likert scale (0 = no, 2 = a lot).
Kolden (1991) reported internal consistency for the total scale of the
Therapeutic Realizations Scale (including two other scales of Unburdening and
Encouragement) of .86 to .87 and test-retest reliability estimates of .65
between sessions 1 and 3. Hill et
al. (1993) found an internal consistency (alpha) of .79 for the client-rated
Mastery-Insight Scale. Diemer et
al. (1996) presented evidence of concurrent validity in that the
Mastery-Insight Scale correlated .84 with the Session Impact
Scale-Understanding Subscale (Elliott & Wexler, 1994).
Because the 3-point scales allows for only limited variability, we used
a 5-point scale (1 = no, 5 = a lot) in the present study.
Internal consistency (alpha) for the present study was .81 for
volunteer clients. Exploration-Insight Gains is a 7-item subscale, using
a 9-point Likert scale (1 = strongly disagree, 9 = strongly agree), of the
Gains for Dream Interpretation (Heaton, Hill, Petersen et al., 1998), which
was developed from client responses to open-ended questions about the helpful
aspects of dream interpretation sessions.
Heaton et al. reported an internal consistency (Cronbach’s alpha) of
.83 for the Exploration-Insight Gains. Zack
and Hill (1998) reported that Exploration-Insight Gains was correlated .69
with Session Impact Scale-Understanding (Elliott & Wexler, 1994) and .53 with the Mastery-Insight Scale, suggesting evidence
of concurrent validity. Internal
consistency (Conbach’s alpha) of Exploration-Insight Gains for the present
study was .88.
the present study, the 3 measures of session outcome were highly
intercorrelated (correlations ranged from .60 to .64) and the internal
consistency of the 3 scores was .79. Hence,
the 3 scores were standardized and averaged to represent session outcome in
Insight into the dreams that volunteer clients presented in the
sessions was assessed using procedures developed by Falk and Hill (1993).
Clients write an interpretation of their dreams in response to the
following question: “What do you think this dream means to you?
How would you interpret it?” Trained
judges independently rate insight of the interpretation using a 9-point Likert
scale (1 = no insight, 5 = moderate insight, 9 = high insight) using Hill et
al.’s (1992) definition for insight (“Client expresses an understanding of
something about himself or herself and can articulate patterns or reasons for
behaviors, thoughts, or feelings. Insight
usually involves an ‘aha’ experience, in which the client perceives self
and world in a new way. The
client takes appropriate responsibility rather than blaming others, using
‘shoulds’ imposed from the outside world, or rationalizing,” pp.
548-549). In previous studies, interrater reliability (Cronbach’s
alpha) between judges ranged from .91 to .97 (Diemer et al., 1996; Falk &
Hill, 1993; Hill, Nakayama, & Wonnell, 1998).
Likewise, it was high for the two teams (each composed of 3 or 4
raters) in the present study (.86 and .90).
Change in insight (post minus pre scores) was used as the measure of
insight into the presented dream in the present study; change in insight was
only moderately correlated with session outcome, r(103) = .24, p
< .05, so it was considered to be an independent index of session outcome.
The therapists rated the extent to which they competently and appropriately
followed the structure of the Hill model using a measure developed by Heaton,
Hill, Petersen et al. (1998). The
items, rated on a 9-point Likert scale (1 = low, 9 = high), include “How
completely did you do the exploration stage?”, “How completely did you do
the insight stage?”, “How completely did you do the action stage?”, and
“How competent did you feel doing the dream interpretation with the
client?” In addition, we asked
therapists to use the same scale to rate two additional items, “How much did
you work to understand the dream according to what is going on currently in
the client’s waking life?” “How much did you work to understand the
dream according to how each of the parts of the dream might reflect a part of
the client?” We expected
no differences between the two conditions on the first four questions, but we
expected that therapists in the waking life condition would score higher on
the 1st additional item and lower on the 2nd additional
item than therapists in the parts of self condition.
Specification of Condition.
To indicate which of the two insight conditions (current waking life or
parts of self) therapists were implementing, judges used a 5-point Likert
scale (1 = definitely waking life, 2 = maybe waking life, 3 = not sure, 4 =
maybe parts of self, 5 = definitely parts of self) to rate the first 10-15 min
of the insight stage. Interrater
reliabilities (Cronbach’s alpha) for the two teams (each with two judges)
were .87 and .99.
