Stations Along the Via Dolorosa Towards Good-Enough Endings.

This article focuses on the prevailing aspiration to reach a "good-enough ending" in analysis, a concept that is partly realistic and partly illusional. I discuss some of the obstacles that interfere with achieving this yearned for goal, and lead to endings that are far from the misleading illusion of the good-enough termination, that many of us believe we have achieved and are many more than it is commonly reported. I describe characteristics, obstacles, blockages, dreads within the analysand, within the analyst and in the space in between, which lead to endings which are far from good enough, by any criteria we might choose. These obstacles include the failure to distinguish between "real" versus "similar to"; emotional excess; emptying out of internal resources and toxemia of therapy/analysis; a fascination with certain levels of mind versus a neglect of others; osmotic pressure for oneness and the terror of perfection; and malignant nostalgia. Reflecting on such complex facets in the analytic process is relevant not only for a deeper understanding of illusions that we and our analysands hold with regard to endings, but also, implicitly, to the understanding of illusions, beliefs, and myths we and our patients have regarding beginnings.

Social media-related nightmare - a potential explanation for poor sleep quality and low affective well-being in the social media era?

Research has posited that social media use during the day may be reflected in nighttime dreams. Nevertheless, no prior studies have explored frightening, unpleasant dreams arising from social media use. This study introduces the construct of the social media-related nightmare by (a) developing and validating a scale capturing negative-valenced dreams with themes of helplessness, loss of control, inhibition, victimization, and making mistakes in social media, and (b) examining relationships between social media use, social media-related nightmares, sleep quality, and affective well-being. A convenience sample of 595 Iranian adult social media users (Mage = 27.45, SDage = 11.42) reported on social media-related nightmare, social media use integration, anxiety, peace of mind, sleep quality, and nightmare distress. The Social Media-Related Nightmare Scale (SMNS) demonstrated a unidimensional structure with sound psychometric properties. The most common nightmares involved the inability to log in to social media and the disruption of relationships with other users. Social media use intensity predicted frequency of social media-related nightmares. These nightmares were correlated with increased anxiety, lower peace of mind, poor sleep quality, and nightmare distress. Importantly, social media-related nightmares mediated the relationship between social media use intensity and low affective well-being (i.e., anxiety and peace of mind), poor sleeping, and nightmare distress. The findings suggest that social media-related nightmares could be a potential pathway through which social media engagement may lead to affective distress and sleep difficulties.

Dreaming in patients with cancer and their partners-an underestimated factor for quality of life?

Sleep disorders are prevalent among patients with cancer and their caregivers as well, affecting their quality of life. But the relationship between sleep quality, dream experiences, and life satisfaction in patients with cancer and their partners is understudied. The present research aimed to quantitatively investigate the dream experiences of oncology patients and explore the interdependence between patients and their partners in terms of dream experiences and life satisfaction. Therefore, a cross-sectional study was conducted with 101 dyads, completing a questionnaire assessing demographic and illness-related data, dream experiences, sleep quality, and life satisfaction. Inferential statistical tests and actor-partner interdependence models were used to analyse the data. Both patients with cancer and their partners reported on average a significant decrease in sleep quality since the cancer diagnosis and for both dyad members significant dreaming predictors for life satisfaction were found. Namely, a positive association for dream stability in patients, and a positive association for positive dream affect as well as a negative association for negative dream affect in partners. Regarding the question of interdependence, dream intensity exhibited a significant group-specific partner effect, but no overall partner effect, leading to inconclusive results that call for more studies in this field. The study suggests that dreaming may affect life satisfaction beyond sleep quality and underscores the significance of acknowledging dream experiences as potential influencers of quality of life in patients with cancer. Additionally, the study stands out for its examination of the role of partners in dyadic dependency, emphasising the importance of understanding their influence on patients' experiences.

Recurring memory reactivation: The offline component of learning.

