23 dreams culminating in attacks of migraine were collected. Despite problems of overlap it was possible to separate out the dreams into six categories on the basis of their manifest content. All but one of the categories were characterized by the presence of powerful negative affect. By far the largest category was made up of dreams of terror.

Several types of dreams reported by psychosomatic patients with alexithymic characteristics are presented. Two special features of the dreams are noted: (1) the dreams contain events which are very traumatic and (2) the protagonists of the dreams failed to fully perceive their own feelings. It is postulated that the failure of the protagonists to fully perceive their own feelings played an important role in fostering the development of the traumatic events. Feelings such as anxiety and sadness are key signals which incite the ego of the dreamer to set protective operations into motion. The diminution of awareness of these feelings may, therefore, delay the implementation of protective operations to a point which allows the traumatic events to progress dangerously far. It is interesting to note that the few psychosomatic patients without alexithymic characteristics who were included in my series reported a type of dream which was identical to one of the types of dreams reported by patients with alexithymic characteristics. This concurrence suggests the possibility that the dreams form a link between the psychologies of these two sub-groups of psychosomatic patients.

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Four examples of catastrophic dreams iη. which the dream action progressed to include the total destruction of the dreamer’s body image are presented. This feature of total destruction of the body image possesses a special heuristic significance because it is a variance with Freud’s clinical experience which helped to shape his view of the factors responsible for the creation of traumatic neurosis. He felt that nothing resembling death can ever have been experienced and therefore he dismissed the idea that the traumatic neurosis could arise as a direct result of the fear of death. Each of the dreams revived a real life traumatic event which had caused a registration in the mind of a shattering experience without causing the destruction of the actual body at the same time. When the same traumatic event was revived in the dream the ego functions available at that time were evidently insufficient either to modify the traumatic event or to awaken the dreamer prior to its denouement. The powerless ego of the dreamer seemed to have been derived from the powerless ego of the patient at the traumatic moment in waking life which was carried over into the dream as a part of the representation of the traumatic event. The destruction of the body image in these dreams apparently played a role in the production of symptoms characteristic of the dissociative syndromes. On the morning following the dream three of the patients awakened in a depersonalized state and the fourth in a catatonic state.