Drug dreams: A neuropsychoanalytic hypothesis

Recent studies have shown that the ventral tegmental pathway stimulates bot h dreaming and drug craving. To investigate a possible clinical link betwee n these two psychic phenomena, psychotherapy notes from the first six month s of an addicted patient's treatment were reviewed, together with verbatim notes from the four years of psychoanalysis that followed. Of 240 dreams re ported by the patient, 58 had manifest content involving the seeking or usi ng of drugs. There was no particular temporal or emotional thematic pattern to these "drug dreams," which persisted through four and a half years of s obriety. Drug dreams are observable phenomena that reflect both the innate structure of the brain and neural changes produced by exposure to addictive drugs. In some addicted persons, exposure to drugs produces a fixed change in neurological functioning with which they must contend for years, possib ly the rest of their lives. Drug craving meets Freud's defining characteris tics for a drive: it is a constant pressure, originating from within the or ganism, to do work. and it constantly demands satisfaction. Because ego and libidinal drives share a common neural pathway, they should not be separat ed conceptually. Solms's finding tin press) that the activating systems for dreaming and for craving are identical, a finding based on observations of tumor- or stroke-provoked brain lesions, is confirmed by observation of th e dreams of a patient whose brain changes were created by drug exposure. Th is study provides further evidence that the origin of the dream is a wish.