DREAMS

What purpose do dreams serve? And does it even make sense to begin with to ask whether dreams serve a biological function just like
eating and breathing, for example?

Some neurobiologists say not, seeing dreams as mere epiphenomena associated with brain activity. But others think that dreams contribute
to epigenetic development or to the processing of recently acquired information. Still others have taken neurobiological data from
brain-imaging studies done in the 1990s and used these data to support a theory holding, as Freud did, that dreams
are psychological manifestations that can convey meaning.

One such theorist is neuropsychologist and psychoanalyst Mark Solms. Solms first
observed that a number of his patients who had suffered damage to the neurons of the
pons and therefore no longer had any periods of REM sleep nevertheless continued to
dream regularly. He then identified two areas of the cortex that had nothing to do with
REM sleep but that, when damaged, caused the loss of the subjective experience of
dreaming.

The first of these areas is located where the occipital, temporal, and parietal cortexes
meet. This area is involved in spatial imagery, among other things, so Solms’s finding
makes intuitive sense: it is hard to imagine being able to dream if your ability to form
mental images were impaired.

The other area of the brain that seems to be necessary for dreaming, according to
Solms’s research, is located in the frontal cortex. The neural pathways that project to this
area use dopamine as a neurotransmitter and are known as the mesolimbic system. The
area itself is involved in positive reinforcement and motivation.

Gérard Larguier, Father Freud’s Dream

http://www.gerard-larguier.com/index_fr.php

Why then should dreams disappear when this part of the brain is damaged? Probably because dopaminergic transmission has been
disrupted. In any case, that is what is seen in people who take medications known to decrease their dopamine levels: they dream far less.
And the opposite is also true: patients who take medications that increase dopaminergic activity along this pathway (for example,
Parkinson’s patients who take L-dopa) dream more intensely than they used to, even though the frequency and duration of their periods of
REM sleep are unchanged.

For Solms, it therefore seems clear that if REM sleep is generated in the most ancestral parts of the brainstem, dreams, in contrast, may
arise in the cortex. The involvement of the frontal and the occipito-temporo-parietal cortexes, which regulate memory, feelings, and
motivation, supports the idea that dreams in some way serve to reprocess subjective events that the individual has experienced previously.
In short, Solms’s theory allows for the possibility that dreams may have meaning and thus preserves the foundations of psychoanalysis, in
contrast to Hobson and McCarley’s model, in which dreams are simply the result of the random bombardment of the cortex by meaningless
signals from the pons.

This theory of the cortical origin of dreams raises several issues. One in particular is the difficulty of reconciling the very fleeting nature of our
memories of our dreams with the very fundamental role that this theory implies dreams play in our psychic equilibrium.

The strange and fragmentary nature of our dreams as we recollect them is central to another daring theory of their origin: we may dream
not when we are sleeping, but only as we are awakening. This theory, developed by French neuroscientist Jean-Pol Tassin, is based on
the paradox that consciousness vanishes during sleep, yet dreams cannot exist unless we are conscious of them. According to Tassin and
his collaborators, during REM sleep, the brain is active, but its activity allows neither consciousness nor dreams.

There is a neurobiological correlate that supports this interpretation: some noradrenergic and serotonergic neuromodulatory neurons that are
necessary for neural information to be stored in the brain for more than a few milliseconds–in other words, necessary for consciousness–
cease to function when you are asleep, but become active again while you are waking up.
Thus, according to Tassin’s theory, as you awaken, these reactivated neurons enable you to become aware of the subliminal images
generated during your sleep, and you then actually construct your dreams during the few hundredths of a second that it takes you to wake
up. This brief interval might also be the time when, as sometimes happens, you incorporate into your dreams the light or the words that have
woken you up.

