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« HOMO DIURNUS VERSUS HOMO NOCTURNUS »
Could it be possible to use patient’s dreams in Clinical Medicine?
Former PROFESSOR at the UNIVERSITIES of GENEVA and TURIN (Psychiatric Department) and MARSEILLE (Medical education on sexology),
This paper is based on two working hypotheses from which stem two practical and clinical perspectives.
First hypothesis : that as evolved human beings, we sleep no differently than did our primitive ancestors, HOMO SAPIENS, in suffering therefore an internal hypnic world diametrically opposed to our conscious state of being awake.
Second hypothesis : that if one accepts the assumption that most of our dreams are produced during REM sleep, it is of these dreams that we should have the greatest recollection, given the frequency of REM cycles. Dreams would therefore be no more than reduced to image boxes containing the effect of strong sensations and emotions perceived during sleep.
Two practical and clinical consequences : Dreams perform the function of maintaining
HOMO DIURNUS vs. HOMO NOCTURNUS
This would determine a kind of double trauma that we suffer at the moment we fall asleep and then again upon waking up; trauma which was no doubt better tolerated by primitive man than by us today.
The dream which would be no more than containers in the form of images of strong
sensations and emotions perceived during sleep, would have the function of maintaining
Furthermore, should this be the case, it may be possible to reconvert the oneiric
images that one recalls, into sensations and emotions which are produced during sleep,
thereby providing information on the changes in auto-
One of the adventures that all human beings would most wish to undertake, is indeed to travel through time. To find oneself, for example, thrown back all of a sudden thousands of years into the past, into a past that was thought unattainable, far more so than any future.
And yet, if one cares to think about it, this voyage into the distant past is not only possible, but emerges as something that indeed happens to each of us when we pass from the state of being awake to that of being asleep. It is not a question of fiction produced by a vivid imagination, but of a pure and simple statement of fact that will even draw upon our most rigorous scientific knowledge. In fact, during the day, that is, when we are awake and fully conscious, we may assume that our way of life, of thinking and of reacting, must necessarily or at least in many respects, greatly differ from that of our first ancestors. It is at any rate most likely that Homo Sapiens was preoccupied with catering, in a manner very different to our own, to his basic needs and sought in particular, to fit in with nature, that is, into the environment in which he lived. On the other hand, today we seem to have become chiefly preoccupied with dominating Nature, of putting it entirely at our disposal.
In addition, the fact that we now feel short of space on this planet Earth and that we are turning towards the cosmos, gives us quite a different mental outlook from that held by primitive man, who was trapped in a limited space and was undoubtedly used to living on a day to day basis.
Nonetheless, if the fact that until today we have not identified signs of existence
of other intelligent life-
Nevertheless, once we are asleep, no scientific evidence exists to show that we sleep any differently than did our distant ancestors. Like them, we are forced to spend approximately one third of our existence in a particular state, that of sleep, which is in stark contrast to that typical of a state of being awake. Whether we are fully active or simply entertaining ambitious projects, or again, embracing our lovers, suddenly we must surrender to an unavoidable imperative, that of being carried away by sleep. Another cycle, or rhythm if one prefers, can turn out to be even more demanding than that which forces us to empty our intestines and in particular our bladder, as even the biological rhythm which forces us to feed ourselves can be better controlled than, at a certain stage, the need to fall asleep.
Not only do we lose at that moment an effective sensory contact with all that surrounds us and become unconscious of external activity, but from the active beings which we can be, we transform ourselves into inert and passive beings ; from the alert beings ready to react that we can show ourselves to be whilst awake, we metamorphose into vulnerable beings, incapable of prompt reaction in the face of real threats and unforeseen dangers.
Furthermore, even the characteristics pertaining to sleep that current science has brought to light, such as the fact that we sleep two types of sleep which alternate, should have no doubt existed for primitive man. That during the sleep phases known as REM, implying a heightened cerebral arousal (with the concomitant revelation of a more than probable intensified consumption of both oxygen and glucose) accompanied by a significant fall in muscular tonus which paralyses a large part of our body, all this could not have not existed in primitive man, even though this all happened without his conscious knowledge.
This primitive man must have also, during the REM phases, had penal erections such as those of men today, erections which moreover, primitive man had perhaps already been aware of, as shown by prehistoric cave drawings.
Thus, it becomes indisputable that in sleeping each night, we regress, at least during several hours, to an organic state certainly identical to that of our distant ancestors whilst they also slept.
From this a striking first conclusion: this undoubtedly somewhat traumatic passage
from a state of conscious awakeness to a state of unconscious sleep, coupled with
a second analogous and opposite “trauma” as one wakes up, was perhaps better tolerated
by Homo Sapiens, since it is probable that for him the world of consciousness and
that of unconsciousness did not have as precise boundaries as they do for us. We
can in this regard draw an analogous approximation with the experience of astronauts
when, as they leave earth, they leave macro-
Furthermore it is more than likely that during sleep, following the interruption
in the main sensorial connections with the outside world that sleep imposes, the
intensity of our auto-
The presumed increase in auto-
One should here recall the theory already put forward by William Jones, according to which it would not be emotions which give rise to sensations, but rather the reverse (11).