One can be aware of the effort needed to memorize a new fact or to recall the name of a new acquaintance. Because of experiences like this, learning can seem to have only two components, encoding information and, after some delay, retrieving information. To the contrary, learning entails additional, intervening steps that sometimes are hidden from the learner. For firmly acquiring fact and event knowledge in particular, learners are generally not cognizant of the necessity of offline consolidation. The memories that persist to be available reliably at a later time, according to the present conceptualization, are the ones we repeatedly rehearse and integrate with other knowledge, whether we do this intentionally or unknowingly, awake or asleep. This article examines the notion that learning is not a function of waking brain activity alone. What happens in the brain while we sleep also impacts memory storage, and consequently is a critical component of learning. The idea that memories can change over time and become enduring has long been present in memory research and is foundational for the concept of memory consolidation. Nevertheless, the notion that memory consolidation happens during sleep faced much resistance before eventually being firmly established. Research is still needed to elucidate the operation and repercussions of repeated reactivation during sleep. Comprehensively understanding how offline memory reactivation contributes to learning is vital for both theoretical and practical considerations.

Influencing dreams through sensory stimulation: A systematic review.

Sleep is typically considered a state of disconnection from the environment, yet instances of external sensory stimuli influencing dreams have been reported for centuries. Explaining this phenomenon could provide valuable insight into dreams' generative and functional mechanisms, the factors that promote sleep continuity, and the processes that underlie conscious awareness. Moreover, harnessing sensory stimuli for dream engineering could benefit individuals suffering from dream-related alterations. This PRISMA-compliant systematic review assessed the current evidence concerning the influence of sensory stimulation on sleep mentation. We included 51 publications, of which 21 focused on auditory stimulation, ten on somatosensory stimulation, eight on olfactory stimulation, four on visual stimulation, two on vestibular stimulation, and one on multimodal stimulation. Furthermore, nine references explored conditioned associative stimulation: six focused on targeted memory reactivation protocols and three on targeted lucid reactivation protocols. The reported frequency of stimulus-dependent dream changes across studies ranged from 0 to ∼80%, likely reflecting a considerable heterogeneity of definitions and methodological approaches. Our findings highlight a lack of comprehensive understanding of the mechanisms, functions, and neurophysiological correlates of stimulus-dependent dream changes. We suggest that a paradigm shift is required for meaningful progress in this field.

Viral simulations in dreams: The effect of the COVID-19 pandemic on threatening dream content in a Finnish sample of diary dreams.

Previous research indicates that the COVID-19 pandemic has affected dreaming negatively. We compared 1132 dreams collected with prospective two-week dream diary during the pandemic to 166 dreams collected before the pandemic. We hypothesized that the pandemic would increase the number of threatening events, threats related to diseases, and the severity of threats. We also hypothesized that dreams that include direct references to the pandemic will include more threatening events, more disease-related threats, and more severe threats. In contradiction with our hypotheses, results showed no differences between pandemic and pre-pandemic samples in the number of threats, threats related to diseases, or severe threats. However, dreams with direct references to the pandemic had more threats, disease-related threats, and severe threats. Our results thus do not suggest a significant overall increase in nightmarish or threatening dream content during the pandemic but show a more profound effect on a minority of dreams.

Trends in waking salivary alpha-amylase levels following healing lucid dreams.

Introduction: Salivary alpha-amylase (sAA) is considered a marker of autonomic nervous system activity in stress research, and atypical waking sAA responses have been reported for traumatized individuals. Lucid dreams, characterized by a dreamer's awareness of their dream state while remaining asleep, have shown promising preliminary evidence of their potential to enhance mental health. This study's objective was to evaluate sAA in relation to healing lucid dreams. Methods: Participants experiencing PTSD symptoms attended a six-day workshop delivered via live video designed to teach techniques for transforming trauma through dreamwork and dream lucidity. Participants (n = 20) collected saliva samples each morning, immediately upon awakening (Time 1) and 30 min afterward (Time 2). sAA levels were determined by enzymatic assay, and the waking sAA slope was calculated as the difference of Time 2 minus Time 1. Participants completed dream reports each morning, with a dream classified as a 'healing lucid dream' when they reported attaining lucidity and remembered their intention to manifest a healing experience within the dreamscape. Results: Of eight participants experiencing healing lucid dreams, four were able to provide usable saliva samples. Statistical tests on these four participants were not significant because of low power. However, nonsignificant positive associations were observed between experiencing more healing lucid dreams and increased waking sAA slope. Conclusion: The results did not reveal a consistent effect of healing lucid dreams on waking sAA slope. Identifying meaningful patterns in this relationship will require larger samples and more stringent control over saliva collection procedures in future studies.

