Dream indicators of change

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Dream indicators are elements in dreams that provide information on processing mechanisms in experience. They can be identified with the help of dream analysis methods based on specially defined categories. The categories are based on theoretical considerations about memory, affect regulation as described in Freud's psychoanalytic theory .

Theoretical background

Many see the birth of psychoanalysis in the appearance of Freud's Interpretation of Dreams . Even today, many clinically active psychoanalysts regard the dream as the “ via regia to the unconscious”, as the central source of knowledge in their “specific science of the unconscious”. Yes, in the last few years there have been new opportunities for interdisciplinary dialogue with related sciences for psychoanalytic dream research .
With the discovery of rapid eye movements in infants, a new chapter in dream research began. The biological dream process moved to the center of research, while psychological dream research and interpretation tended to be relegated to the background. It was only in the last two decades that various research groups tried to combine neurobiological and psychological dream research in a new way. The psychoanalytic dream theory and interpretation received a new interest and sparked heated controversy. The most famous took place between Allan J. Hobson and Mark Solms . In a new work on "Hobson's protoconsciousness and Freud's primary process", Solms (2012) traces an approach by the biologically oriented brain researcher Hobson to Freud's dream theory.

Historical notes

As Fischmann, Leuzinger-Bohleber and Kächele (2012, pp. 834ff.) Outline, Freud's detailed account of an almost complete analysis of the Irma dream can be regarded as a hallmark of psychoanalytic dream research (Freud 1900a). Thanks to the detailed documentation of the individual steps in the interpretation of dreams, Freud made it possible for him to controversially discuss his understanding and to critically develop his concepts further. Franz Alexander (1925) was the first to examine “dream couples and dream series” and discovered the phenomenon of the repetition of dream contents. Associated with this was the question of why the same problems are dealt with over and over again in dream series. Thomas French (1952, 1954, 1958) postulated in his three-volume work "The Integration of Behavior" that every dream has a characteristic logical structure. In addition, dreams of a certain individual show logical structures that indicate unresolved unconscious conflicts of this person.
What has become less well known is that Alexander Mitscherlich (1947) published 103 dreams of an analysand in order to illustrate what the patient was trying to convey with these dreams. In the 1960s, Enke and his colleagues presented a formal affect and relationship analysis of psychosomatic patients. Geist & Kächele (1979) used Helmut Thomä's first tape-recorded psychoanalysis to precisely examine certain dream configurations. They thus opened up new possibilities for empirical dream research in psychoanalysis. Leuzinger-Bohleber (1987) first investigated changes in cognitive processes using a dream diary of a transvestite analysand and developed a series of hypotheses on changes in the manifest dream content and the handling of dreams in a psychoanalysis that was judged to be successful on the basis of different perspectives. These hypotheses were then supported by a computer-aided, theory-led content analysis based on the dream narratives of the first and last 100 hours of analysis of four tape-recorded psychoanalytic treatments (Leuzinger-Bohleber 1989). In the dreams of the final phase of successful psychoanalysis, the spectrum of affects in the manifest dream content expands (motives of joy, surprise, pride, triumph, sadness, distancing, etc. Anxiety dreams were less common than at the beginning of the treatment, but they did occur still ahead). In addition, there are more successful solutions than unsuccessful solutions. Furthermore, the dream ego is less often in the observer position and more active. Finally, more mature object relationships and more people emerge as depictions of animals (cf. Leuzinger-Bohleber 1989).
“At a later point in time, it was examined how the development over the entire course of one of these four psychoanalytic treatments, which the patient Amalie X can evaluate (Kächele et al. 1999). The exclusive examination of the dreams of the initial and final phases of the treatment leaves open how the change processes take place in the course of the therapy. We found both courses of measured variables with variations around a mean value in the intensity (such as in the aggressive and fearful emotions) as well as changes in parameters that move up or down along the time axis. The finding that the patient Amalie X already had special dream abilities at the beginning of the treatment was surprising. From the beginning she shows the ability to actively organize relationship patterns in her dreams. The changes were evident in the quality of these relationships: they became friendlier and more caring.
The systematic changes over time in the dream atmosphere are impressive: self-related negative emotions decrease significantly: on the other hand, object-related negative emotions show a stable variability around a mean value, show no trends, neither up nor down. Over the course of the patient's dreams, an ability for successful problem-solving strategies becomes increasingly evident ”(see Fischmann, Leuzinger-Bohleber and Kaechele, 2012, p. 836). Other interesting studies have been carried out by psychoanalysts in the field of experimental sleep dream research. With the possibility of measuring the physiological characteristics of sleep, it became possible to collect dreams in the sleep laboratory with targeted awakenings from different sleep phases. In laboratory experiments it could u. a. The ability of dreams to be influenced by visual and acoustic subliminal stimulation before going to sleep as well as the significance of the dream for memory are examined.

