My own experience (research, occupational and personal) has shown how the dreams of those with addictive behaviors are valuable resources of information about how the person is adapting to treatment and the recovery process. This is because dreams reflect the process of adaptation while the person moves from active addiction to a substance free life.

During this time, the person can be shown how to use their dreams to develop their own ability to interpret their psychological state. Sharing their dreams can help them to build relationships with others, for example in dream groups, and avoid the isolation that so often precedes a return to addictive behavior. The approach discussed below demystifies "dream work" so that the dreamer becomes their own expert, becoming increasingly aware of their own emerging ability to understand themselves. I suggest that dream work used in early treatment can have an empowering effect on the recovering substance misuser.

While many workers prefer to use the latent content of a dream, and metaphor, for interpretative purposes, the manifest content presents a good starting point. Working with dreams at this level is also useful because the manifest dream often mirrors current waking feelings and concerns. As part of the accepting that there is a substance problem the person often moves through various stages of acceptance, ambivalence and. It follows that their dreams will reflect where they are in this process.

Jeremy Taylor suggests that every dream, including the nightmare, comes in the service of the individual's change and growth. Thus any dream that is recalled, regardless of its emotional valence, is remembered because the information contained in the dream can help self development. I have found that people, especially women, admit to being able to express aspects of themselves that they feel particularly ashamed off through telling their dreams. This may be because they can minimize the impact of their shame as it "only occurred during a dream". Giving dreams cathartic value regarding motifs of shame, guilt, rage and other so called "negative" emotions, while allowing a fragile sense of self to maintain its integrity.

This paints a very different picture from traditional approaches to dreams and addictive behaviors. The common portrayal of the alcoholics dream is one where the dream is an indication of sickness - the alcoholic dreams of drinking alcohol, which represents imminent relapse.

There are some exception to this view. For example Shelly Marshal is open to the idea of 12 step work during dreams (i.e. Alcoholics anonymous programme). Likewise Wayne McEwing believes that as recovery progresses dream content reflects the spiritual changes happening within the person. However, these are American ideas and have yet to become firmly established in the United Kingdom in addiction treatment, in fact the idea that "using dreams" can come in the service of wholeness and spiritual growth is opposed by some researchers.

As my ideas are not (at present) based in "empirical research" so it is often hard to defend them with some academics.

The lesson that I have learnt is that sometimes the world of hard empirical evidence cannot be carried over into the world of clinical practice. Life isn't so black and white, there are lots of grey areas. I am a researcher but I accept, as a therapist, that all people are individual, and just because 7 out of 8 studies show that using dreams are associated with relapse, it doesn't mean that I can translate that into my working practice to set up a self-fulfilling prophecy for my clients.

I would prefer to create an environment where the client can talk about using dreams without fear of judgement, and then be given the support to work through any issues that the dream sharing allows to emerge which may well threaten sobriety.

There are other benefits from using dreams in the treatment of addictive behaviors. For example, one of the benefit will be the bonds made while sharing dreams in treatment groups Because dreams are a universal phenomenon, everyone has them at some point. Dreams are great levelers and help people to identify with each other. So dream sharing can help to develop social bonds, and subsequently, build group solidarity and trust; both important aspects of the formal addiction treatment process.

I suggest that as soon as the person enters treatment, they should be encouraged to keep a dream diary alongside their recording of other important daily events. These dreams can be shared in therapy sessions. The main benefit of this approach will be that during the time they are in treatment, the client will be able see their dream content change. Even over a few months some pretty dramatic differences in the themes and feelings which accompany dreams can be observed. These changes often delight the dreamer and instil a sense of self understanding which increases self confidence, and "psychological mindedness."

In my own research I have compared the dreams of people with an addictive behavior with those who have not. This type of study shows that the type of dreams experienced by people with addictive behaviors are very different emotionally to a control group. Abstinent alcoholic's dreams contained higher levels of unpleasant emotion, more self hate, more cognitive activity and were generally much more unpleasant. However, there was a marked gender differences between male and female abstinent alcoholics. Females were far more prone to unpleasant dream emotion than their male counterparts, and more anxious about the behavior of other dream characters.

Male abstinent alcoholics tended to be less interested in the events occurring around them in the dream and more preoccupied with their own activities.

Abstinent women also reported more physical aggression towards other women. Indicating obvious issues with women in their lives (usually family members), or, an alternative interpretation is that there are conflicts with their own femininity. However, such group comparisons only provides general descriptions, or averages, and should be treated cautiously when making generalized statements.

The second type of experience I want to share with you is dream telling on a more personal level.

The following examples show how manifest dream content can be used to assist the therapeutic process. I have included 3 dreams; one "death using self" dream, one "ambivalent" dream, and one "impactful" dream, which were shared with me by people who awoke during the night in early recovery whilst in treatment. Woken by the intensity of their dreams and deeply disturbed by their content they talked to me, and opened up, telling what their dreams revealed to them.

