Bruce Dow, M.D.

Truth and Fiction

At first glance, truth and fiction appear to be opposites, but if we think of Fiction, including novels, plays, poems, then truth and (great) fiction may actually be synonyms.  Certainly there is truth in Tolstoy’s War and Peace, Shakespeare’s Hamlet, Robert Frost’s Stopping by Woods on a Snowy Evening.  A great fictional character or setting, though created “out of thin air” by the author, is based on lived or witnessed experience which is somehow captured in the novel, play, or poem as “true”.

We need to keep this fact in mind as we consider the process of revising a nightmare, which the dreamer claims to be directly based on his or her lived traumatic experience.  How can we presume as therapists (or self-therapists) to rework “truth” to make it more palatable?  Aren’t we doing the dreamer a disservice by attempting to sugarcoat a bitter or ugly traumatic event (or events) from their past?  The answer to such questions is no, or at least not necessarily.  In revising a nightmare, we are looking for a hidden truth, buried in the debris of a terrible past event.  Can we help the dreamer find that truth, and then run with it all the way back to health?

Clearly, there is a risk that we will just come up with a lie, allowing the dreamer to avoid, run away from, or remain in denial about, their uncomfortable past moment or moments.  Dream revision doesn’t work for everyone.  Some people have trouble getting their minds around the idea of creating a “fiction” in the midst of their trauma.  The goal is to find a fiction that carries its own truth.

When working with a PTSD sufferer on dream revision, I sometimes see their eyes light up as we come upon a successful insight into their trauma, a hidden truth buried in the rubble.  It is gratifying to see this “hope” expressed in their eyes.  Their eyes seem to be saying, “Yes! I can do this!  I see a way out of my suffering, a light at the end of my long dark tunnel.”

The change we decide upon is often something small, seemingly insignificant, possibly overlooked in the past, just a thread perhaps, but if we pull on it, the whole fabric of their straitjacket may unravel, eventually freeing them from their bondage.

PTSD is a kind of slavery or emprisonment.  By changing their posttraumatic nightmare, we are releasing the PTSD sufferer: removing their shackles, unlocking their prison door.  Dream revision, rather than being fiction, can be truth, the truth that sets the PTSD sufferer free.