Therapists signed up for a seminar in dream interpretation being aware
that one of the requirements was to participate as a therapist in a study.
Students were not required to take this particular seminar, although
they were required to take some seminar during their graduate program.
All therapists signed consent forms indicating their willingness to
have their data used in the research project.
To increase the probability that therapists would be committed to their
assigned condition and deliver the treatment effectively, they were allowed to
select their preferred condition (waking life vs. parts of self).
Therapists (6 in the waking life condition; 6 in the parts of self
condition) conducted their chosen condition with all their assigned volunteer
clients. All therapists had been
trained previously in the Hill model and were trained further in the
designated condition. All
therapists conducted one practice session using the designated condition
(waking life or parts of self). During
the study, each therapist presented one case for group supervision and
discussed other cases as needed.
Volunteer clients were recruited from introductory psychology classes
through sign-up sheets that advertised a study on personal problem-solving.
They were asked to bring in a dream to use in problem solving. A total of 153 students signed up for the study, but 24
canceled their sessions ahead of time and 19 failed to show up for their
appointments. Hence, 110
completed all assigned tasks of the study.
When volunteer clients first came in, they gave a written copy of their
dream to a therapist. If the dream was too lengthy (i.e., more than a half page),
the therapist asked the volunteer client to pick a segment to discuss in the
session. Volunteer clients then
read the selected segment of their dream to themselves and rated it on valence
(using the Semantic Measure of Emotional States), vividness, and recency.
Then volunteer clients wrote an initial interpretation of their dream.
Finally, volunteer clients completed the Need for Cognition Scale and
Attitudes toward Dreams-Revised (along with other measures not included in the
present study) in a random order.
Each therapist saw between 8-10 volunteer clients in single sessions
that lasted from 35 to 145 min (M = 73.42, SD = 18.01).
Sessions were audiotaped (with the client’s permission) through the
insight stage so that judges could determine adherence to the assigned
condition. Therapists informed
volunteer clients that the sessions and tapes would be kept confidential.
Also, therapists were not aware of volunteer client scores on any
measures (e.g., need for cognition, attitudes toward dreams, ratings of
therapist told the volunteer client that they would work collaboratively to
figure out the meaning of the dream and briefly described the three-stage
model. Volunteer clients were
asked to tell their dream in the first person present tense and describe their
feelings both during the dream and upon awakening.
For each successive image, volunteer clients were asked to describe the
image in great detail and then associate to the image by talking about
whatever thoughts or images came to mind.
Unlike the manner in which the exploration stage is typically
conducted, therapists did not ask volunteer clients about triggers for the
dream images from any current or past events in their lives because this might
have favored the waking life condition. When
volunteer clients spontaneously brought up triggers from waking life,
therapists acknowledged the triggers but did not explore them.
At the end of the exploration stage, which usually lasted about 30 to
45 min, the therapist summarized what the volunteer client had said about the
images and stated clearly that they were moving on to the insight stage.
the beginning of the insight stage, therapists gave a brief rationale for the
assigned condition. For the waking
life condition, therapists said something like, "What we would like
to do now is try to understand your dream from the perspective of your current
waking life. Research has shown
that dreams are related to waking life events.
So, what do you think the dream might mean in terms of your current
waking life?" Therapists
then worked with volunteer clients to understand how the dream fit with what
was going on in the client's life. If
volunteer clients tried to shift focus (e.g., to parts of self), therapists
stated that although other types of interpretation might be helpful, they were
going to focus only on waking life. For
the parts of self condition, therapists said something like,
"Let’s try to understand your dream from the perspective that each of
the images of the dream represents a part of yourself.
Theory suggests that we incorporate (take in) important people, ideas,
events, or feelings and they become parts of ourselves and get enacted in the
dream as different characters or objects.
By understanding the different parts of ourselves, we can begin to
integrate all of the parts and develop a more cohesive sense of self.
So, what do you think the dream might mean if you think of the images
as representing different parts of yourself?”
If volunteer clients tried to shift focus (e.g., to waking life),
therapists stated that although other types of interpretation might be
helpful, they were going to focus only on parts of self.
At the end of the insight stage, which lasted at least 15 min,
therapists in both conditions asked volunteer clients to summarize what they
had learned about themselves.
in both conditions then said that they were moving to the action stage.