Dreaming during gastrointestinal endoscopy under propofol, ciprofol, or remimazolam anesthesia: study protocol for a parallel-design double-blind, single-center trial.

BACKGROUND: Dreaming sometimes occurs during sedation. It has been reported that factors such as different anesthetics, depth of anesthesia, age, sex, and preoperative psychological state may affect dreams. Ciprofol and remimazolam are novel choices for painless endoscopy. Herein, we aimed to investigate dreaming during gastrointestinal endoscopy under propofol, ciprofol, and remimazolam anesthesia respectively. METHODS: This is a prospective, parallel-design double-blind, single-center clinical trial. Three hundred and sixty subjects undergoing elective painless gastroscopy, colonoscopy, or gastroenteroscopy will be enrolled. Eligible subjects will undergo propofol-, ciprofol-, or remimazolam-induced anesthesia to finish the examination. Interviews about the modified Brice questionnaire will be conducted in the recovery room. Incidence of dreaming is set as the primary outcome. Secondary outcomes include type of dreams, improvement of sleep quality, evaluation of patients, incidence of insufficient anesthesia, and intraoperative awareness. Safety outcomes are the incidences of hypotension and hypoxia during examination and adverse events during recovery. DISCUSSION: This study may observe different incidences of dreaming and diverse types of dreams, which might lead to different evaluations to the anesthesia procedure. Based on the coming results, anesthesiologists can make a better medication plan for patients who are going to undergo painless diagnosis and treatment. TRIAL REGISTRATION: This trial was registered at the Chinese Clinical Trial Registry on May 18, 2023 (registration number ChiCTR2300071565).

Alexithymia and aspects of dreaming: Differential associations of alexithymia facets with dream variables.

Research on aspects of dreaming associated with alexithymia has yielded mixed results. The present study recruited a young adult online sample of 577 participants who completed validated indices of alexithymia, emotion suppression, negative moods, and eight aspects of dreaming, with a focus on evaluating a counterintuitive previous finding that alexithymia and two of its core facets were associated with greater self-reported typical emotional intensity of dreams. Total alexithymia and facet scores showed differential relationships to aspects of dreaming including dream recall frequency, emotionality, meaningfulness, nightmare frequency, nightmare distress, usefulness of dreams in problem-solving and creativity, and learning about oneself through dreams. Planned hierarchical regression controlling for demographics, alcohol use, and dream recall frequency indicated that the difficulties identifying feelings (DIF) facet of alexithymia was a significant positive predictor of dream emotionality, whereas the externally oriented thinking (EOT) facet was a significant negative predictor. Stress, but not emotion suppression, mediated the positive relationship between DIF and dream emotionality. The likely role of dream emotionality in higher ratings of nightmare distress, dream meaningfulness, and learning about oneself through dreams among those with higher DIF scores is noted, along with other findings and the strengths and limitations of the study.

Acetylcholine and metacognition during sleep.