Clinical and extra-clinical dream research

Comparison of clinical and extraclinical dream research in the LAC depression study

As is well known, in extraclinical dream research it is much easier to examine the manifest dream content for methodological reasons: The work on the latent dream content and the like. a. By systematically following the associations to the dream in the analytic session and trying to find indicators for the current transference / countertransference events in them, extraclinical researchers face demanding methodological problems. Although individual psychoanalysts such as Jiménez (2012) fundamentally question whether the concept of the latent dream content is still relevant in today's clinical practice, the current experience in the LAC Depression Study shows that for the psychoanalytic colleagues an understanding of the latent meaning of dreams and whose relation to the current transmission process is an important part of your treatment technique. For many of them, systematic reflection on latent structures of meaning in dreams is an important source of insight into changes in their long-term patients that extend into the unconscious. Therefore, the question of the meaning of the latent dream thought still seems open to us. However, it can only be systematically pursued through clinical-psychoanalytic research, as will be briefly illustrated below.

Systematic clinical-psychoanalytic dream research as part of the LAC study

The cliffs of clinical psychoanalytic research are well known. They range from the random selection and summary of clinical material in order to prove certain theoretical points of view, from hermeneutically closed lines of argument, narcissistic-looking considerations instead of self-critical, open reflections on clinical observations to the presentation of psychoanalytic "starfalls" instead of "normal" or even failed treatments. Furthermore, especially in training cases, there is the risk of an (unconscious) construction of desired psychoanalytic insights that correspond to prevailing and fashionable theoretical concepts and thus "confirm" them over and over again. This tends to hinder new, innovative developments and unconventional ideas in psychoanalysis. Nevertheless, like many psychoanalysts today, we consider it important in the LAC Depression Study not to throw the child out with the bath water and to completely forego clinical-psychoanalytic dream research, because, despite all these difficulties, most of the most so far have been based on clinical-psychoanalytic research insights gained through psychoanalysis on unconscious fantasies and conflicts (cf. Leuzinger-Bohleber, 2010 a, b). Therefore tries u. a. the "Projectgroup for Clinical Observation" of the International Psychoanalytical Association to improve the quality of clinical-psychoanalytic research (see website of the International Psychoanalytical Association ).
One possibility to counter the dangers of clinical research just mentioned is the psychoanalytic expert validation, which was developed in the DPV catamnesis study and has since been used in various studies (cf. Leuzinger-Bohleber, Rüger, Stuhr & Beutel 2002; Leuzinger-Bohleber, Engels & Tsiantis 2008). It aims to avoid distortions in subjective perception, e.g. B. to be systematically identified and corrected by psychoanalytic experts in a group through unrecognized countertransference problems. As will be shown by way of example, this increases the quality of clinical-psychoanalytic research.
The starting point for the systematic clinical-psychoanalytic dream research within the framework of the LAC study are the weekly clinical conferences, in which the ongoing treatments are regularly presented and discussed in intervision groups. In addition, a clinical workshop takes place three times a year. In some cases, specific experts are invited. The detailed clinical observations are related to the conceptualizations as contained in the “Manual for Treating Chronic Depressed Patients” by David Taylor (cf. also Taylor 2010) and which were discussed in the initial training of the LAC therapists, and with their own Considerations connected. The insights gained in this “clinical-psychoanalytic research” are summarized by the therapists in systematic individual case studies and published after several “control steps”, which are defined in the method of psychoanalytic expert validation (cf. Westenberger-Breuer & Maccarrone Erhardt 2010; Sturmfels 2010; Leuzinger-Bohleber 2012). Since the colleagues at the clinical conferences know the current treatments well, their “expert knowledge” is used as a systematic aid in drafting case presentations and in understanding and writing down “narrative truths”. When selecting the focus of the case presentation, the clinical (lesson) material presented and the theoretical considerations, colleagues are involved and used as critical readers. To briefly characterize these “clinical truth-finding processes” here: The psychoanalytic peer group acts as a sensitive control of the communication of “narrative truth” in the case report: An author does not want to stand in front of colleagues in a peer group as someone who omits, glosses over or even falsifies problematic clinical material . The colleagues therefore become good, but also critical internal and external objects in the process of writing and thus to a certain extent guarantors of the “narrative truth” of the case reports.
In the publication mentioned, Fischmann, Leuzinger-Bohleber and Kaechele (2012) exemplarily illustrated how in the LAC study this clinical-psychoanalytic and extra-clinical-psychoanalytic dream research in the sleep laboratory is combined (p. 847ff.). It was surprising for the authors how well the clinical-psychoanalytical insights into the dream changes of the clinician (M. Leuzinger-Bohleber) coincided with the extra-clinical analyzes of dreams carried out by T. Fischmann - in their opinion a good possibility of one external validation of clinical-psychoanalytic research.

