Published in the North American Journal of Medicine Vol. 22 No. 66, March 2016
“All dreams come in the service of health, healing, and wholeness.”
Jeremy Taylor, noted expert on dreams
When I heard what the theme for this NAJOM issue would be—insomnia—I thought to submit a related article on another issue of the night: Dreams. The world of dreams is not standard fare in most modern acupuncture clinics, but one has to wonder why. Obviously the ancients in China recognized the importance of dream images, since two chapters in the Neijing (one each in Lingshu and Suwen) are largely devoted to the diagnostic significance of dreams. It is only a modern prejudice that causes us to ignore the significance of dreams, seeing in them nothing but the leftover flotsam and jetsam of everyday life. Obviously the writers of the Neijing thought otherwise, and I have to agree with them, and I will try to demonstrate this with some cases below.
When client dreams are brought into the clinical encounter, surprising insights can occur, and at times we are told precisely what to do. It is not just the psychiatrist or psychologist who can make creative use of client dream images; this is fertile material for acupuncturists as well. One just needs to be able to creatively read the symbols of the dream—often in terms of yin-yang and five phases—and then bring that understanding into the treatment, or at least the understanding of the patient.
Heiner Fruehauf, Ph.D., L.Ac., a noted sinologist and classical scholar, often makes the point in his lectures that ancient Chinese medicine is best understood as an “ancient symbol science”. If our East Asian medical tradition is one of reference to symbolism, how can we ignore then the images welling up from the depths of our patients’ psyches. It seems intuitively obvious that the images that emerge from the patient’s unconscious are relevant to treatment. The cases I cite below exhibit clear images that connect to the five phases, and I think make the case that it is not so difficult to bring these images into treatment.
Case 1
SH was a young woman who came to my group acupuncture shift at the college where I work as a supervisor. She was seeking treatment for long-standing, debilitating anxiety—to the extent that she could not carry on normal activities of daily living. Many days she would not go out of her house at all. Slowly over a period of four months of treatment from various student interns her symptoms lessened. One day she shared that she was considering applying for admission to a masters program in transpersonal psychology. She still clearly suffered from anxiety, and she expressed this career desire in a rather mousy way, almost afraid to hear herself state this plan. At this point something happened that I still have no way to explain: I asked a question of her that I had never asked of a patient, and I have no idea now what I was thinking. I inquired if she had had any recent dreams. I had in fact studied dream interpretation since 1993 in the style of Jeremy Taylor, a noted proponent of what is called projective dreamwork, but I had never contemplated using this approach in my clinic.
SH at first said no, but then a moment later she said she had just a fragment of a dream: A snake on a road. That was it. I probed a bit so that I could develop a better picture. This stage of asking clarifying questions is important in dreamwork. Most people pick up significant detail in their dreams, but when relating them to others much of the meat is left off the bones. With just a few clarifying questions I was able to flesh out the picture considerably. The snake was yellow and green. The road was an unpaved, dirt and passed through a wooded area. The snake was facing her but not moving, and SH was not frightened.
Let us consider the images:
• Snakes are common symbols of transformation in many cultures, perhaps due to how they shed their skins. (Remember, SH wanted to become a transformational therapist.)
• Snake is also in the Chinese system the animal associated with the SP organ-network. (Her pulse pattern was typically the SP sho in Japanese Meridian Therapy.)
• The yellow color of the snake and the dirt road point to the Earth element.
• The trees and green color of the snake direct our attention to the Wood element.
So, my thought at the time was that I had to combine Earth and Wood in her treatment. LR-3 taichong is an Earth point on a Wood channel. One translation of taichong is “Great Thoroughfare”. A thoroughfare is a road—remember the snake was on a road. For this reason I decided to add a needle at LR-3 to what I wanted the intern to do for the patient. I asked the patient to pay attention to that needle. When I came back a short while later after the removal of the needles, I asked SH if she had any insights from the needle. With eyes bulging she exclaimed: “I became the eyes of the snake!” Wow! I was blown away and so was she. She was a transformed person. And I might remind readers of the obvious additional Wood element in SH’s reference to becoming the eyes.