Acetylcholine is a neurotransmitter and neuromodulator involved in a variety of cognitive functions. Additionally, acetylcholine is involved in the regulation of REM sleep: cholinergic neurons in the brainstem and basal forebrain project to and innervate wide areas of the cerebral cortex, and reciprocally interact with other neuromodulatory systems, to produce the sleep-wake cycle and different sleep stages. Consciousness and cognition vary considerably across and within sleep stages, with metacognitive capacity being strikingly reduced even during aesthetically and emotionally rich dream experiences. A notable exception is the phenomenon of lucid dreaming-a rare state whereby waking levels of metacognitive awareness are restored during sleep-resulting in individuals becoming aware of the fact that they are dreaming. The role of neurotransmitters in these fluctuations of consciousness and cognition during sleep is still poorly understood. While recent studies using acetylcholinesterase inhibitors suggest a potential role of acetylcholine in the occurrence of lucid dreaming, the underlying mechanisms by which this effect is produced remains un-modelled and unknown; with the causal link between cholinergic mechanisms and upstream psychological states being complex and elusive. Several theories and approaches targeting the association between acetylcholine and metacognition during wakefulness and sleep are highlighted in this review, moving through microscopic, mesoscopic and macroscopic levels of analysis to detail this phenomenon at several organisational scales. Several exploratory hypotheses will be developed to guide future research towards fully articulating how metacognition is affected by activity at the acetylcholine receptor.

Reduced REM and N2 sleep, and lower dream intensity predict increased mind-wandering.

Mind-wandering is a mental state in which attention shifts from the present environment or current task to internally driven, self-referent mental content. Homeostatic sleep pressure seems to facilitate mind-wandering as indicated by studies observing links between increased mind-wandering and impaired sleep. Nevertheless, previous studies mostly relied on cross-sectional measurements and self-reports. We aimed to combine the accuracy of objective sleep measures with the use of self-reports in a naturalistic setting in order to examine if objective sleep parameters predict the tendency for increased mind-wandering on the following day. We used mobile sleep electroencephalographic (EEG) headbands and self-report scales over 7 consecutive nights in a group of 67 healthy participants yielding ~400 analyzable nights. Nights with more wakefulness and shorter REM and slow wave sleep were associated with poorer subjective sleep quality at the intraindividual level. Reduced REM and N2 sleep, as well as less intense dream experiences, predicted more mind-wandering the following day. Our micro-longitudinal study indicates that intraindividual fluctuations in the duration of specific sleep stages predict the perception of sleep quality as assessed in the morning, as well as the intensity of daytime mind-wandering the following hours. The combined application of sleep EEG assessments and self-reports over repeated assessments provides new insights into the subtle intraindividual, night-to-day associations between nighttime sleep and the next day's subjective experiences.

Longitudinal Study of Early Adversity and Disturbing Dream Frequency: Moderating Role of Early Negative Emotionality.

Although disturbing dreams are prevalent in youth and are associated with psychopathology, little is known about their developmental course and risk factors. We aimed to examine the association between early social environment and subsequent disturbing dream frequency across adolescence as moderated by early negative emotionality. Measures of children's early social environment and negative emotionality were collected from the mothers of 410 children (5-42 months old) and measures of disturbing dream frequency directly from the children (13-18 years old). Preliminary steps identified subgroups of families with distinct profiles of social environment using latent variable mixture modeling, and captured changes in disturbing dream frequency using latent growth modeling. Regression and moderation analyses were conducted to test the study objectives. Results showed that the diverse family patterns were best captured by two profiles reflecting adverse and positive social environments and that overall disturbing dream frequency decreased during adolescence. Moderation analyses showed that when early negative emotionality was higher, DD frequency was not only more elevated in an adverse environment, but lower in a positive environment. These results indicate that the development of disturbing dreams is most strongly associated with a combination of individual and environment factors. Our study adds to the literature by refining our conception of individual traits and disturbing dream development and has implications for the prevention of bad dreams, nightmares, and associated psychopathologies.

Altered parasympathetic activity during sleep and emotionally arousing wakefulness in frequent nightmare recallers.