Comparison of therapy and laboratory rooms in the LAC depression study

A relatively small number of the chronically depressed patients in the LAC study were willing to examine their mostly seriously disturbed sleep behavior in the sleep laboratory. They were woken up during the REM dream phases and asked to share their dreams. In the morning they were also asked to share their dreams. These taped dreams were transcribed and analyzed using the dream coding model by Moser and von Zeppelin (1996). In this model, too, only the manifest dream contents are examined. However, the authors rely on an elaborate model of dream generation and therefore capture latent dream content, which they understand in some cases differently than in the “classical” dream theory. Briefly summarized in this model it is postulated that so-called dream complexes - activated by current events - process all information of unresolved conflicts and traumatic situations during the dream. The dream looks for a solution, or rather, for the best possible adaptation of these dream complexes. A dream, which is usually a pictorial event, consists of at least one situation that is brought about by a “dream organizer”. In this theoretical understanding, the dream organization is a bundle of affective-cognitive processes that creates a micro-world - the dream - and determines its actions at the same time. Within this system, the dream complex represents a template that enables the actual dream organization.

It is postulated that a dream complex comes from one or more such complexes that are stored in long-term memory. These complexes, in turn, are rooted in conflictual and / or traumatic experiences that we encounter again condensed in the form of introjects. They correspond to Freud's latent dream thought (see Latent dream content ). They are activated by external stimuli, which are structurally similar to the stored situations of the complexes and which urge a solution. The solution sought for these complexes is determined by the need for security and the desire to participate. Moser and von Zeppelin (1996). summarized these processes in the two principles “security” and “involvement”. They determine the dream organization.

Desires play a specific role within these complexes in that they combine ideas of one's self with those about others (self and object models) as well as with generalized interaction representations (RIG: representation interaction generalized, i.e. how the self imagines that togetherness in usually takes place) connect. Conflicting complexes are areas of bundled desires, RIGs and self and object models with a repetitive character, which are characterized by unbound affective information. Affects within such areas are linked by so-called k-lines, but at the same time blocked and therefore not localizable. In order to resolve these conflicting complexes, it is necessary to bring the affective information back into a relationship reality in order to make it tangible again. This is attempted in dreams, which have the function of finding a solution for the complex (cf. also Moser, 2013, Moser & Hortig, 2014, Hortig and Moser, 2012a, b).
Fischmann, Leuzinger-Bohleber u. Kaechele (2012, p. 840ff.) Were able to show that, by analyzing the manifest dream content of an analysand from the LAC depression study Laboratory Dreams with the help of an empirically validated method (Doell-Hentschker 2008), clinically relevant progress could be determined.
Thus, the comparison of the clinical dreams from the beginning of psychoanalysis with those from the 3rd year of the analysis showed systematic changes in the relationship patterns of the analysand. In the first dreams the dreamer was mostly alone: ​​nobody helped him to endure his fears, panic and despair. The dreamer's scope for action increases and the emotional spectrum increases (in the dreams from the beginning of the analysis we often only find panic - in the third year of the analysis we observe surprise, joy, satisfaction, humor, but also fear and pain).

The dream atmosphere also changes considerably with the increase in the variety of affects, but also in intensity and with the decrease in manifest fear. The increasing ability of the dreamer to perceive different and even contradicting emotions becomes more and more evident. New feelings of anger and anger as well as positive ones such as affection, tenderness and sexual attraction emerge at the end of the second year of treatment. The dream subject is no longer a (distant) observer, but takes an active part and is involved in intense emotional interactions with others.

In addition, in the third year of analysis, the dreams show clearer problem-solving strategies (more successful than unsuccessful problem-solving) and a wider range of different problem-solving strategies. The dream subject is no longer flooded - as is typical for traumatic situations where the dreamer experiences extreme helplessness and inability to act. In his dreams, at the end of his psychoanalysis, the analysand experiences helpful objects that are ready to support him. This is an important indicator of the changed inner world of objects in the extremely traumatized patient.