A year later I ran into SH and hardly recognized her. She explained that she decided after that treatment that she needed time away to think about her life. She drove down to the Arizona desert. Driving on a dirt road through the desert one day a large rattlesnake crossed in front of her. She pulled to the side of the road and followed the snake through the desert (hardly the behavior of a person with serious anxiety!). As she walked she said it became clear that it was not the appropriate path to go back to school to study psychology. In fact she realized her path was to study Chinese medicine. She returned to Portland to apply to a program there. When I met her she had just put those plans on hold for a few years, since she had just learned she was pregnant.
So, in this, which by the way was my very first case of using dreams in Chinese medicine, we had direction from the images to an actual point name. That is not necessarily the goal of such dreamwork, but it does happen in a small percentage of the cases. Mostly what happens is that a direction for treatment will be revealed.
Case 2
PS is a 68-year old female. Before this dream took place she had a cone procedure for cervical dysplasia, and was healing more slowly than anticipated, a cause of some significant worry.
In the dream PS has a third floor apartment in a brownstone. She is walking home and is stalked by a man who then forces his way into the apartment. After him comes a parade of others, almost clone-like. They will not leave, not even when she gets forceful in her language and manner. The dream switches to a first floor apartment in one of those magical changes that can happen in dreams. PS calls 911, and the police come to remove the invaders. She awakes from the dream unclear if they succeeded in getting them all. She then falls back to sleep and is told date in a second dream with no images a: October 3rd. No images as in most dreams, just a date.
PS had suffered numerous emotional and physical traumas in her childhood. This dream tells her story and tells me also what to focus on in treatment. In the imagery the story starts in the third level, i.e., the upper jiao. I take this to mean her disease process starts with emotional violation to the LU/PC. The LU aspect is possibly her long-held grief about her childhood and the the cancer death of her husband. I see the PC involvement as the transgressions against her sacred boundaries in her youth. Interesting that the imagery then moves to the first floor (lower jiao), which is where the recent surgical procedure took place.
The building is a brownstone. I take this as Earth. She calls 911. From 9 to 11 is Spleen time in the Chinese clock. So, in two ways I feel the images tell me to treat her with a focus on the Spleen. It also seems, just as an aside, that she should be advised to work with a counselor since clearly the traumas of her life are still very much at play in her psyche. The dream images tell us clearly the disease process (invasion of the stalker and other men) starts in the upper jiao but then progresses to the lower jiao. PS took this whole discussion to heart (no pun intended) when I explained it to her.
Now, which Spleen points need to be treated? The second part of the dream included the date October 3rd. That is the third day of the tenth month. I took the 3 and 10 as indications for treatment and needled SP 3 and 10 bilaterally. Of course that is not all that I did in her treatment, but when I needled those points, I stepped out of the treatment room for a bit and let her meditate with them. She left in a lovely state of radiant shen, much more clear than I normally managed to achieve with her.
Case 3
TH is a 67 year old female who at the time of this dream was very ill and all the more worried because she had no biomedical diagnosis. She was suicidally depressed, very anxious, and in chronic whole body pain. As it turns out she had chronic Lyme disease that was subsequently diagnosed with proper laboratory testing. The dream, as you will see, gives very clear instruction about how her treatment should proceed, not simply for the immediate treatment but over time.
In the dream TH and her mother are in a wooden rowboat on a narrow river in a jungle. The sides of the river rise steeply with thick green foliage, so that it almost feels canyon-like. The boat comes around a turn and to the right there is a slight rise with a native village at the top. TH and her mother land the boat there. At this point in the dram TH’s mother leaves the dream. TH walks to the top of the rise and is met there by the village witch doctor (these were the words TH used). He is dressed in typical “primitive” fashion, including a bone through the nose. His hut is right next to them. TH walks into the hut uninvited and sees there are many wicker baskets with lids. She knows there are poisonous snakes in them. TH reaches into a basket and pulls out a live snake and bites off its head. This is the end of the dream.
The first image is one of LR Constraint: narrowed river, green, wooden boat. In the village we have interesting images: snake again, as in the first dream, drawing our attention to SP. But we have in this dream a specific part of the snake—the head, the most yang part of the body. The Yijing hexagram that goes with SP is the first one in which all six lines are yang lines. So snake itself is all yang, and not only that but in the image we have the most yang part of that all yang creature. Yang within yang. This is what the patient instinctively knows to take as her medicine in the dream.