But how then to explain the subjective impression that we dream during the night? Researchers who have analyzed EEG traces for entire
nights of sleep have found that even sound sleepers may awaken as many as 10 times per night, then fall back to sleep again rapidly, even
if the next morning they report that they slept straight through the night. During these “micro-awakenings” that last only a few seconds or
fractions of a second, the brain finds itself in a state identical to wakefulness, but for such a short time that we very rarely remember it the
next day. It would be during these micro-awakenings that we might dream, that is, organize our often bizarre mental images into coherent
stories. And as the generator of these bizarre mental images, REM sleep seems the ideal candidate, though non-REM sleep can generate
some strange images too. What makes this theory even more plausible is that REM sleep is the phase of sleep in which spontaneous
awakenings are the most frequent.

This model thus provides an explanation for the illogical, impossible or unreal nature of the story lines of most of our dreams: because the
return to consciousness that gives rise to dreams occurs in a very short time span, often following a period of REM sleep, the images we
remember are too disparate to be integrated into a coherent story, and our conscious brain may therefore have to “force” reality a bit to
assign a meaning to them. This would not be the only instance in which the brain plays tricks on us in an attempt to give a meaning to
confusing stimuli; certain optical illusions and split-brain experiments offer other examples of this same phenomenon (follow the Experiment
Module link to the left).

For Tassin, dreams would thus represent the conscious expression, during awakening, of the unconscious brain activity that occurs while we
are asleep. Dreams would thus remain dependent on sleep, because they would arise from the sudden reactivation, at the moment of
awakening, of the serotonergic and noradrenergic neurons whose activity is indispensable for consciousness.

If this theory proves correct, many observations could be interpreted differently. For example, when you awaken someone who is sleeping,
you aren’t interrupting her dreams, but rather making them happen! And Jouvet’s sleeping but “disinhibited”cats were simply reproducing
movements that they also made during the daytime, without consciously perceiving images associated with these movements–in other
words, without dreaming.

This view of dreams has the further advantage of leaving open the possibility that dreams may have a meaning for the people who dream
them. Because if their dreams occur in the space of a few hundred milliseconds, then the mental censor that may be active when they are
awake is not in place, thus allowing bizarre dream content that might be worth interpreting.

 
      
SLEEP DISORDERS

Since the 1970s, laboratories that do research about sleep have been established in many parts of the
world. Thanks to their discoveries, we now know that the health problems caused by lack of sleep are far
more numerous than we once imagined. These laboratories have also identified over 100 different
disorders that can affect our sleep. Besides insomnias and disturbances in circadian rhythms,
hypersomnias and parasomnias represent the two other main categories of sleep pathologies.