They asked volunteer clients how they would change the dream, translate
fantasized changes in dreams to changes in their lives, continue working on
the dream, or develop a ritual to honor the dream.
To maintain the distinction between the two conditions, therapists
focused on changes in waking life or parts of self respectively.
At the end of the action stage, which lasted at least 10 min,
therapists asked the volunteer clients to summarize what they had learned
about the dream and what they were going to do about what they had learned.
Immediately after the session, volunteer clients completed (in random
order) the post-session outcome measures (Mastery-Insight Scale, Gains from
Dream Interpretation, Depth) and wrote another interpretation of the dream.
Concurrently, therapists completed the adherence measure.
After the measures were completed, therapists provided volunteer
clients with a written debriefing statement about the study, references for
dream interpretation, and information about the campus counseling center.
They also answered any questions that volunteer clients had about the
Insight Ratings. Seven judges were trained to rate insight into dreams using data from previous studies until they reached high interrater reliability (Cronbach’s alpha > .70). After training using dreams from previous studies, judges were given randomly-ordered copies of the dreams and the corresponding pre- and post-session interpretations (judges were not aware of condition or whether interpretations were pre- or post-session). Judges independently rated the amount of overall insight in the pre- and post-session interpretations considering them at the same time so that they could compare levels of insight. Three or four judges rated each dream. Scores were averaged across judges.
Three different judges rated the dreams for distortion.
They were trained using data from previous studies until they reached
high interrater reliability (Cronbach’s alpha > .70).
They then rated the dreams from the present study in random order.
Therapists rewound the tapes to the point immediately after they
described what would happen in the insight stage so that judges would not hear
what condition was being conducted. Two
judges (different people than those who judged insight and distortion)
listened to the first 10 to 15 min of the insight stage for each session and
rated therapist adherence to condition.
whether sessions fit the criteria for the assigned conditions.
We established a priori the criterion that therapists had to judge
themselves as adhering at least 7 on a 9-point scale to their own condition
and 4 or less on the other condition. Furthermore,
we a priori set the criterion that judges had to rate therapists at least 4 on
the 5-point scale, indicating that therapists adhered to the assigned
condition. For two sessions in which the tapes were inaudible, we
examined the therapists’ adherence ratings and found them to be very
acceptable (8 or 9 on the assigned condition and 1 on the other condition).
In addition, these two therapists were judged as adhering highly in all
their other sessions, so we assumed that their adherence ratings for the
inaudible sessions were accurate; hence, we retained these two sessions for
the data analyses. Five sessions
(1 in the waking life condition, 4 in the parts of self condition) were
dropped for not adhering to the assigned condition, leaving a total of 105
sessions for the data analyses.
1 shows the means and standard deviations for all variables.
Scores for Depth and Exporation-Insight were within one standard
deviation of scores in other dream interpretation studies (e.g., Diemer et
al., 1996; Heaton et al., 1998; Rochlen et al., 1999), indicating that
therapists were comparable to therapists in previous dream interpretation
studies (note we could not compare scores on the Master-Insight Scale because
we changed the rating scale from a
3- to 5-point scale). Table 2
shows the intercorrelations (using Pearson Product Moment correlations) among
variables used in the analyses.
in the waking life condition had higher ratings of their beliefs in the waking
life focus (M = 4.83, SD = .41) than did therapists in the parts
of self condition, M = 4.00, SD = .63, t(10) = 2.71, p
< .05, although therapist belief in the parts of self focus did not differ
between conditions. Furthermore,
no differences were found (using t-tests) between conditions for other
therapist variables (age, years of experience, number of dream interpretation
sessions conducted previously, and self-ratings of theoretical orientation).
differences between conditions were found for therapist-rated adherence to the
stages (exploration, insight, and action) or for overall competence. For this study, therapist adherence ratings on the
exploration stage (M = 8.12, SD = 0.88), insight stage (M
= 7.81, SD = 0.96), and action stage (M = 7.01, SD =
1.24) were within one standard deviation of scores (with one exception)
reported for therapists in the Hill et al. (1997) dream interpretation study
(exploration M = 7.25, SD = 0.97; insight M = 6.47, SD
= 1.19, and action M = 6.08, SD = 1.33) and the Rochlen et al.