Chronic Lyme disease is an instance of what in ancient Chinese medicine was referred to as Gu syndrome, a type of “demon possession”. In fact many chronic Lyme patients will use this language and relate that they feel possessed, not themselves at all. Gu in the classical literature is called “the ultimate yin evil”. So what does TH choose as her medicine to combat such a yin evil? Of course she chooses pure yang, the head of a snake.
Aconite is described as the most yang herb. TH’s recovery took a quantum leap six months into her care with me when I felt she was ready to receive a formula with aconite in it. On the acupuncture side moxa was clearly indicated in this imagery of needing yang support, and indeed TH came to love moxa.
As an aside I will point out that there is a clever word play in this dream. There is a “witch” doctor. TH did not know at the time “which” doctor to go to in her attempts to deal with this condition. Dreams often have word plays like this. Also, note that she ends up with a healer who practices a close-to-the-earth, natural medicine. Traditional East Asian Medicine is of course such a medicine.
I have tried with these three examples to give a sense of how dream images can be translated into specific points. In all three cases much more could be developed from the images than what I presented, but I hope I demonstrated at least that diagnostic information does occur in dreams, just as is maintained in the Neijing. There are many more dreams I could have shared, since I have by now years later listened to and used literally hundreds of patient dreams in my practice. I have noticed that when the patient is informed of the process, (s)he will buy into it in a different way from the typical acupuncture treatment. I believe patients are encouraged that information relevant to their condition is welling up from their unconscious.
If I have succeeded in piquing your interest, I point you to the work of Jeremy Taylor, a noted teacher of dreamwork. His books and articles can be found at www.jeremytaylor.com. He shares a method that is readily learned with a little dedication. I will share some very basic guidelines of his approach:
- Have the dreamer tell the dream one time through without interruption in the first-person present tense, e.g., “I am walking down a road and I see a snake…”
- Invite the dreamer then to retell the dream a second time during which clarifying questions can be asked; after this second telling your insights can be offered
- If you choose to talk to your patient about the dream images and what you make of them, always preface your insights with the phrase: “If this were my dream, Sally, I would consider the stream to be a…” or “In my imagined version of your dream, I would…” In this way we acknowledge the projection that can so easily occur when confronted with someone else’s images.
- Stay in the images! Do not use them to tie everything to your favorite theories.
- All dreams are kept absolutely and forever confidential just like everything in our treatments. (I have permission to share the dreams above and I have changed the identifying initials and ages.)
- If you insert a needle (or do moxa) based on the dream images, let the patient know what you are doing and thinking; you can have them work with that needle in a different way—they might direct their breath to it, or listen to its story, or in some other way creatively engage in the treatment of that point
- Give them an opportunity at the end to share (if they so choose) any insights gained
Bringing the world of client dreams into our treatments has the potential to deepen our relationship with our patients. It is bonding to share the images that well up from the depths of our psyches. A good first step for those interested in this approach is to start to work their own dreams in the way I have outlined above. Not every dream is a health dream, but some are. Put a pen and paper next to your bed and write down your dream IMMEDIATELY upon waking. Find time to sit down and consider the story being told in the images. Revisit the images through the day, as often the dream seems to yield to interpretation in a layer by layer manner. It will not be long before the images start to speak to you in the terms of Chinese medicine.
As acupuncturists we should be clear that what we do is not psychotherapy. A great deal of training is required to do that well. I do not enter into that type of psychotherapeutic dialogue with my patients, although I might well recommend counseling when it seems appropriate. What I do is acupuncture, moxa, bodywork, and herbal medicine. The images of client dreams are often as useful in determining how to treat a patient as reported symptoms, color, palpation findings, voice, odor and all the other five-phase keynotes we learn from our classical texts, and many times the images tell us aspects of the patient’s life and well-being that we would not otherwise have an easy access to.
Bob Quinn lives, practices, and teaches in Portland, OR. Lately he has been reading the poetry of Muso Soseki.