ONIROLOGUES


Ernest HARTMANN

 

 

 

Dr. Ernest Hartmann, researched sleep, the nature of dreaming; died at 79

 

Décès d'Ernest Hartmann, à l'âge de 79 ans

Le spécialiste de l'étude des cauchemars

 

By Bryan Marquard

http://www.bostonglobe.com

 

Boston Globe - 25/8/2013 - Though Ernest Hartmann didn’t know “The Nature and Functions of Dreaming” would be the last book he published in his lifetime, there was almost a valedictory feel to the way he addressed readers in it.

“I have been fascinated by dreams for many years (for almost my entire life in fact); my own dreams, my patients’ dreams, and the biology and psychology of dreaming,” he began the first chapter.

An internationally known researcher, Dr. Hartmann wrote and thought as much or more about dreams than anyone else in the past half century. He explored the sleep cycle and how medications affect it. He also delved deeply into nightmares and used dreams to study a variety of boundaries in each person’s life, including the sometimes thin borders among waking, daydreaming, and sleeping.

The remains of today and days past, all the faces and places encountered along the way, can join hands in the minds of dreamers, he believed. “First of all, dreaming connects,” he wrote in a 1996 scientific paper. He added that “even those who believe dreaming throws things together in a more or less random fashion must admit that a dream image somehow connects material in our memories, imaginations.”

Dr. Hartmann, who directed the Sleep Disorders Center at Newton-Wellesley Hospital and was the first editor of the journal Dreaming, died, apparently heart failure, Aug. 7 (2013) while riding his bicycle from his vacation home in Truro to buy newspapers, a favorite routine he couldn’t set aside even though he had undergone surgery a few weeks earlier. He was 79 and lived in Newton Highlands.

Part of a distinguished psychoanalytic family, and trained as an analyst, he chose his own path by spending decades contemplating what dreams and nightmares reveal about the mind. “The waking mind is on a hunt,” Dr. Hartmann told the Boston Phoenix in 1999. “The dreaming mind is on an exploration.”

His own travels, waking and sleeping, ranged widely geographically and intellectually. Born in Vienna, he was a son of Heinz Hartmann, a psychoanalyst who was a favorite of Sigmund Freud. Young Ernest met Freud and joked in later years that “Freud was 80 and I was 2, so it was not a great meeting of the minds.”

Nor was the encounter an immediate inspiration. “He wanted to be a carpenter when he was a child and he gradually decided that he was a scientist,” said his brother, Dr. Lawrence Hartmann, a former president of the American Psychiatric Association.

Curious from early on, Ernest Hartmann “was always looking for some interesting new way of thinking about things,” said Dr. Anton Kris, a clinical professor of psychiatry at Harvard Medical School and a friend since the two were children. “He enjoyed his use of his mind. He was constantly in intellectual motion.”

As World War II began in Europe, the Hartmann family moved to Paris, then Switzerland, and then New York City, where Dr. Hartmann graduated from the Fieldston School.

At the University of Chicago, he graduated with a bachelor’s degree in 1952 and began graduate studies in biology, philosophy, and literature before going to the Yale University School of Medicine, from which he graduated in 1958. Postgraduate studies took him to Paris, New York City, Harvard Medical School, and the National Institute of Mental Health before he graduated from the Boston Psychoanalytic Institute in 1972.

During some of those years he also served as a lieutenant commander in the US Public Health Service. More recently, he was a psychiatry professor at Tufts University School of Medicine until retiring last year.

Beginning in the early 1960s, Dr. Hartmann conducted pioneering research and in 1967 published his first book, “The Biology of Dreaming.” Adding context to his inquiries, he studied how animals sleep and had a lifelong affinity for elephants.

“Of course there’s a biology of dreaming,” Dr. Hartmann told the Globe in 1999, but he added: “There’s no way that makes dreams random and meaningless.”

“Everything was material for study,” said Dr. Gerald Denis, an associate professor of medicine at the Boston University School of Medicine, a longtime friend who was part of Dr. Hartmann’s monthly dream discussion group. Participants described their own dreams in an informal extension of Dr. Hartmann’s scholarly work.

“We end up knowing each other’s unconscious really well,” Denis said.