Without attempting to draw a final conclusion, one can nonetheless query why people
are compelled to spend a good third of their lives in sleeping, which already appears
to be too short, – especially now that the studies begun in the 1950s on the structure
of sleep have revealed that it is impossible to regard the state of sleep as a mere
biological necessity for the recovery of energy. Practical questions in this respect,
could even make us query whether it is not precisely sleep itself that provides us,
with regularity, with the possibility of an essential re-
It is highly probable, in addition, that those people who have a lot of difficulty
in falling asleep, leaving aside the possible fear of losing the conscious control
of oneself, fear, precisely, an intensification in auto-
Nonetheless, many personality troubles or borderline cases as well as clearly psychotic
troubles, indicate very often a basic disturbance in the auto-
In addition, in the domain of sexology, from a physiological perspective one can
presume that the search for sexual excitement and the onset of an orgasm would also
have the function of obtaining an intense auto-
Can one therefore envisage concrete action in respect of these clinical problems,
by taking in charge firstly the sleep-
Nonetheless, one of the elements of sleep is represented by dreams, or better still,
if one wants to be more precise, by the recollection that we can have of our dreams.
The fact of dreaming, and thus of recollecting them, has always presented a problem
for humans. It is quite likely that Homo Sapiens had been as impressed by the memory
of his dreams as by the onset of storms or the threat of wild animals, since the
dream could upset the order of things by introducing within man the same sense of
incoherence and incongruity. The explanation of the oneiric phenomenon in ancient
times finished, as we know, by attributing dreams to obscure forces, presumed to
be superior, belonging sometimes to the category of friendly divinities tendering
advice, sometimes to powerful demonic influences prophesising dangers. The Egyptians,
as much as the Greeks later on, had to a certain extent “tamed” dreams in willing
to give, in the case of sickness and through the so-
Freud perhaps first led the way in enabling us to acquire the means of creating a true oneiric science. As we know, the psychoanalytical vision of dreams is centred notably on the idea that they target the realisation of a desire (6). And as this same desire can in turn give rise to that which is prohibited, automatically the dream may reveal the existence of a conflict. This equally implies that the defensive strategies that intervene in the conflict in question introduce disguises of the oneiric content, which express themselves by interposed symbols. There are indeed nine editions, beginning with the first in 1900, of Freud’s Interpretation of Dreams, and already he himself constantly tried to modify and complete his own vision of the oneiric phenomenon. Contemporary psychoanalysis continues constantly to rethink the way in which dreams can be interpreted and used (15, 18).
In contrast to this interpretative position on dreams, are current trends which argue
that they can be explained in a more functional manner, to the effect that they serve
both as a sort of repeated confirmation of the individual’s genetic code (12), and
as encouraging cerebral development via the go-
Whilst it is known that dreams can occur during periods during which sleep is at
its deepest, and therefore that which is classified as N-
Although we know that these REM phases of sleep are not absolutely indispensable
for dreams to take shape (18) it is certain that in laboratory experiments, if one
wakes the subject that has been dreaming at the moment when he shows signs of rapid
eye movement, he immediately relates the content of the dream which, it appears,
he was then having. On the other hand, if one wakes a subject who does not show these
signs, and who therefore, was in an N-
(4, 5). In addition, depressive states, for example, as well as certain medications, are susceptible of altering the frequency and the distribution of REM sleep cycles.
An important problem arises from all these considerations. Since in a night of approximately eight hours sleep, there will result from a recorded hypnogramme a total of approximately two hours of REM phases, the latter being the potential producers of dreams, how is it that we can remember so little of our dreams?
So too, a related problem remains, that of the real duration of our dreams. In this
respect, the so-
The dream, made up essentially of images, thus giving the impression of a sort of scenic image comparable to a film occurring within ourselves, could be explained in a new way (2), all the more so as, for example, those blind from birth, not being able to produce images, often premise the recital of their dreams on a sound or olfactory scenario.
One is, in sum, encouraged to think that at the origin of the oneiric experience
there is at first only a considerable increase in auto-
Furthermore, sexology once again, can show that human beings have often greater difficulty in managing pleasure and therefore our vital energy, than pain, and hence the drop in energy. And it is precisely sexual arousal, if it is considered excessive, that can provoke a form of imbalance, more intense than, for instance, that induced by aggressiveness (1).