The correspondence of the clinical and extra-clinical analysis is remarkable, an aspect of great importance from a scientific perspective. However, the clinical case study offers more psychodynamically relevant clinical and structural information than the extra-clinical one, which is content with the manifest dream content and also has no further biographical data available with which the results of its analysis could be supported. On the other hand, the consistency of the findings consolidates the reliability of the clinical case analysis, which in turn underpins the method of the clinical case study.

Therefore, in today's psychoanalysis, we have a variety of methodological approaches in clinical and extraclinical dream research in psychoanalysis. This opens up new opportunities for psychoanalysis. As Fischmann, Leuzinger-Bohleber and Kächele (2012) outlined on the basis of an individual case from the ongoing LAC Depression Study, this study can, on the one hand, make a contribution to clinical-psychoanalytic dream research on the basis of differentiated individual case studies. On the other hand, thanks to developments in therapy research, as they u. a. at the University of Ulm (from the research group of Horst Kächele and Helmut Thomä), at the University of Zurich (from the research group of Ulrich Moser and Vera Hortig) and at the Sigmund Freud Institute, Frankfurt (research group: Marianne Leuzinger-Bohleber, Tamara Fischmann , Margerete Schött, Anna-Christine Schmidt, Jannis Pohl, Patrick Rachel, Teresa Pleitner formerly Stephan Hau), a number of sophisticated, extra-clinical examination methods for changing the manifest dream content during psychoanalysis are available. The research groups in Zurich and at the Sigmund Freud Institute are developing, in collaboration with S. Doell-Hentschker, training in the analysis of manifest dream contents.

Results obtained with such methods are also accepted by representatives of the non-psychoanalytical scientific world and therefore open new doors to the interdisciplinary dialogue between psychoanalysis and other sciences. We found the possibility of comparing dreams, as they were told in the clinical-psychoanalytic situation, to be particularly convincing with those that were reported by the analysands of the LAC Depression Study at the same time in the sleep laboratory (see also Fischmann, Russ and Leuzinger-Bohleber, 2013).

Combining clinical and extra-clinical dream research represents a major challenge for today's psychoanalysis. One of the strengths of clinical-psychoanalytic research is that it provides insights into the complex interaction of unconscious fantasies and conflicts in the development and persistence of psychopathological symptoms, such as z. B. chronic depression, can communicate narrative . If the narration is successful, laypeople can also be given an impression of what really happens in psychoanalytic treatment. It is well known that some findings can "only be told and not measured"

On the other hand, psychoanalysis, like any other scientific discipline, is now obliged to provide the public with evidence of the short-term and lasting effects of its treatments. This means that psychoanalytic treatments in designs that follow the criteria of evidence based medicine must also be checked, as is currently done in the LAC depression study.

