Body Schema Self-Awareness and Related Dream Content Modifications in Amputees Due to Cancer

Purpose: the evaluation of body image perception, pain coping strategies, and dream content, together with phantom limb and telescoping phenomena in patients with sarcoma who underwent surgery for limb amputation. Material and Methods: consecutive outpatients were evaluated at T0 (within 3 weeks after surgery) and T1 (4–6 months after surgery) as follows: demographic and clinical data collection; the Groningen Questionnaire Problems after Arm Amputation; the West Haven-Yale Multidimensional Pain Inventory; the Body Image Concern Inventory, a clinical trial to identify telescoping; and a weekly diary of dreams. Dream contents were coded according to the Hall and Van de Castle coding system. Results: Twenty patients completed the study (15 males and 5 females, mean age: 53.9 ± 24.6, education: 7.8 ± 3.4). All subjects experienced phantom limb and 35% of them experienced telescoping soon after surgery, and 25% still after 4–6 months. Both at T0 and T1, that half of the subjects reported dreams about still having their missing limbs. At T1 the patients’ perceptions of being able to deal with problems were lower, and pain and its interference in everyday life were higher yet associated with significant engagement in everyday activities and an overall good mood. The dream content analysis highlighted that males were less worried about health problems soon after amputation, and women showed more initial difficulties that seemed to be resolved after 4–6 months after surgery. Conclusions: The dream content analysis may improve clinicians’ ability to support their patients during their therapeutic course.

Note on the Relevance of Dreams for Evolutionary Psychology

In the past in evolutionary psychology both dream theory and content have been largely ignored. Recently exploration of Freudian and Jungian ideas has begun, making a more extensive examination of dreaming desirable. Further, dream content analysis can provide data for testing evolutionary hypotheses concerning behavior.

Dream Content Analysis of Male Schizoprhenic Patients

This study explored two hypotheses — that the dream report content of groups are different from each other; and that with significant psychological change in a group there will be significant alteration in their dream report content. This study supported the first hypothesis — different groups do indeed have different dream report content (male paranoid schizophrenics compared to male college students); but did not support the second hypothesis — that with significant psychological change, dream report content altered (male paranoid schizophrenics before treatment and after improvement). The failure to support the second hypothesis may be related to the small number of content items compared and to the psychological states of the patients not being sufficiently different. It was possible to extract from the dream reports some areas of concern for the male paranoid schizophrenic patient, which suggested an avoidance of and a withdrawal from bodily concerns and interpersonal relationships. If there are before and after differences in dream report content they may be mostly related to the increase of active activities relative to passive ones following improvement and to a decrease in negative statements in the dream reports.