Narcolepsy occurs just Narcolepsy, formerly called “sleeping sickness”, is a hypersomnia that is characterized by excessive
as commonly as sleepiness during the day and, in extreme cases, by sudden irresistible bouts of sleep that occur several
Parkinson’s disease and times per day. People with narcolepsy can thus literally fall asleep at any time. In addition, during these
multiple sclerosis, but attacks, they pass directly from a state of wakefulness to a state of REM sleep, unlike healthy people, who
much less is known about always go through a period of non-REM sleep first. In fact, many of the symptoms of narcolepsy can be
it. It is often confused with seen as the intrusion of a phase of REM sleep into a person’s waking life.
other pathologies such as
epilepsy and often takes
more than 10 years to be
diagnosed accurately.
This disease does seem
to have a genetic
component, but its
expression is likely
influenced by
environmental factors as
well.
Here is an example of a
case of narcolepsy
reported by a physician.
The patient, a French
shepherd about 30 years
of age, said that he would
sometimes discover that
he had been sleeping
standing up while he was
supposed to be watching
his herd. He also
sometimes had strange
visions, dreamt while he
was walking, or suddenly
found himself standing in
the kitchen of a
neighbouring farmhouse,
without knowing how he
had gotten there. Once,
he had fallen on the floor More and more studies in animals and humans (see sidebar) tend to suggest that hypocretins (also
in the middle of a known as orexins), a class of neuropeptides produced solely by the neurons of the hypothalamus, play a
conversation with the role in narcolepsy. Several post mortem analyses have found far fewer of these neurons in the brains of
clerk at the post office. people with narcolepsy than in those of healthy persons.
When he felt like laughing,
or was angry, his legs
In its most complete form, narcolepsy is also accompanied by a condition that is startling, to say the least,
would often tremble, and
to those who witness it: cataplexy, a sudden decrease in muscle tonus, varying in intensity and lasting less
he would collapse like a
than a minute. The signs of cataplexy range from a simple weakness in the neck, knees, or facial muscles
marionette whose strings
to total paralysis that causes the individual to fall to the ground.
had been cut. At night, he
slept poorly and
An attack of cataplexy is usually caused by a strong emotional trigger such as laughter, anger, surprise, or
sometimes felt as if he
sexual arousal. People having a cataplectic attack are often still conscious but unable to move, which
were paralyzed.
makes this condition fairly terrifying. Once again, the connection with REM sleep is quite apparent: muscle
atonia in all respects similar to that which occurs during REM sleep to prevent our bodies from acting out
our dreams.
Narcolepsy is also seen
in animals, including
Sleep paralysis and sleep hallucinations are
other symptoms of narcolepsy. Sleep paralysis is
goats, donkeys, ponies,
and several breeds of a temporary inability to speak or to move while falling asleep or waking up–a highly
dogs that display a disconcerting experience, especially when the person having it doesn’t know its cause.
genetic disorder with
symptoms similar to those
Sleep hallucinations are strange, unpleasant experiences that resemble waking dreams.
of narcolepsy in humans. They occur during the transition from waking to sleeping, as well as during periods of
These breeds of dog were reduced alertness in the course of the day.
discovered to have a
mutation on the
hypocretin receptor 2
gene.

Hypocretin is a
neurotransmitter that is
synthesized solely by the
neurons of the
hypothalamus that project
Parasomnias is an umbrella term for a variety of abnormal phenomena that occur during
to structures involved in
various aspects of sleep. sleep. Several types of parasomnias affect children in particular. One example is night
Normally, the secretion of terrors, a phenomenon completely different from simple nightmares.
hypocretins helps to
maintain muscle tonus
and alertness by
activating monoaminergic
and cholinergic neurons.
Apparently, the mutation
of the hypocretin receptor
2 gene causes
 Nightmares are dreams involving visual images that
are frightening enough or negative emotions that are
hyperexcitability in the strong enough to cause the dreamer to wake up
neurons that generate scared and anxious. This feature differentiates a
REM sleep and alters the nightmare from a simple bad dream that doesn’t
circuits that inhibit REM cause the dreamer to wake up. In children, nightmares
sleep. In humans, the are associated with normal aspects of psychological
development, such as separation anxiety or sibling
degeneration of the rivalry. In adults, nightmares tend to be precipitated by
neurons that produce stress or by physical factors such as fever. Some
hypocretins would violent, recurring nightmares may also be related to
post-traumatic stress.
have the same effect.

The Nightmare, by Heinrich Füssli (1792).

Private collection.

Night terrorsare events that are biologically and psychologically distinct from
nightmares. They begin when children are 3 to 6 years old and generally disappear
during adolescence. Children in the throes of a night terror scream and cry. Their eyes
are open, and they may say incoherent things while gesturing emphatically. Unlike
nightmares, of which people can clearly recall some details once they awake, night
terrors are characterized by confusion upon awakening, the lack of any recall of
elaborate dream imagery, and intense activation of the autonomic nervous system,
causing symptoms such as sweating, and elevated heart rate and blood pressure. Also,
nightmares occur mainly during periods of REM sleep in the second half of the night,
whereas night terrors typically occur during deep (Stage 3 and Stage 4) non-REM sleep,
during the first part of the night. An entire night-terror episode can last 1 to 20 minutes.
The next morning, the child usually wakes up in a good mood, having forgotten the
entire incident.

