You are dreaming that a hippo is charging towards a lake, and you are caught between the two, about to be trampled to death with no avenue of escape. Then all of a sudden you realise this is just a dream, turn around and the hippo stops in its tracks, turning into a gently grazing horse.
This phenomenon is known as lucid dreaming: we are aware that we are in a dream and may have some control over its course. It has been thought to provide a link between reason and emotion, or even spirituality. Indeed it appears that in the perfect lucid dream, there is a harmony between reason and emotion, with conscious awareness in the background keeping a watch over, but not interfering too much, with the unfolding dreamlike action. At least 60 per cent of people have experienced lucid dreams sometime in their lives, but only around 20 per cent do so regularly—once a month or more.
Over recent years more precise scanning of neural electrical activity, combined with greater knowledge of brain structure and biochemistry, have fostered substantial progress in understanding the mechanisms of lucid dreaming. Significantly, it shares similar patterns of neurological activity not only with its two close relatives, near-death experience and out-of-body experience, but also with a range of psychotic conditions. These include schizophrenia, states of paranoia and the not uncommon depersonalisation disorder where sufferers feel they are observing their own actions from outside and often describe their waking life as like a continuous dreamlike state.
Of course, if we carry on dreaming lucidly while we are awake we are in trouble. But some sufferers from psychoses can be treated by being trained to dream lucidly and confront their demons while safely tucked up in bed: a possibility that has revived the long discredited Freudian idea of dream therapy. The difference this time round is that the dream will provide the focal point of the therapy rather than just a putative window into a patient's mental state and history.
Lucid dreams occur during REM (rapid eye movement) sleep, when, apart from the characteristic fluttering of the eyelids, our pulse quickens and sexual arousal is likely. REM is a state between deep sleep and consciousness, when the brain is disassociated from working memory and awareness is cut off from sensory perception. Lucid dreaming often develops from normal dreams in the REM state, when the person gains awareness of the fact that they are dreaming. When this happens, they can often undergo out of body experiences, such as a sensation of levitation.
According to John Allan Hobson, professor of psychiatry at Harvard University and a pioneer of REM sleep research, dreams become lucid when the dorsolateral prefrontal cortex, one of the main seats of working memory and consciousness, emerges from the deactivated state it is normally in when asleep, while sensory perception remains inactive. At this stage the sleeper can learn to edit and manipulate dreams, while still allowing them to run freely or "unconsciously" for periods. (Significantly, the action tends to take place in real time during lucid dreams, at the same rate as while awake, perhaps supporting the threat simulation theory.)
Pilot studies conducted thus far suggest that dream therapy can definitely help sufferers of delusions and hallucinations. One study in the Netherlands involving 23 nightmare sufferers during 2006 found that their bad dreams, whether they were triggered by traumatic experiences such as rape, or by psychiatric disorders, could be treated through training them to dream lucidly. Such training often uses various visual cues, like lights turned on periodically during sleep: whenever REM is detected, a light is flashed gently at the sleeper. It is also possible to "edit" dreams to have a happy ending, for example by saying out loud while you are awake what you want to happen in your dreams, or repeating a desire over in your head. Further studies are being carried out to explore the full potential of this.
In the case of some serious psychotic conditions, a similar state to lucid dreaming is also entered while awake, leading to disassociation between consciousness and sensory perception. The possibilities for treatment here lie in taking patients into a normal lucid dreaming state and training them to play out fears or psychoses there, in order to gradually amend or eradicate them. This area in particular is creating excitement among psychiatrists and neurobiologists alike—as well as adding new relevance to the wisdom expressed in the Coen brother's 1998 film The Big Lebowski: "If you will it, dude, it is no dream."