A past president of the Association for the Study of Dreams, Dr. Hartmann looked into the unconscious minds of thousands through the years, including through his studies of troubled sleep.

“I believe that the nightmare, far from being a failed or aberrant dream, is one of the most important kinds of dream, and the one in which we can most easily observe a process which probably occurs in all dreams,” he wrote in one scientific paper. “In this sense the nightmare is the most useful of dreams.”

On a parallel path with science, he pursued literature, and he published his own poetry.

“He liked to identify himself as a poet, a scientist, a researcher,” said his daughter, Kate of South Portland, Maine. “The bottom line is that he was not like anyone you ever met. He was really interested in everything.’

Dr. Hartmann, who retained the Austrian accent of his youth, “was always reading a dozen books,” his daughter said. “I was at his house the other night and was picking up poetry journal after poetry journal.”

His marriages to the former Barbara Hengst and Eva Neumann both ended in divorce. Gatherings of family, extended family, and friends were always important to him, though, often for meals or time on the Cape.

“He wanted to have everyone there together, the more the merrier,” his daughter said. “You always knew how glad he was to see you and how sorry he was to see you go, so hellos and good-byes were a big deal.”

Dr. Hartmann particularly adored his 9-year-old grandson. “He just loved Henry,” his daughter said.

“The love affair between a grandparent and a grandchild is one of the great love affairs on earth,” Dr. Hartmann’s brother said.

Dr. Hartmann could be nearly as devoted to other friends and relatives. “I think he held tight to what was dear to him, and what was dear to him was home and the places and people he loved,” his daughter said.

In an age when many avoid phone conversations, “he was very much someone who called,” she said. “And if anyone called my Dad, he picked up. He wanted to be connected to people.”

In addition to his daughter, brother, and grandson, Dr. Hartmann leaves a son, Jonathan of New Haven.

A memorial service will be held at 2 p.m. Oct. 6 in Wilson Chapel at Andover Newton Theology School in Newton.

“The thing I think about him so much is he didn’t let anything deter him from life,” said Barbara Kislak, a Truro neighbor of Dr. Hartmann’s. “He really believed in life.”

That was true the crisp, clear morning he left his Truro house for a final bicycle ride, and true as he concluded his last book, still musing about how everything seemed connected.

“After all my years of trying, I do not completely understand dreaming . . . have I really discovered something? Or have I created something, invented something? Does it matter? Are the two processes — discovery and creation — really separable?”


 

 

Ernest Hartmann : Selected Papers to 2013


 

The Nightmare is the Most Useful Dream

 

Par Ernest Hartmann, M.D.


Tufts University School of Medicine; Newton-Wellesley Hospital, Boston

 

I will argue here that far from being a “failed dream” or an aberration of some sort, the nightmare is in fact the paradigmatic dream. The nightmare presents us, in the clearest form, what is present in all dreams. Thus, the nightmare is the most useful dream in our attempt to study dreams in general. I will also discuss ways in which the nightmare can be useful to the dreamer (the functions of the nightmare).


Towards a Definition of the Nightmare

The term nightmare has had a somewhat confused history, since it has been used in a number of different senses. Thus, some well-known past works on nightmares clearly refer to what we now call night-terrors. This is true of Ernest Jones’s classic work On the Nightmare (1931) as well as portions of John Mack’s work Nightmares and Human Conflict (1970). Sometimes nightmare has even been used to describe an object one is afraid of (e.g., “the nightmare in my closet”), rather than a frightening dream.

As with many concepts and notions in psychology, there is still no perfect definition of the nightmare. However, it is now accepted that the nightmare is a long frightening dream, which awakens the sleeper; it usually occurs during the second half of the sleep period and, if the sleeper happens to be in a sleep laboratory, it can be shown that the awakening comes from a long REM period (Kryger, et al, 1994; Hartmann, 1984). By this modern definition, the nightmare can be clearly differentiated from the night-terror, which is a sudden arousal accompanied by a feeling of terror, occurring early during the sleep period and generally accompanied either by no remembered content or a single distressing image. Thus, the night-terror is not a dream and almost all reasonably introspective persons can themselves tell the difference. In the sleep laboratory, the night-terror arises from a sudden arousal out of deep slow-wave sleep (stage 3 or stage 4 sleep).