Enuresis (involuntary bed wetting during the night) of course does leave obvious traces the next morning.
Children are diagnosed as enuretic if they wet the bed more than twice per week after age 5 or 6–in other
words, long after they are toilet-trained. The best approach to this problem is not to punish or humiliate the
child, but rather to be supportive to help maintain the child’s self-esteem. This problem generally
disappears on its own by adolescence.

Somnambulism is another form of parasomnia that is especially common in children. It involves

sleepwalking during non-REM sleep. About one-third of all children display this behaviour at some time or
other, and about 3% do so at least once per month. As with enuresis, episodes of somnambulism generally
disappear gradually as the child grows older, so that only 1 to 4% of adults still have them occasionally.

Contrary to popular belief, it is not dangerous to wake up someone who is sleepwalking. But it can be fairly
hard to do so, because episodes of somnambulism, which generally last about 10 minutes, typically occur
during the deepest stage of non-REM sleep, Stage 4, and hence during the first sleep cycles of the night.
Thus somnambulism is neither caused nor accompanied by dreams.

Episodes of somnambulism are believed to be triggered when something such as a noise, or the need to
urinate, wakes up the body without waking up the brain. The sleepwalker may then get up, walk to the
kitchen, open the fridge, eat a snack, pick up the telephone, or play some music, with no conscious
awareness of any of these actions. Because this state of very partial cognitive functioning obviously entails
some dangers, the best thing to do with a sleepwalker is gently guide him or her back into bed.

Somniloquy–talkingin one’s sleep–can happen during either REM or non-REM sleep.

The words are generally so poorly articulated and the sentences so meaningless that
 anyone who hears them will be at a loss to interpret them. Those utterances that occur
during REM sleep do, however, tend to be somewhat more intelligible.

Bruxism is a strange parasomnia. It consists in repetitive, involuntary grinding of the

teeth that causes them to suffer abnormal wear and tear and also causes discomfort in the
jaw muscles. Though about half of all people move their jaws in their sleep, only about
6% display the tooth-grinding during the light stages of non-REM sleep that
characterizes bruxism. The mechanisms of this disorder are not yet fully understood,
though it is now agreed that they do originate in the central nervous system. People who
suffer from bruxism will generally benefit from reducing their stress and from wearing a
special device in their mouth to prevent tooth damage.

REM sleep behaviour disorder is a rare but fascinating pathology sometimes seen in older people. It
consists in a form of sleepwalking that may superficially resemble somnambulism, but is significantly
different, because the people engaged in this behaviour are in REM sleep rather than non-REM sleep.
Normally, during REM sleep, people’s muscles are completely paralyzed, except for those involved in
respiration and in moving their eyes. But individuals who suffer from REM sleep behaviour disorder do not
experience this characteristic paralysis. Instead, they literally jump out of bed and mime their dreams while
continuing to sleep! This disorder is very dangerous, because people who have it often injure themselves
while externalizing their dreams, attempting to fight or flee some non-existent assailant. Sometimes the
dreamers may cast their bedmates in the role of the assailant, who may then find his or her own dreams
rudely interrupted! Luckily, this condition does respond to some medications, such as the benzodiazepine
clonazepam.

Many people with this disorder have been shown to have damage in the areas of the brainstem normally
responsible for the muscle atonia of REM sleep–the same areas where the production of lesions in cats
enabled them to “externalize their dreams”. These areas that allow muscle atonia during REM sleep likely
developed during the evolution of our species precisely to prevent what happens to people who have REM
sleep behaviour disorder.

Sleep paralysis, which is very common in people with narcolepsy, can also occur in isolation, with no other
associated pathology. This parasomnia is manifested when the individual is falling asleep or waking up,
and it typically lasts just a few minutes. During this period, the person can neither move nor speak. This
paralysis of course causes significant anxiety. It may also be accompanied by visual, auditory, and even
tactile hallucinations, known as hypnagogic hallucinations.
WHEN FEAR TAKES
THE CONTROLS

From a psychological perspective, fear, anxiety, and anguish are three different things. But they are related and
may be regarded as three different degrees of the same state: the one that people experience when their
sympathetic nervous system impels them to act, but action is in fact impossible.