Individual evidence

  1. ^ Hall, CS, & Van de Castle, RL The content analysis of dreams, 1966. Appleton-Century-Crofts, New York.
  2. ↑ Moser, U. & Zeppelin, I. v. (1996): The Dreamed Dream. Stuttgart (Kohlhammer)
  3. ↑ Freud, S. (1900a): The Interpretation of Dreams. GW 2/3.
  4. ↑ Leuzinger-Bohleber, M. (2010a): Psychoanalysis as a "science of the unconscious" in the first century of the IPA. International Psychoanalysis 18, special edition for the 100th anniversary of the IPV, 24-26.
  5. ↑ Fonagy, P., Kächele, H., Leuzinger-Bohleber, M. & Taylor, D. (eds.) (2012): The significance of dreams: Bridging clinical and extraclinical research in psychoanalysis. London (Karnac Books).
  6. ↑ Aserinsky, E. & Kleitman, N. (1955): Two types of ocular motility occuring in sleep. J App Physiol 8, 1-10.
  7. ↑ Hartmann, E. (1973): The biology of dreaming. Springfield (Thomas).
  8. ↑ Kaplan-Solms, K. & Solms, M. (2000): Neuro-Psychoanalysis. An introduction with case studies. Stuttgart (Klett-Cotta), 2003.
  9. ^ Ellman, S. & Weinstein, L. (2011): REM sleep, dreaming and the role of endogenous stimulation. Ann Psychoanal.
  10. ^ Solms, M. (2012): Hobson's protoconsciousness and Freud's primary process. Manuscript for the DGPT conference in Lindau, 2012.
  11. ↑ Fischmann, T., Leuzinger-Bohleber, M., Kaechele, H. (2012) Dream research in psychoanalysis: clinical studies, dream series, extra-clinical research in the laboratory. Psyche - Z Psychoanal 66: 833-861.
  12. ↑ Erikson, EH (1954): The dream pattern of psychoanalysis. Psyche - Z Psychoanal 8, 1955, 561-604.
  13. ↑ Schur, M. (1966): Some additional 'day residues' on the specimen dream of psychoanalysis. In: Loewenstein, RM (ed.): Psychoanalysis. A general psychology. New York (International Universities Press), 45-85.
  14. ↑ Thomä, H. (1987): Who was Freud's “Irma”? Notes on KR Eissler's “A Farewell to Freud's 'Interpretation of Dreams'”. Psyche - Z Psychoanal 41, 987-991.
  15. ↑ Peters, UH (1989): Irma - Emma - Martha - Anna. Some additional remarks on statements by KR Eissler and H. Thomä. Psyche - Z Psychoanal 43, 830-848.
  16. ↑ Alexander, FG (1925): About dream couples and dream series. Internal Z Psychoanal 11, 80-85.
  17. ^ French, TM (1952): The integration of behavior. Vol. I: Basic postulates: 1. Chicago (University of Chicago Press).
  18. ^ French, TM (1954): The integration of behavior. Vol. II: The integrative process in dreams. Chicago (University of Chicago Press).
  19. ^ French, TM (1958) The integration of behavior. Vol. III: The reintegrative process in a psychoanalytic treatment. Chicago (University of Chicago Press).
  20. ↑ Mitscherlich, A. (1947): From the origin of addiction. Collected writings, vol. 1. Frankfurt a. M. (Suhrkamp), 1983, 141-404.
  21. ↑ Enke, H., Ohlmeier, D. & Nast, J. (1968): A formal affect and relationship analysis in dream series of patients with psychosomatic illnesses. Z Psychosom Med Psychoanal 14, 15-33.
  22. ↑ Geist, WB & Kächele H. (1979): Two dream series in a psychoanalytic treatment. Yearb Psychoanal 11, 138-165.
  23. ↑ Leuzinger-Bohleber, M. (1987): Change in cognitive processes in psychoanalyses, Volume I: a hypothesis-generating individual case study. Ulm (PSZ).
  24. ↑ Leuzinger-Bohleber, M. (1989). Change of cognitive processes in psychoanalyses, Volume II. Five aggregated individual case studies. Ulm (PSZ).
  25. ↑ Kächele, H., Eberhardt, J. & Leuzinger-Bohleber, M. (1999): Expressed relationships, dream atmosphere & problem solving in Amalia's dreams - Dream series as process tool to investigate cognitive changes. A single case study. In: Kächele, H., Mergenthaler, E. & Krause, R. (Ed.) Psychoanalytic Process Research Strategies II. Ulm, http://www.horstkaechele.de/ english section.
  26. ↑ Leuschner, W. Hau, S. & Fischmann, T. (2000): The acoustic influenceability of dreams. Tübingen (Edition discord).
  27. ↑ Leuschner, W. (1986): Communication on an acoustic method of experimental dream excitation. Psyche - Z Psychoanal 40, 341-354.
  28. ^ Strauch, I. & Meier, B. (1992): On the trail of dreams. Results of experimental dream research. 2nd edition Bern / Göttingen / Toronto (Huber), 2004.
  29. ↑ Schredl, M. (1999): The nocturnal dream world. An introduction to psychological dream research. Stuttgart (Kohlhammer).
  30. ↑ Leuschner, W. & Hau, S. (Ed.) (1995): Dream and Memory. New results from psychological, psychoanalytic and neurophysiological research. Münster (LIT Verlag).