An abstinent client told a very disturbing dream where she dreamt that she was looking in at herself hanging dead in a toilet, wearing her night-clothes. The emotional atmosphere in the dream was one of intense sadness. When she awoke this woman was very distressed. Using probes to amplify various aspects of the dream (e.g. how did the dream's setting relate to her use of drugs), it transpired that she always used drugs at home in her toilet. The dreamer was dead, in clothes she associated with using drugs, in the room where she administered her drugs. In the dream she was aware of looking in at this scene. It was suggested to her that the dream addressed the death of her addictive self. After some time she admitted feeling afraid of the future. I asked her to take her feelings of sadness and fear into her group work, where she could begin to address her grief about the loss of her old (albeit unhealthy) self image as an "addict"(sic), and face the void she felt in front of her without her old identity.

Ambivalent attitudes towards becoming substance free can also be observed in dream content.

In the following dream, recalled during early treatment, the dreamer was in an enclosure with other members of his treatment group. Outside the enclosure walking around the perimeter fences were the person's old dealer and some using friends who were trying to get in. To the dreamer it felt that those outside the fence were free and it was him that was trapped. The person admitted to feeling the urge to join their friends, and could not understand why they wanted to get inside the fence. He awoke feeling extremely scared. This dream shows how it is possible to project onto other dream characters the dreamers struggle and confusion at what was occurring in their life, as they attempt to become clean and lead a life without drugs.

During waking therapy these are all real issues which need to be addressed before healthier life choices can be made. However, as is often apparent, change is never easy, so this dream allowed the dreamer to voice some of his misgivings about giving up drugs and thereby addressing his own ambivalence.

Then of course there are "using dreams", where the person is actively drunk or stoned. These dreams are often accompanied by motifs of guilt, shame and fear. Sometimes these dreams are so vivid and realistic that the person awakens unsure of whether they have actually relapsed or not.

These dreams are often interpreted by the individual as an indication of potential relapse. However, I believe that the "using dream" has many meanings.

One of which may be that the individual wants to use drugs, but this is not written in stone, or a concrete predictor, that this will happen. What may determine "outcome" may be how the dreamer acts upon the dream. It may well be that even the dreaded using dream come in the service of continued abstinence. Instead of seeing things as black and white perhaps we should encourage the dreamer to use dreams as a vehicle to self development. They may be both a sign of health and distress. Rather than something to be feared these dreams should be embraced and shared with other group members, therapists, and sponsors, so they can be used to identify weaknesses and strengths in the person's search for sobriety. Treatment often works to free the client from shame and guilt around using. Such dreams are a good place to start looking at these issues.

The last dream shows how dreams can positively influence recovery. It comes from a women who's dreams formed a crucial turning point in her attempts to seek help for her addictive behaviors. She described the dream as follows:

"We (Me, my brother- also a drug user- and our dealer) had to get to the top of this mountain. There was the most beautiful full moon. The moon started to move and come towards us. It got bigger and bigger. I could see it and it was blue, covered in silk powder and I was dangling off the top of the mountain trying to touch it. They said I would fall if I wasn't careful but I remember thinking "If I miss touching the moon as it whizzes by then it doesn't matter because I might as well be dead." It was that important - like my life depended upon it. As it whizzed by I leaned right over and I touched it I was covered in this blue sparkly stuff. I had it all over me, on my neck, hands and I rubbed it all over my body. The other two didn't touch it. When I woke up I felt like I had been through something quite major, like my spirit had been cleansed. I had been healed. I was then that the changes in my life began to happen."

This dream shows that it is not just unpleasant dreams that are memorable, psychological health can also be observed through dream content. This dream was perceived by her as an integral part of her healing process. Listening to this moving dream, this woman's motivation and commitment to her recovery became obviously apparent. As a matter of interest, all three "dreamers" who so trustfully disclosed their dreams to me*, are still substance free some 2 years later, and at least 2 of them still actively use their dreams.

In closing, the examples used here show how dream content can be used to describe substance mis-users dreams in general and explore emerging psychological themes in early recovery from substance misuse. I have suggested that both group and individual analysis is useful. Through dreams it is possible to educate the client regarding their own psychology and if they continue to observe their dreams they can use them as indicators of the psychological well being throughout their recovery. They may even wish to set up their own continuing dream groups, post treatment and learn how to play and learn about themselves in the wonderful world of dreams.

* Consent was given by all the dreamers to included their dreams in this article. My thanks to them and I acknowledge their continued courage.

Useful reading:

Shelly Marshall (1995). Your dream of Recovery: Dream Interpretation and the 12 Steps. Virginia Beach: ARE Press.

Wayne McEwing (1991) Dreams and Recovery. Dream Network Journal, Vol.10(4).

Jeremy Taylor (1992).Where people fly and Water Runs Uphill. New York: Warner Books.