Fear is a strong, intense emotion experienced in the presence of a real, immediate threat. It originates in a
system that detects dangers and produces responses that will increase the individual’s chances of surviving them.
In other words, it triggers a sequence of defensive behaviours. In humans, fear can also arise at the mere thought
of a potential danger. The main neural pathways in which this defensive reaction originates are well known, as are
the circuits at the centre of this natural alarm system: those in the amygdala.
Anxiety is a vague, unpleasant emotion that reflects some apprehension, distress, and diffuse fears about no one
thing in particular. Anxiety can be caused by various situations. Some examples: having so much information that
you cannot process it all; not having enough information, so that you feel helpless; having trouble accepting
certain events, such as the death of a loved one; and experiencing other kinds of unpredictable or uncontrollable
events in your life.

Anxiety can also result from a specifically human and hence neocortical process: imagining situations that do not
exist but that you are afraid of. It is this anxiety of cortical origin that can be relieved by medications such as
benzodiazepines, which potentiate the effect of GABA, the main inhibitory neurotransmitter in the cortex.

While temporary anxiety is normal and has no lasting effects, persistent anxiety often inhibits us from taking
action, and this inhibition can quickly lead to pathological conditions. Chronic anxiety can also disturb the
performance of many cognitive functions such as attentiveness, memory, and problem-solving.

Though the word “anguish” comes from the same Indo-European root as “anxiety” (angh, meaning to tighten or
compress), the two conditions differ in that anguish is always accompanied by physiological changes such as
sweating, a racing pulse, and a feeling of suffocating, while anxiety is not.

Anguish is characterized by the intensity of the psychic discomfort experienced, which results
from extreme uneasiness, a sense of being defenceless and powerless to deal with a danger
that seems vague but imminent. Anguish often occurs in the form of attacks that are very hard
to control. Victims have trouble analyzing the source of their anguish, and feeling the onset of
the associated palpitations, sweating, and trembling only makes them more agitated. People
who are experiencing anguish become focused on the present and can no longer perform more
than one task at a time. They show signs of muscle tension and have difficulty breathing, as
well as digesting their food.

Fear is a common, natural emotion. But when it gets out of control, it can lead to many different mental
disorders. For example, generalized anxiety is a chronic fear with no particular trigger. Phobias are fears
of specific things (such as spiders, crowds, or closed spaces), taken to the extreme. Obsessive-
compulsive disorder often involves an excessive fear of something, such as germs, that drives
individuals to engage in repetitive rituals to ensure that they do not come into contact with the thing they
fear. Panic attacks involve the sudden triggering of physical symptoms of distress, often accompanied by
the fear of imminent death. Post-traumatic stress often occurs when a situation or stimulus reminds
someone of a traumatic experience that they underwent long ago but that suddenly seems immediately
present once again.

The stage fright we feel when we have to address an audience and the stress we feel when we are about
to be put to a test where a lot is at stake are also forms of anguish, both of which generally dissipate as
soon as the waiting is over and we begin the task at hand. Anguish can have a positive side, if it lets us
mobilize our energies to give the best of ourselves at key moments. But once again, it becomes harmful if
it paralyzes us and keeps us from taking action.

Cand frica ia controlul

Din punct de vedere psihologic, frica, anxietate, angoasă și sunt trei lucruri diferite. Dar intre ele exista
o legatura și pot fi considerate ca trei intensitati diferite ale aceleiasi stari: una pe care oamenii o
experimenteaza, atunci când sistemul lor nervos simpatic ii impulsioneaza să acționeze, dar acțiunea
este, de fapt imposibil.