(1999) dream interpretation study (exploration M = 7.46, SD =
1.52; insight M = 7.11, SD = 1.56, and action M = 6.49, SD
= 1.53). (The exception was that
therapist adherence ratings for the insight stage for this study were a
standard deviation higher than in Hill et al., 1997).
Hence, therapists adhered to the three stages about the same as
expected, therapists in the waking life condition rated themselves as adhering
more to waking life interpretations than did therapists in the parts of self
condition, t(96.15 for unequal variances) = -.29.36, p <
.001. Likewise, therapists in the parts of self condition rated
themselves as adhering more to parts of self interpretations than did
therapists in the waking life condition, t(103) = 35.11, p <
.001. In conjunction with the
evidence presented earlier (i.e., that judges who listened to the tapes of the
insight stage were able to accurately determine who did which condition), we
can assert that therapists adhered to their appropriate conditions.
(using dummy codes) were entered into regression equations for session outcome
and change in insight. No overall
(or individual) therapist effects were found for the total sample, waking life
condition, or parts of self condition for any of the regression analyses.
Hence, even though the professor had more experience than the graduate
student therapists, no differences were evident in the data.
Furthermore, using t-tests, no effects were found for volunteer
client gender or race on session outcome or change in insight.
Hence, therapist effects, volunteer gender and race were not considered
in subsequent analyses.
there was such a range in terms of length of session, we were concerned that
session length might have been related to the session outcome measures.
However, correlations revealed that session length was not related to
session outcome or insight change.
of Session Outcome and Insight Change
determine whether relationships between variables were linear, quadratic, or
cubic, plots were drawn and curves estimations calculated for all the linear,
quadratic, and cubic trends for all of the predictor variables paired with
each session outcome variable. For
attitudes toward dreams and valence in relation to session outcome and for
valence in relation to insight change, the linear, quadratic, and cubic
relationships were all significant, but the linear relationships accounted for
almost all of the variance. Hence,
only the linear relationships were considered in subsequent analyses. To test the simple relationships between the predictor
variables and session outcome and changes in insight, we first examined the
Pearson correlations. We also did
regression analyses to examine the unique relationships among predictors and
session outcome variables.
Pearson correlations (see Table 2) revealed that Attitudes Towards
Dreams-Revised and valence of dreams were both significantly related to the
composite index session outcome (composed of scores on Depth, Mastery-Insight
Scale, Exploration-Insight Gains), such that better session outcome was
attained when volunteer clients had positive attitudes and presented pleasant
dreams. A simultaneous multiple
regression analysis with the predictor variables of condition (waking life or
parts of self focus in the insight stage), need for cognition, attitudes
toward dreams, valence of the dream, distortion of the dream, vividness of the
dream, and recency of the dream and the criterion of session outcome was
significant, F(9,97) = 4.58, p < .001, R2 =
.25, adjusted R2
= .19. Attitudes toward dreams
was a significant unique predictor, part correlation (partialing out variance
from all other predictors and the criterion) = .27, t = 3.07, p
< .01. In addition, valence of
dreams was a significant unique predictor, part correlation = .29, t =
3.25, p < .01. Another
hierarchical regression analysis was conducted including all the above
variables in the first block and the interaction between need for cognition
and distortion and the interaction between need for cognition and condition in
the second block. Neither of the
interaction effects was significant. Hence,
volunteers clients who had the best session outcome had positive attitudes
toward dreams and presented pleasant dreams.
Pearson correlations (see Table 2) revealed that valence of dreams was
significantly related to changes in insight, such that more change in insight
occurred when the volunteer clients presented pleasant dreams.
Using the same predictors as in the analysis for session outcome, a
simultaneous multiple regression analysis was not significant.
An additional regression including the interaction between need for
cognition and distortion and the interaction between need for cognition and
condition was not significant (nor were any of the individual predictors).
Thus, volunteer clients who gained the most insight into their dreams
presented pleasant dreams.
client attitudes toward dreams and the valence (pleasantness) of dreams were
the best predictors of a composite index of session outcome for volunteer
clients in single sessions of dream interpretation.
In addition, valence of dreams was the best predictor of gains in
insight into dreams (based on changes in ratings of written dream
interpretations), although this finding must be considered as tentative given
that no control group was used and changes could have been due to effects of
interpreting the dream twice. Hence,
volunteer clients gained most from dream interpretation when they had positive
attitudes toward dreams and worked with pleasant dreams.
