Monday, October 31, 2016

Conflict between "Sweet Release of Death" and "The Continuing Lure of this Wonderful World"

A divorced man in his forties,who lives a secluded lifestyle after he readily and truthfully cooperated over his marijuana use with the law enforcement, instead of refusing to answer questions and getting a lawyer to lie about it, which caused him to go to jail, leaving him with a deep distrust of society's way of conducting its affairs with honest people, especially by those who are in charge of arresting, prosecuting and judging, and spends most of his waking hours tending after his business, of which he is the owner, and who comes to me primarily to pick up a prescription of Seroquel 100 mg. for his anxiety, insomnia and bouts of depression, for he rather be working than be in my office, suddenly volunteered, which is quite unusual for his reticent self, that he has recurring dreams, and since he has nothing better to report he might as well tell them to me, not because any good will come out of doing so but to fill up the 45-minute session.

The dreams have the same theme though their form changes.  I have to be somewhere for something important, like to take an examination, or go to do a difficult job, but I cannot reach there because of obstacles like I cannot remember where I parked the car, or the car itself is missing if I do find the place where I had left it, or if the car is not missing the keys are. I may even visualize where I had left the keys but don't quite know how to get to them. As for taking the test, I make it to the school but I cannot find my way to the classroom. Or I am on the dock for family vacation but there is no boat. I wait and wait for it to show up. Or my body itself fails upon me. My feet get heavy and my body feels so tired I can hardly move. Or I fall down with no strength to get up. I crawl on all fours to be at the spot where I have to be but without success. 
All of these dreams are very scary. My heart beats real fast. I feel all amped up, confused and clenched. My body feels like it is ready to fight. It usually happens in early morning. Especially if I have been waking up through the night.  

The patient always inhibited did not volunteer any associations.
So with nothing to go on I decided to tell him the psychoanalytic theory as to why we dream of being back in school and being examined and not doing well on it and how it is classified as a typical dream (typical dreams are those that uniformly occur in all of us). We dream of being back in school and dreading to take a test lest we fail when we have something important to do the next day, the worry of which tries to wake us out of sleep. The aim of the dream is to reassure the dreamer - so he can continue to sleep - that don't worry about tomorrow's important thing that you are all hyped up about. Don't lose sleep over it, For you did same kind of worrying over facing examinations in school which the next day you would do quite well on. So just like in the past all that worrying was for naught, your fear over tomorrow's difficult situation will be over nothing too. Freud pointed out that one always dreams of getting tested on a subject that one did quite well in the school not on a subject in which one failed, or at least on one which was not one's favorite.
But patient rejected the interpretation and claimed that nothing about next day's job, or other challenges of life, bother him anymore, for he is too old for all that, and that could not be causing him to go back to school and worry about taking tests in his dreams.
But, then, after a hiatus of time, he said, may be as a young man he did get quite uptight over situations he had to face the next day and would worry whether he will be able to get the job done right or not. "But as I have aged, I can talk myself out of being anxious by telling myself that you have always succeeded in whatever difficulty you have had in the past so why worry about tomorrow today."
So he now talks himself out of the worrying instead of letting the dream do it after falling asleep.
So he did confirm the correctness of Freud's theory of "examination dreams".
When pressed to try and scour in his mind for more associations however faint or far fetched they may seem to him to the other elements of the dream, the only one that came up was to his being stranded on the dock and how his family would go to St. Clair Shores (part of the Great Lakes) every weekend and how they were the happiest days of his life. But in the dream the dock is on a ocean not where the family dock was. And in the dream the family is not around, or was there before but no longer, or they have already left for vacation and waiting for him to join them or they keep coming in and out of the dream picture but so faintly that he cannot be sure what role they are playing.  "It is all very hazy."
With no associations emerging, I fell upon the psychoanalytic theory once again, and conjectured that all these dreams have the same theme: not being able to reach somewhere you want to be so badly because of  obstacles. That place could only be the final resting place, the mother earth's bowel, your mother's womb where you felt safe and happy. It is a wish to be dead and free from life's tensions.
However, this greatest wish of all is naturally accompanied with such fear that you recoil from it and start thinking of all the other less fearful things in life that you rather face than die. These are counter-wishes, the wishes that will be fulfilled by staying alive, the pull of life (moh/maya), the enticement to be eternally entangled in life's obstacles and frustrations instead of dying. And the fear of dying in torn out of context and displaced upon the fear of living (life's vexing and frightening problems) exaggerating its strength, making them look insurmountable, waking you out of sleep in panic.
Patient said this makes lot of sense but proudly declared that he has no fear of dying. and then added, "It is injury that I fear." Obviously the fear of death had been displaced, to lessen its terror, to fear of getting injured. And then further confirmed that we were on right track by saying, "On the other hand my father has great fear of death. He is a very tough man. Hard as a nail, always on task. But whenever he has an ailment he gets very worried. If it is a cough it got to be lung cancer. For me death holds no fear. For I reason if death comes you won't know it, you won't be aware that you are dead. Death is not being in pain anymore, no longer to worry about anything, the final checkout. So I have no fear of death. My feet will no longer hurt from neuropathy that wakes me out of sleep. No suffering will affect me because I will already be dead.
And I must confess doctor that when I have real bad day, a real tough day, I calm myself that 'sweet release of death' will fix it. And it is on those nights that I have these dreams from which I wake up in such a panic. And by the way these dreams are very very vivid. I see everything in color. I see every detail. All the surroundings of whatever I am dreaming of, the trees, the building, they are all so vibrant, the car is brilliantly red, the key shines like silver. Why everything becomes so life like, so colorful? "
"Because they are temptations to lure you back to living. They seem to say when it is such a vibrant, wonderful world why you want to die?"

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