Although the nightmare can be clearly differentiated from the night-terror, there is no clear demarcation between a nightmare and an anxiety dream. Both are dreams; we can think of a continuum of frightening dreams and say that the nightmare refers to the more frightening and terrifying end of the continuum. Also, at the nightmare end of the continuum one is more likely to say one was awakened by the nightmare, rather than simply remembering it.

Perhaps because of these confusions and problems of definition, the nightmare has sometimes been set to one side, as though it were not really a dream; or it has been considered a “failed dream,” (Kramer, 1991), in both cases suggesting that understanding nightmares is some sort of separate issue not truly connected with understanding dreams.


The Nightmare as a Paradigm for All Dreams


My view is the opposite. I believe that the classic nightmare is the perfect way to begin an understanding of dreams in general. For the majority of people a nightmare is probably the most powerful, forceful dream they will ever experience. And the nightmare in a traumatic or stressful situation often provides the simplest, clearest case of what may happen more obscurely in other dreams. I am not speaking here of the chronic, repetitive, post-traumatic nightmare. The repetitive PTSD subtype of nightmare could indeed be thought of as a “failed dream,” since it does not evolve in any way, is very disturbing to the dreamer, and has no function attributed to it. These repetitive PTSD nightmares are quite rare. They can be of interest in their own right and have been studied, but are not my subject here (see Hartmann, E., 1996). I refer to the far more common nightmare which is not usually repetitive, but occurs frequently at times of trauma or stress, and can occur in a whole series of gradually evolving shapes.

My associates and I have been studying for some years the dreams and nightmares that occur after a traumatic event. A nightmare we have seen very commonly goes something like this: “I am walking along a beach, when suddenly a huge tidal wave comes and overwhelms me. I am swept away—I don’t know whether I’ll get to the surface before I wake up.” This nightmare is important because we can see so clearly what is going on. The traumatized person, who for instance has recently been attacked or has just escaped from a fire, dreams of drowning, or almost drowning in a tidal wave. What is going on here? Obviously the person is not dreaming about the actual events experienced, but dreaming about the emotion associated with them. The dream contextualizes (pictures) the emotional state of the dreamer. Typically, these dramatic nightmares are not repetitive, but gradually evolve and change. These are especially useful objects of study, at least for those of us (and I believe it is most of us) who believe that the emotional concerns of the dreamer are somehow expressed in the dream and other mental activity such as daydreams, fantasies, and stories. The reason that nightmares after trauma are especially useful for the study of dreams is that the dominant emotion or emotional concern is most evident in these cases. The first emotion is usually “I am terrified, I am overwhelmed.” Later, there are often emotions such as grief or survivor guilt (“why was I spared when the other person died or was injured?”).

Dreams and nightmares collected in numerous series from people who have undergone a severe trauma frequently include dreams such as the following :

“A huge tidal wave is coming at me.”
“A house is burning and no one can get out.”
“A gang of evil men, Nazis maybe, are chasing me. I can’t get away.”

The person is dreaming the dominant emotion. The way we formulate it is that the powerful dream image (tidal wave, etc.) contextualizes (supplies a picture-context for) the underlying emotion — in this case fear or terror. Sometimes a slightly different emotion which could be called vulnerability or helplessness is also involved producing similar or slightly different dreams, such as :

“I dreamt about children, dolls — dolls and babies all drowning.”
“He skinned me and threw me in a heap with my sisters. I could feel the pain. I could feel everything.”

Sometimes survivor guilt or other forms of guilt are dominant :

“A shell heads for us (just the way it really did) and blows up, but I can’t tell whether it’s me or my buddy Jack who is blown up.”
“I let my children play by themselves and they get run over by a car.”

Thus, the suggestion is that the dream image contextualizes the dominant emotion or emotional concern of the dreamer and that this can be seen most easily in the nightmares after a single trauma, whereas in a less defined situation — a typical dream of a typical student — there may be no single powerful emotion, rather a number of relatively mild emotional concerns, and the dream is much less predictable (Hartmann, 1998).


Studies of the Contextualizing Image

The many examples, such as those mentioned, cannot be considered a research study, since obviously we may have chosen examples that dramatically illustrate a thesis. Therefore, we have recently attempted to approach these contextualizing images (CIs) in a more quantitative manner.