In contrast, the type of interpretation (waking life vs. parts of
self), need for cognition, and other characteristics of the presented dream
(distortion from waking life, vividness, and recency) were not significantly
associated with session outcome or insight change.
We discuss each of the findings in the following sections.
Client Attitudes Toward Dreams
toward dreams was positively related to session outcome.
Attitudes toward dreams probably reflects volunteer clients’
willingness to consider that dreams have something to do with what is going on
in their lives or in their personality. If
volunteer clients value dreams, they probably feel that they can learn a lot
from working with them in sessions. On
the other hand, if volunteer clients do not think that dreams are valuable,
they may be unwilling to consider any interpretation. They may think that dream interpretation is akin to palm
reading or astrology and hence might not pay much attention to the session.
importance of attitudes toward dreams in predicting session outcome is
consistent with the Hill et al. (1997) findings that students who were willing
to participate in dream interpretation sessions had positive attitudes. The findings differ somewhat from those of Zack and Hill
(1998), who found a quadratic but not a linear relationship between attitudes
and session outcome. It should be
noted that the quadratic and cubic relationships were also significant in the
present study but were minuscule compared to the amount of variance accounted
for by the linear effect. In both
studies, volunteer clients with more positive attitudes toward dreams had
better session outcomes than did students with more negative attitudes.
Differences occurred in the middle range.
We would suggest that the larger sample size in the present study
allowed for more stable relationships to emerge, although these results need
to be replicated.
results for attitudes should be considered in light of the Rochlen et al.
(1999) results. They found that
volunteer clients with below average attitudes toward dreams and dream recall
could be trained in the skills needed for dream interpretation (e.g.,
description, association, interpretation, action).
Once trained, their outcome for dream interpretation sessions was
equivalent to that of previous studies of samples with a normal range of
scores on attitudes and dream recall. These
results suggested that training may be effective for helping people with
negative attitudes recognize the benefits of working with their dreams. In addition, therapists should not dismiss the idea of
working with dreams with people who have negative attitudes; instead they
could train clients in the skills needed to do dream interpretation (e.g.,
description, association) and in what to expect from the dream interpretation
of the Presented Dream
clients had better session outcome and gained more insight into their dreams
when they presented pleasant rather than unpleasant dreams. For example, a volunteer client who had a positive session
outcome brought in the following pleasant dream (before the dream, she wrote,
“About four years ago I had this dream that I really did not know what to
make of. It was when I was
pregnant with my daughter X. I
remember being upset with her father at the time.
When I hung up on him, I was crying and very upset.
I then called on Jesus to help me.
At this time I remember my tears drying and me suddenly falling
was walking in the most beautiful green meadow that I have ever seen. The skies were very blue and everything seemed to be at rest.
Every little creature you can imagine was at peace.
I remember suddenly that a white baby lamb came up to me.
When I looked down to see the lamb, I was dressed in a long white robe.
The lamb rubbed my leg and then we started walking together and
playing. When I woke up all I
could remember was that I felt loved and peaceful.”
contrast, a volunteer client who had a negative session outcome brought in the
following unpleasant dream,
dream started out with a black sky when I realized I am in the woods. I notice the two figures in all white outfits coming towards
me. I started to run for my life.
I started to run as far as I could and stumbled a lot but never got
caught. I was being pursued
relentless. I saw a black pond
and decided to jump into it to avoid being caught.
Regardless, the two white figures jumped into the pool in pursuit after
me. I was panicking so much that
I almost drowned. I got out of
the pool and saw that the two figures were still running after me.
I immediately woke up.”
may have been easier for the first volunteer client to discuss her dream
because it was soothing, affirming, hopeful, and provided a resolution to her
painful life situation. In
contrast, it may have been difficult for the second volunteer client to
discuss her dream because it suggested threat and conflict, without much of a
sense of hope or resolution. Therapists
may need to work harder when volunteer clients present unpleasant dreams to
help them figure out how to solve problems suggested by such dreams.
important caveat in understanding these results about the pleasantness of
dreams is that these were single sessions.
It may be that volunteer clients felt vulnerable discussing unpleasant
dreams in single sessions because they would not have an ongoing relationship
with their therapists. Perhaps
therapists in ongoing therapy should consider working first with pleasant
dreams to help build the alliance, and then only venture into working with
more unpleasant dreams once they have a solid alliance.