Nightmare disorder is characterized by dysfunctional emotion regulation and poor subjective sleep quality reflected in pathophysiological features such as abnormal arousal processes and sympathetic influences. Dysfunctional parasympathetic regulation, especially before and during rapid eye movement (REM) phases, is assumed to alter heart rate (HR) and its variability (HRV) of frequent nightmare recallers (NM). We hypothesized that cardiac variability is attenuated in NMs as opposed to healthy controls (CTL) during sleep, pre-sleep wakefulness and under an emotion-evoking picture-rating task. Based on the polysomnographic recordings of 24 NM and 30 CTL participants, we examined HRV during pre-REM, REM, post-REM and slow wave sleep, separately. Additionally, electrocardiographic recordings of resting state before sleep onset and under an emotionally challenging picture-rating task were also analyzed. Applying repeated measures analysis of variance (rmANOVA), a significant difference was found in the HR of NMs and CTLs during nocturnal segments but not during resting wakefulness, suggesting autonomic dysregulation, specifically during sleep in NMs. As opposed to the HR, the HRV values were not significantly different in the rmANOVA in the two groups, implying that the extent of parasympathetic dysregulation on a trait level might depend on the severeness of dysphoric dreaming. Nonetheless, in the group comparisons, the NM group showed increased HR and reduced HRV during the emotion-evoking picture-rating task, which aimed to model the nightmare experience in the daytime, indicating disrupted emotion regulation in NMs under acute distress. In conclusion, trait-like autonomic changes during sleep and state-like autonomic responses to emotion-evoking pictures indicate parasympathetic dysregulation in NMs.

Learning beyond sensations: How dreams organize neuronal representations.

Semantic representations in higher sensory cortices form the basis for robust, yet flexible behavior. These representations are acquired over the course of development in an unsupervised fashion and continuously maintained over an organism's lifespan. Predictive processing theories propose that these representations emerge from predicting or reconstructing sensory inputs. However, brains are known to generate virtual experiences, such as during imagination and dreaming, that go beyond previously experienced inputs. Here, we suggest that virtual experiences may be just as relevant as actual sensory inputs in shaping cortical representations. In particular, we discuss two complementary learning principles that organize representations through the generation of virtual experiences. First, "adversarial dreaming" proposes that creative dreams support a cortical implementation of adversarial learning in which feedback and feedforward pathways engage in a productive game of trying to fool each other. Second, "contrastive dreaming" proposes that the invariance of neuronal representations to irrelevant factors of variation is acquired by trying to map similar virtual experiences together via a contrastive learning process. These principles are compatible with known cortical structure and dynamics and the phenomenology of sleep thus providing promising directions to explain cortical learning beyond the classical predictive processing paradigm.

The neurocognition of dreaming: key questions and foci.

Until recently, understanding the neurobiology of dreaming has relied upon on correlating a subjective dream report with a measure of brain activity or function sampled from a different occasion. As such, most assumptions about dreaming come from the neuroscience of rapid eye-movement (REM) sleep from which many, but not all, dream reports are recalled. Core features of REM sleep (intense emotional activation, a reduction in activity in most frontal regions, particularly the dorsolateral prefrontal cortex, along with increased dopamine, acetylcholine, cholinergic activation) align with typical dream characteristics (characterised by fear, reduced reality monitoring, increased bizarreness and hyperassociativity, respectively). The default mode network offers a way of understanding the nature of dreaming more independently from a REM sleep context, and electroencephalography methods paired with serial awakenings to elicit dream reports demonstrate how high-frequency activity in posterior regions may be associated with dreaming. Nevertheless, all measures of dreaming rely fundamentally on recall processes, so our understanding of dreaming must embrace and address memory's crucial involvement in dream report production.

What is sleep exactly? Global and local modulations of sleep oscillations all around the clock.