  31. ^ Fiss, H. (1995): The post-Freudian dream. A reconsideration of dream theory based on recent sleep laboratory findings. In: Leuschner, W. & Hau, S. (Ed.): Dream and memory. New results from psychological, psychoanalytic and neurophysiological research. Münster (LIT Verlag), 11-35.
  32. ↑ Jimenez, JP (2012): The manifest dream is the real dream: the changing relationship between theory and practice in the interpretation of dreams. In: Fonagy, P., Kächele, H., Leuzinger-Bohleber, M. & Taylor, D. (eds.): The significance of dreams: Bridging clinical and extraclinical research in psychoanalysis. London (Karnac Books), 31-48.
  33. ↑ Leuzinger-Bohleber, M. (2010b): Depression and Trauma. From the analysis with a chronically depressed person. In: Leuzinger-Bohleber, M., Röckerath, K. & Strauss, LV (eds.): Depression and neuroplasia. Psychoanalytic Clinic and Research. Frankfurt a. M. (Brandes & Apsel), 206-226.
  34. ↑ Leuzinger-Bohleber, M., Rüger, B., Stuhr, U. & Beutel, M. (2002): “Research and healing” in psychoanalysis. Results and reports from research and practice. Stuttgart (Kohlhammer).
  35. ↑ Leuzinger-Bohleber, M., Engels, EM & Tsiantis, J. (eds.) (2008): The Janus face of prenatal diagnostics: A European study bridging ethics, psychoanalysis, and medicine. London (Karnac Books).
  36. ↑ Taylor, D. (2010): The Tavistock Manual of Psychoanalytic Psychotherapy - With Special Consideration of Chronic Depression. Psyche - Z Psychoanal 64, 833-861
  37. ↑ Westenberger-Breuer, H. & Maccarrone Erhardt, R. (2010): "Above all, I want to have my peace and quiet ...". The depressive withdrawal. In: Leuzinger-Bohleber, M., Röckerath, K. & Strauss, LV (eds.): Depression and neuroplasticity. Psychoanalytic Clinic and Research. Frankfurt a. M. (Brandes & Apsel), 186-197.
  38. ↑ Sturmfels, Ch. (2010): Case Report on the Treatment of Depression. In: Leuzinger-Bohleber, M., Röckerath, K. & Strauss, V. (eds.): Depression and neuroplasticity. Psychoanalytic Clinic and Research. Frankfurt a. M. (Brandes & Apsel), 197-206.
  39. ↑ Leuzinger-Bohleber, M. (2012): Changes in dreams - from a psychoanalysis with a traumatised, chronic depressed patient. In: Fonagy, P., Kächele, H., Leuzinger-Bohleber, M. & Taylor, D. (eds.): The significance of dreams: Bridging clinical and extraclinical research in psychoanalysis. London (Karnac Books), 49-85.
  40. ↑ Moser, U. & Zeppelin, I. v. (1996): The Dreamed Dream. Stuttgart (Kohlhammer)
  41. ↑ Moser, U. (2013). What is a micro world? Psyche - Z Psychoanal, 67, 401-43
  42. ↑ Moser, U., & Hortig, V. (2014). Interactive relations in dreams: resonant and responsive interaction, shifting, verbalization and self-change. Psyche - Z Psychoanal, 4 (68), 336-362
  43. ^ Hortig, V., & Moser, U. (2012a). Transformations in the Analytical Microworld. Progress analysis using the example of a child analysis hour, (66), 121–144
  44. ^ Hortig, V., & Moser, U. (2012b). Interferences of neurotic processes and introjective relationship patterns in the dream. Psyche - Z Psychoanal, 66, 889-916
  45. ↑ Doell-Hentschker, S. (2008): The changes in dreams in psychoanalytic treatments. Affect theory, affect regulation and dream coding. Frankfurt a. M. (Brandes & Apple).
  46. ↑ Leuzinger-Bohleber, M., Bahrke, U., Beutel, M., Deserno, H., Edinger, J., Fiedler, G., ... & Will, A. (2010). Long-term psychoanalytic and cognitive-behavioral therapies for chronic depression: The LAC Depression Study. Psyche, 64 (9-10), 782-832.
  47. ↑ Döll-Hentschker, S. & Scheiber, J. (2013). Manual for dream coding according to Moser & von Zeppelin, unpublished manual. Frankfurt am Main
  48. ↑ Beutel, ME, Leuzinger-Bohleber, M., Rüger, B., Bahrke, U., Negele, A., Haselbacher, A., ... & Hautzinger, M. (2012). Psychoanalytic and cognitive-behavior therapy of chronic depression: study protocol for a randomized controlled trial. Trials, 13 (1), 117.
  49. ↑ Fischmann, T., Russ, M., Baehr, T., Stirn, A. & Leuzinger-Bohleber, M. (2012a): Changes in dreams of chronic depressed patients - the Frankfurt fMRI / EEG study (FRED). In: Fonagy, P., Kächele, H., Leuzinger-Bohleber, M. & Taylor, D. (eds.): The significance of dreams: Bridging clinical and extraclinical research in psychoanalysis. London (Karnac Books), 159-183.
  50. ↑ cf. u. a. Leuzinger-Bohleber 2012
  51. ↑ (see summary of the LAC study, Sigmund Freud Institute )