First of all, a rating scale was devised for CIs in which a scorer, blind as to what sort of dream material he or she is scoring, first decides whether there is a powerful, vivid, detailed image, and gives it an intensity score from 0 (no image) to 3 (extremely powerful). This is the CI score. Then the scorer tries to choose an emotion, out of a list of 18 (see table 1), that might be contextualized by to this image. So far CI scores have demonstrated good inter-rater reliability, from .60 - .85 on a variety of dream material.

When dreams and daydreams from college students were compared on a blind basis, the CI score was shown to be higher (about twice as high) in dreams than in daydreams (Hartmann, et al, 1998). Material obtained in subjects wearing a “nightcap” device, enabling them to be awakened differentially during REM sleep, non-REM sleep, sleep onset, or waking, was likewise scored on a blind basis for CIs. CI scores were significantly higher in the material from REM sleep than from non-REM sleep, and the material from non-REM sleep was significantly higher than material from waking (Hartmann and Stickgold, 1999).

Returning to our initial interest in deciding whether CIs were more frequent and more intense after trauma, we compared dream series of various lengths, obtained from 10 different persons who had experienced an acute trauma and had written down or told their dreams in the period afterwards (a total of 451 dreams), with dreams reported by 306 college students. The CI scores overall were significantly higher in the trauma group than in the student group (p < .001) (Hartmann, et al, 1998). In a related study, examining the group of college students, we compared CI scores from those who on a questionnaire reported no history whatever of sexual or physical abuse to those who reported a history of any kind of abuse — physical or sexual, in childhood, adolescence, or more recently. The dreams scored on a blind basis showed that the students who reported any history of trauma had significantly higher CI scores than the other students (Hartmann and Zborowski, 1999).

Thus, even though dreams are notoriously difficult to score reliably, we do have evidence that CI scores are higher after trauma. Our hypothesis, obviously not easy to prove conclusively, is that the same pattern of contextualizing emotional concerns seen above is found in all dreams, although it is less evident. The pattern is most easily seen after a traumatic event, but can also be found readily in stressful situations and in defined situations such as pregnancy or in patients who suffer from one dominant emotion (discussed in detail in Hartmann, 1998).

Thus I believe that the nightmare, far from being a failed or aberrant dream , is one of the most important kinds of dream, and the one in which we can most easily observe a process which probably occurs in all dreams. In this sense the nightmare is the most useful of dreams.

An Adaptive Function of Nightmares ?


Of course it is true that the usefulness outlined above is to the researcher or the psychologist — to us as students of the dream — not necessarily to the dreamer him/herself. Actually, I do believe that the nightmare may be useful to the dreamer as well, and I will discuss this briefly here. It is taken up in great detail in Hartmann, 1998. I discuss at length in my book the difficulty of proving or even attempting to prove something like a function of dreaming, or a function of nightmares.

Without clear-cut research studies, but with a great deal of clinical experience, my thinking is along the following lines. Starting again with the clearest case, an ordinary adult who has experienced a single trauma, we often see a progression. First, there may or may not be one or two dreams portraying the actual trauma. Then very quickly we obtain various kinds of “tidal wave dreams” (nightmares). Successive dreams seem to bring in more and more of the dreamer’s life, usually making use of emotional connections. Thus, if the person is feeling primarily terrified or overwhelmed, other situations connected with the same emotions will surface in dreams. If grief, guilt, etc. are especially prominent, other situations involving these emotions will be found. I believe that this whole developing series is of use to the dreamer. First of all, the dreams reduce the intensity of the emotional distress by juxtaposing the current trauma with various other events in the person’s life, making connections to other similar or not-so-similar events, and so on. In addition to this immediate effect of “calming the storm,” I believe the gradually evolving connections are useful in themselves. When trauma is dreamt about (or thought about, fantasized about, worked on in therapy, etc.) it is no longer uniquely distressing; it gradually becomes part of a fabric or a network. Presumably the next time a similar trauma occurs, it will already have a context in which it can be considered, rather than standing out as “the most awful thing that has ever happened to anyone.” In this sense I believe that dreaming has an adaptive function, and again that this adaptive function can be seen most readily when starting with the developing nightmares following a trauma. Very similar views on an adaptive function of dreaming have been voiced by a number of others, starting with very different data and clinical experience. For instance, French and Fromm (1964), Greenberg and Pearlman (1993), Breger (1971), Cartwright (1991), and Kramer (1993) have all proposed adaptive functions of dreaming, though stated in somewhat different terms.