Wakefulness, non-rapid eye-movement (NREM) and rapid eye-movement (REM) sleep differ from each other along three dimensions: behavioral, phenomenological, physiological. Although these dimensions often fluctuate in step, they can also dissociate. The current paradigm that views sleep as made of global NREM and REM states fail to account for these dissociations. This conundrum can be dissolved by stressing the existence and significance of the local regulation of sleep. We will review the evidence in animals and humans, healthy and pathological brains, showing different forms of local sleep and the consequences on behavior, cognition, and subjective experience. Altogether, we argue that the notion of local sleep provides a unified account for a host of phenomena: dreaming in REM and NREM sleep, NREM and REM parasomnias, intrasleep responsiveness, inattention and mind wandering in wakefulness. Yet, the physiological origins of local sleep or its putative functions remain unclear. Exploring further local sleep could provide a unique and novel perspective on how and why we sleep.

Conscious entry into sleep: Yoga Nidra and accessing subtler states of consciousness.

Human sleep is a dynamic and complex process comprising sleep stages with REM and NREM sleep characteristics that come in cycles. During sleep, there is a loss of responsiveness or a perceptual loss of conscious awareness with increasing thresholds for wakefulness as sleep progresses. There are brief bursts of wakefulness or Wake After Sleep Onset (WASO) throughout a nocturnal sleep. Conscious experience during nocturnal sleep is known to occur during lucid dreaming when one is aware during dreams when the dream is occurring. Most cultures have known lucid dreaming since antiquity. However, conscious experience during dreamless sleep is relatively lesser known. Nevertheless, selected Indo-Tibetan meditation literature has documented it since antiquity. Minimal Phenomenal Experience (MPE) research describes lucid dreamless sleep as its target phenomenology. "Conscious entry into sleep" posits tonic alertness is maintained post sleep onset through the sleep stages for sustained durations of time until an eventual loss of conscious awareness. Entering sleep consciously and being aware during dreamless sleep, including Slow Wave Activity, is plausibly to be in the state of "Yoga Nidra" or Yogic sleep. An attentive sleepful state provides access to subtler states of consciousness and significantly deepens the levels of silence. It is phenomenologically distinct from hypnagogic hallucinations and lucid dreaming. Unfortunately, sleep studies validating this phenomenology are yet to be done. Therefore, an experimental methodology akin to those used in lucid dreaming experiments is described.

Affect Across the Wake-Sleep Cycle.

Affective scientists traditionally have focused on periods of active wakefulness when people are responding to external stimuli or engaging in specific tasks. However, we live much of our lives immersed in experiences not related to the current environment or tasks at hand-mind-wandering (or daydreaming) during wakefulness and dreaming during sleep. Despite being disconnected from the immediate environment, our brains still generate affect during such periods. Yet, research on stimulus-independent affect has remained largely separate from affective science. Here, we suggest that one key future direction for affective science will be to expand our field of view by integrating the wealth of findings from research on mind-wandering, sleep, and dreaming to provide a more comprehensive account of affect across the wake-sleep cycle. In developing our argument, we address two key issues: affect variation across the wake-sleep cycle, and the benefits of expanding the study of affect across the full wake-sleep cycle. In considering these issues, we highlight the methodological and clinical implications for affective science.

The Ponto-Geniculo-Occipital (PGO) Waves in Dreaming: An Overview.

Rapid eye movement (REM) sleep is the main sleep correlate of dreaming. Ponto-geniculo-occipital (PGO) waves are a signature of REM sleep. They represent the physiological mechanism of REM sleep that specifically limits the processing of external information. PGO waves look just like a message sent from the pons to the lateral geniculate nucleus of the visual thalamus, the occipital cortex, and other areas of the brain. The dedicated visual pathway of PGO waves can be interpreted by the brain as visual information, leading to the visual hallucinosis of dreams. PGO waves are considered to be both a reflection of REM sleep brain activity and causal to dreams due to their stimulation of the cortex. In this review, we summarize the role of PGO waves in potential neural circuits of two major theories, i.e., (1) dreams are generated by the activation of neural activity in the brainstem; (2) PGO waves signaling to the cortex. In addition, the potential physiological functions during REM sleep dreams, such as memory consolidation, unlearning, and brain development and plasticity and mood regulation, are discussed. It is hoped that our review will support and encourage research into the phenomenon of human PGO waves and their possible functions in dreaming.