Frica este o emoție puternică, resimtita ca o experiență intensă în prezența unui pericol real, imediat.
Emotia provine dintr-un sistem care detectează pericolele și genereaza răspunsuri care vor crește
șansele individului de a supraviețui . Cu alte cuvinte, se declanseaza o succesiune de comportamente
defensive. La om, frica poate apărea, de asemenea, la gandul de un potențial pericol.

Anxietatea este o emoție vagă, neplăcuta, care reflectă o anumită teamă, suferință, și temerile difuze
despre nici un lucru în particular. Anxietatea poate fi cauzată de diferite situații. Câteva exemple:
informații multiple ce nu pot fi procesate; informații insuficiente, ce trezesc reactii de neajutorare;
probleme cu acceptarea anumite evenimente, cum ar fi moartea unei persoane dragi; și se confruntă
cu alte tipuri de evenimente imprevizibile sau incontrolabile în viața ta.

Anxietatea poate duce, de asemenea, dintr-un proces specific uman și, prin urmare, neocorticale:
imaginându-situații care nu există, dar că vă este frică de. Această anxietate de origine corticala, care
pot fi ameliorate prin medicamente, cum ar fi benzodiazepinele, care potențează efectul GABA,
principalul neurotransmițător inhibitor in cortexul.

În timp ce anxietatea temporar este normal și nu are efecte de durata, anxietate persistentă de multe
ori ne împiedică să ia măsuri, și această inhibare poate duce rapid la condiții patologice. Anxietate
cronica poate perturba, de asemenea, performanța de multe funcții cognitive, cum ar fi atentie, de
memorie, și de rezolvare a problemelor.
Deși cuvântul "durere" vine din aceeași rădăcină indo-european ca "anxietate" (angh, adică pentru a
strânge sau comprima), cele două condiții care diferă în suferință este întotdeauna însoțită de
modificări fiziologice cum ar fi transpirație, un puls de curse, și un sentiment de sufocant, în timp ce
anxietatea nu este. Victimele au probleme analiza sursa de angoasa lor, și senzație de debutul de
palpitații asociate, transpirație, și tremurând doar le face mai agitat. Oameni care se confrunta cu
durere devin concentrat pe prezent și nu se mai poate efectua mai mult de o sarcină la un moment
dat. Ele arată semne de tensiune musculara si au dificultati de respiratie, precum si digerarea
alimentelor lor.

Frica este o emotie comuna, naturale. Dar atunci când acesta devine de sub control, aceasta poate
duce la mai multe tulburări mintale diferite. De exemplu, anxietate generalizata este o teama cronica,
cu nici un declanșator special. Fobiile sunt temeri de lucruri specifice (cum ar fi paianjeni, mulțimile,
sau spații închise), luate la extrem. Tulburarea obsesiv-compulsiva implică adesea o teamă excesivă
de ceva, cum ar fi microbii, care conduce persoanelor fizice de a se angaja în ritualuri repetitive pentru
a se asigura că acestea nu vin în contact cu ceea ce se tem. Atacurile de panica implica declansarea
brusca de simptome fizice de stres, de multe ori însoțită de frica de moarte iminentă. De stres post-
traumatic apare adesea atunci când o situație sau stimul amintește cineva de o experiență
traumatizantă care au suferit mult timp în urmă, dar care pare dintr-o dată prezent imediat din nou.

Tracul ne simțim atunci când avem de a aborda o audiență și stresul ne simțim atunci când suntem pe
cale de a fi puse la un test în care un lot este în joc sunt, de asemenea, forme de suferință, ambele din
care în general disipează cât mai curând în așteptare este peste si vom începe sarcina la îndemână.
Durere poate avea o latură pozitivă, în cazul în care ne permite să mobilizeze energiile noastre pentru
a oferi cele mai bune de noi înșine la momente cheie. Dar, încă o dată, devine nociv, dacă ne
paralizează și ne ține de la a lua măsuri.