More precisely, not far removed from the point of view of neuro-
All dreams in short, would be reduced to their possible recollection, thus excluding
in advance the possibility that there may be dreams hidden in the memory and inapt
for one reason or another to manifest themselves. One phrase allows us to pin-
In addition, one can even introduce a mathematical formula in support of the idea that a rebalancing referred to above should take place in practice between implicit memory, this is, unconscious or even corporal memory, and explicit memory, that is conscious memory. This mathematical formula could be expressed in the following manner:
where O is ONEIRO in Greek, meaning the dream¹. [1.This formula was developed by
a professional mathematician, Mrs J. Weger, of Geneva]. Further, keeping in mind
what has been called a reconversion of oneiric images into feelings or emotions not
only allows one to highlight any possible perturbed auto-
A subsequent illustration of the above proposition is to use as an analogy, the zoom
mechanism of a camera. The zoom, as we know, enables photos to enlarge or reduce
images targeted by the camera’s own lens. Yet an excess in auto-
In other words, while asleep, each subject appears spontaneously to try to rebalance
themselves in respect of their auto-
Hence a notable fact: if this drop in muscular tonus which normally brings about fairly widespread forms of muscular paralysis, is insufficient, one faces reactions of a motor sort, which can range from a few sudden movements to the possibility that the subject performs somnambular acts which are sometimes very violent and quite often inhabitual. This does not exclude, in this regard, possible relations between this phenomenon, called more specifically REM phase troubles, and that which is called in contrast, nocturnal terrors.
By way of conclusion, one can without ado affirm that Homo Diurnus, the human being awake and in a fully conscious vigilant state, is future oriented, which enables the individual to glimpse the realisation of his plans and the persistence of technological progress. The present with its potent but fleeing feelings and emotions, one could say, is often more disturbing than satisfying without a shred of doubt. Nonetheless, when he goes to sleep, this same Homo Diurnus transforms himself into Homo Nocturnus and is confronted by the vital energy of the present against which the future appears still very fluid. All the more so as it is a present of a somewhat unchangeable nature, as in all probability it is identical to that which it already was at the beginning of humanity; an internal constant as opposed to the variability of the outside world.
It follows that the dream places itself as an indicator of inevitable oscillations between that which we know of our personal history of which explicit memory is the witness, and that which has been “chosen” by our body day after day in a vital and inextricable epigenetic mix which has given rise, in short, to implicit memory, which is also far more powerful than explicit memory.
To conclude, the recollection of a dream would then be but the result of automonitoring, warning us that our future path has suffered or must suffer some necessary readjustments for our adequate evolution.
1. ABRAHAM, G., VLATKOVIC, D. (1995): Douleur et plaisir, Genève, Georg.
2. ABRAHAM, G., KAUFMANN, Y.A., KRONI, W. (2002): Introduction à une possible onirologie clinique.
Médecine et Hygène, 2410.
3. ABRAHAM, G. (2002): The Psychodynamic of Orgasm. Int. J. Psycho-
4. EPSTEIN, A.W. (1975): Cerebral Correlates of Dreaming. Transactions of the American Neurological
Association, 100, 22.
5. EPSTEIN, A.W., (1979): Effect of Certain Cerebral Hemiphrenic Diseases on Dreaming. Biological Psychiatry,
6. FREUD, S., (1900): The Interpretation of Dreams. Standard Edition, vol. IV-
7. GERALD, A.M., SHAFFERY, J.P., OKSENBERG, A., SPECIALE, S.G., ROFFNARK, H.P. (1995): A Functional
Role for REM Sleep in Brain Maturation. Behavioural Brain Research, 68, 1.
8. HOBSON, J.A. (1988): The Dreaming Brain, New York, Basic Books.
9. HOBSON, J.A. (2002): An Introduction to the Science of Sleep. New York, Oxford Univ. Press.
10. KANDEL, E.R., SCHWARTZ, J.H., JESSEL, T.M. (2000): Principles of Neural Science.
New York, McGraw-
11. JAMES, W. (1890): The Principles of Psychology. New York, Henry Holt & Co.
12. JOUVET, M. (1992): Le sommeil et le rêve. Paris, Odile Jacob.
13. LANGS, R. (1999): Dreams, Emotional Adaptation. Phoenix, Zeig, Tucker & Co.
14. LENZI, P., ZOCCOLI, G., WALKER, A.M., FRANZINI, C. (2000): Cerebral Circulation in REM Sleeps: Is Oxygen a Main Regulatory Factor? Sleep Res. Online, 3, 77.
15. LEUSCHNER, N., MAU, S., FISCHMANN, T. (2000): Die akustische Beinflussbarkeit on Träumen. Tübingen, diskord.
16. MADEN, P.L., VORSTRUP, S. (1991): Cerebral Blood Flow and Metabolosm During Sleep.
Cerbrovasc. Brain Metab. Rev., 3, 281.
17. MAURY, A. (1817-
18. SIEGEL, J.-
19. SOLMS, M. (1997): The Neuropsychology of Dreams, Mahwah, N.J., Erlbaum.
20. STICKGOLD, R., HOBSON, J.A., FOSSE, R., FOSSE, M. “Sleep, Learning and Dreaming: