Psychoanalysis and narcolepsy

Abstract

Narcolepsy occurs in association with dream-like epiphenomena including bizarre hallucinations, sleep paralysis and cataplexy. This association between narcolepsy and dreaming has altered the definition of dreaming, stretching that definition to include the REMS-associated states of narcolepsy, and resulting in a redefinition of dreams as bizarre, hallucinatory mental activity that can occur in a state of either sleep or wake. Historically, the bizarre dreams of narcoleptic patients provided fertile ground in support of the psychoanalytic therapy for the illness. The belief that REM sleep can be equated with the presence of dreaming has led to the use of dream reports from narcoleptics during sleep onset REMS periods as a model for the psychological and physiological characteristics of the dream state. The REM sleep epiphenomena of narcolepsy, considered as characteristic of the dream state, have been integrated and applied in forming the conceptual framework for some of the most widely accepted neuroscientific theories of consciousness. Theorists have extended the postulate that dreams are bizarre, hallucinatory mental activity, into the theory that dreams are a form of visual hallucination. The conception of REM dreaming as bizarre and REM sleep as a psychodynamically primitive state of CNS activation parodying the psychoanalytic Id persists in modern versions of Activation-Synthesis theory including AIM. © 2010 Springer-Verlag New York.