Given that clients in ongoing therapy probably bring in more unpleasant
than pleasant dreams, researchers should investigate the factors that allow
long-term clients to feel safe and profit from discussing unpleasant dreams.
results for valence are somewhat consistent with those of Zack and Hill
(1998). In both studies,
volunteer clients with more pleasant dreams had better session outcomes than
did those with less pleasant attitudes. Differences
occurred in the middle range. It
should be noted that quadratic and cubic relationships were also significant
in the present study (as was true in the Zack and Hill study) but they were
minuscule compared to the amount of variance accounted for by the linear
effect. As we suggested for the
results for attitudes and session outcome, the larger sample size in the
present study may have allowed for more stable relationships to emerge,
although these results need to be replicated.
to our hypothesis, need for cognition did not predict client-rated session
outcome either by itself or in interaction with the distortion level of the
dream or the type of interpretation. These
findings are similar to those of previous studies that found that various
measures of psychological-mindedness did not predict session outcome (Cogar
& Hill, 1992; Diemer et al., 1996; Hill et al., 1997).
Hence, even though therapists may like to work with clients who have
high need for cognition and who are psychologically-minded, we find no
empirical evidence that such clients benefit more from dream interpretation.
should note, however, that need for cognition was related to attitudes toward
dreams. People who enjoy thinking
in general also like to think about their dreams.
However, it appears that it is the more specific attitudes toward
dreams rather than the more general enjoyment of thinking that is related to
session outcome. Need for
cognition was also related to distortion of dreams, suggesting that people who
are high in need for cognition have more unusual dreams, which makes sense
because they are interested in their thought processes and hence might be more
open to fantastical dreams.
Characteristics of the Presented Dream
were surprised that distortion level, vividness, and recency of dreams did not
predict how much volunteer clients benefitted from dream interpretation
sessions. Perhaps distant dreams
were just as or maybe were even more important to work with than more recent
dreams because the volunteer clients persisted in remembering them. In addition, volunteer clients probably only brought in
dreams that were vivid enough to make them salient (this is supported by the
mean ratings of almost 7 on a 9-point scale, indicating that the ratings were
at the high end of the scale). A
limitation of the present study in terms of studying dream characteristics is
that volunteer clients were allowed to bring in dreams of their choosing,
which may have skewed the selection to more interesting dreams. Probably the only way to test whether variables such as
distortion, recency, and vividness make a difference in terms of session
outcome would be to require participants to bring in randomly-chosen dreams.
At this point, we do not know why volunteer clients selected particular
dreams to discuss in sessions.
Life Vs. Parts of Self Interpretation
depth and insight were equally high for both waking life and parts of self
conditions. These session
outcomes were consistent with those of previous dream interpretation studies
and higher than regular therapy (Cogar & Hill, 1992; Diemer et al., 1996;
Heaton, Hill, Hess et al., 1998; Heaton, Hill, Petersen et al., 1998; Hill et
al., 1993; Hill et al., 1997; Hill et al., 2000; Rochlen et al., 1999; Wonnell
& Hill, 2000; Zack & Hill, 1998).
Hence, both types of interpretation were as effective as when
therapists used their clinical judgment about what type of interpretation to
no differences were found between conditions in terms of volunteer
client-rated session outcome or insight gains, therapists reported subjective
differences in implementing the conditions.
Therapists in the waking life condition thought that it was relatively
easy to do the sessions because volunteer clients could readily relate their
dreams to waking life and hence needed minimal justification for
participating. Therapists in the parts of self condition, however, reported
that they had more difficulty explaining the rationale and convincing
volunteer clients that parts of dreams reflected parts of themselves (which
may have been reflected in the differential therapist non-adherence in that we
had to discard four parts of self sessions and only one waking life session).
With particular volunteer clients, therapists enjoyed the parts of self
condition because they could be creative and playful, but they had more
difficulty with some reluctant volunteer clients and with dreams that were
obviously related to waking life. Obviously,
therapists were able to provide convincing rationales because the session
outcomes were equivalent for the two conditions, but the subjective difficulty
in implementing the parts of self condition with some volunteer clients is an
important consideration. Therapists
may need to be trained in how to provide convincing rationales for
interventions that lack immediate face validity.
results of this study must be considered in the context that most of the
therapists were graduate students (although several had extensive experience
with dream interpretation), clients were volunteers receiving course credit
and may not have been motivated for dream interpretation, only single sessions
were used, and session outcome was assessed only immediately post-session.