Other Uses of Nightmares

The above proposal of an adaptive function of dreams suggests a basic quasi-biological function — something that is useful to the organism and increases its well-being and chance of survival. In addition to this basic function, individuals have of course made use of their nightmares in any number of different ways, especially in furthering their self-knowledge with or without the help of psychotherapy. Artists have painted pictures of their nightmares and other dreams, and writers have used a striking nightmare image as a starting point for their stories. I have suggested elsewhere that the Christian idea of hell probably derives from nightmares — certainly it is peopled with very typical nightmare-creatures (Hartmann, 1984). It is clear that artists have been able to make use of their nightmares in their art. This might be thought of as an occasional, rare use of nightmares in a few creative people, but I believe it may occur more often than most people believe. My evidence for this comes from studies I conducted some years ago of persons who suffer from frequent nightmares — at least one per week, and had done so for years. I studied 50 of these individuals in great detail (Hartmann, 1984), and obtained data on at least 50 more persons with a similar history. After the people had described nightmares to me in detail — and indeed the nightmares often sounded extremely frightening and disturbing — I asked whether they had ever sought help or treatment for the nightmares and whether they had even considered seeking treatment. Over half of the group neither sought treatment nor considered treatment. When I asked them why, some of them answered in terms of the use they made of nightmares in their artistic productions. However, the most common answer was something like : “I don’t know. The nightmares are so much a part of me. I think I must be making use of them in some way, even though I don’t know exactly how.” So there are a surprising number of people who believe that their nightmares are of use to them, even if only some are able to state just what the use might be (art or self-knowledge).

Conclusion

In summary, I believe that nightmares are not aberrant or failed dreams. Rather, they can be extremely useful and I have outlined several types of usefulness. I am most convinced of the issue I raised first and discussed at length — that the nightmare is the most useful dream because in the nightmare we can see most clearly the contextualization or picturing of emotion, which I believe is a central aspect of all dreams.

References

Cartwright, R. 1991. “Dreams that work : The relation of dream incorporation to adaptation to stressful events". Dreaming, 1:3-10.
French, T., Fromm, E.. 1964. Dream Interpretation. New York: Basic Books.
Greenberg, R., Pearlman, C. 1993. "An integrated approach to dream theory : Contributions from sleep research and clinical practice". In The Functions of Dreaming. Moffit, A., Kramer, M., and Hoffman, R., eds. Albany : State University of New York Press.
Hartmann, E. 1984. The Nightmare : The Psychology and Biology of Terrifying Dreams. New York: Basic Books.
Hartmann, E. 1998. Dreams and Nightmares : The New Theory on the Origin and Meaning of Dreams. New York : Plenum Press.
Hartmann E, Kunzendorf R, Rosen R, Grace N. 1998. Contextualizing Images in Dreams and Daydreams. Sleep, 21S:279.
Hartmann E, Rosen R, Grace N. 1998. Contextualizing Images in Dreams : More Frequent and More Intense After Trauma. Sleep, 21S : 284.
Hartmann, E., Stickgold, R. 1999. Sleep, 22S, in press.
Hartmann, E., Zborowski, M. 1999. Sleep, 22S, in press.
Jones, E. 1931. On the Nightmare. London : Hogarth Press.
Kramer, M. 1991. The Nightmare : A Failure in Dream Function.
Dreaming, 6:277-285.
Kramer, M. 1993. "The selective mood regulatory function of dreaming : an update and revision”. In The Functions of Dreaming. Moffit, A., Kramer, M., Hoffman, R., eds. Albany: State University of New York Press.
Kryger, M., et al. 1994. Principles and Practice of Sleep Medicine. Philadelphia : Harcourt Brace Jovanovich.
Mack, J. 1970. Nightmares and Human Conflict. Boston : Little, Brown and Company.

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