Furthermore, results of this study might not generalize to dream
interpretation conducted within ongoing therapy.
This limitation is particularly important in light of the consideration
that clients in ongoing therapy might be more willing to work with unpleasant
dreams if they have a strong therapeutic alliance.
implication of these findings is that therapists should be cautious about
using dream interpretation with clients who do not value dreams and with
unpleasant dreams, especially in single or initial sessions.
We would not suggest that therapists avoid using dream interpretation
in these situations, but we would suggest that therapists educate clients
about the value of working with dreams, be supportive with clients who present
unpleasant dreams, and spend more time in the action stage to help resolve
problems reflected in unpleasant dreams.
the basis of these results, therapists can feel justified using their clinical
intuition to decide whether to use waking life or parts of self
interpretations. Both seem to be
effective, although therapists may need to give better rationales and
explanations to help clients understand the parts of self focus.
Further research should examine other types of interpretation, such as
the experience itself or early childhood experiences (Hill, 1996),
interpersonal dynamics (Kolchakian & Hill, 2000), or spirituality (Davis
& Hill, in press).
that the amount of variance accounted for by attitudes toward dreams and
valence of dreams was small, we suggest that researchers investigate other
factors (e.g., the therapeutic alliance, therapist techniques, client
involvement) that might influence the outcome of dream interpretation
sessions. We need to know more
about when, with whom, and how to use this intervention.
Moreover, research is needed about the manner of interpretation.
In this study, therapists worked collaboratively with clients to
construct interpretations, as Hill (1996) suggested.
One can easily imagine, however, that we would have obtained different
results if therapists had provided the interpretations authoritatively or had
encouraged clients to construct their own interpretations.
In conclusion, we recommend that researchers continue looking for
variables that influence the process and outcome of dream interpretation
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E. Hill, Rachel E. Crook, Maria A. Turkson, Teresa L. Wonnell, Jason S. Zack,
Aaron B. Rochlen, Misty R. Kolchakian, and Jamila N. Codrington were all in
the Department of Psychology, University of Maryland at the time of the study.
Aaron Rochlen is now in the Department of Educational Psychology at the
University of Texas. Jason Zack is with etherapy.com.
Frances A. Kelley, Timothy L. Davis, Leslie E. Laldanado, and
Suthakaran Veeresamy were all in the Counseling and Personnel Services
Department, University of Maryland at the time of the study. The fourth through twelfth authors are listed in random
order because they contributed equally to the study.
wish to express our gratitude to Gregory Hancock for statistical consultation
and to Emilie Y. Nakayama for reading a draft of this paper.
paper was presented at the Association for the Study of Dreams, Washington DC,
July, 2000 and at the American Psychological Association, Washington DC,
concerning this article should be addressed to Clara E. Hill, Department of
Psychology, University of Maryland, College Park, MD 20742.
Electronic mail may be sent to firstname.lastname@example.org.
1. Means and standard deviations of all Measures Completed by Clients
for Cognition Scale
Insight into Dream
Insight into Dream
N = 105. Pre and post
insight were judges’ ratings on insight in client written dream
interpretation from before and after the session.
High scores indicate high levels on all variables.
2. Correlation Matrices of all
Predictor and Session Outcome Variables Used in the Analyses
ATD-R Valence Distortion Vivid
N = 105. Session Outcome =
a composite of the Depth Scale, the Mastery-Insight Scale, and the
Exploration-Insight Gains Scale. Insight
Change = post - pre scores on judge -rated insight in written interpretations
of dreams, NCS = Need for Cognition Scale, ATD-R = Attitudes Toward Dreams,
Valence = pleasantness of the dream as measured by the Semantic Differential
Measure of Emotional States, Distortion = a judge-rated measure of how close
the dream was to waking life, Vividness = client-rated index of vividness of
the dream, recency = client-rated index of how recent the dream was. High scores indicate high levels on all variables.
* = .05, ** = .01, *** = .001
September 22, 2000
of Authors: The first author has a Ph.D., the rest have M.A.s
Affiliation of First Author: Department of Psychology, University of Maryland, College Park, MD 20742,
Copyright ©2003 Association for the Study of Dreams. All Rights Reserved.